Resolutions Process

In case of a complaint

Health Partners strives to provide you with quality products and services. However, we recognise that despite our best intentions, members may have concerns or complaints regarding their interactions with us.

To ensure that all feedback and concerns are heard and addressed fairly and satisfactorily, we have a formalised Dispute Resolution Process. If you are not satisfied with, or have concerns about our products, service, decision on claims, or service from a Health Partners Participating Provider, please take the steps below.

Your personal information is handled in accordance with our Privacy Policy.

Step 1: Talk with us directly

We are committed to discussing and addressing your concerns promptly. Please contact us by the methods below.

To assist us in helping you, gather all documentation, including your membership details, and consider the questions that may assist us in resolving the issue.

Online
Send us a message online via the contact page

Phone
Membership & Fund: 1300 113 113
Optical: 1300 115 115
Dental: 1300 114 114

Mail
Health Partners
Reply Paid 1493
Adelaide SA 5001

In person
With a Member Care Consultant, Supervisor or Manager at the centre that handled your matter.

Step 2: Resolving the matter

Once you have explained your concern, we will work toward resolving the matter to your satisfaction. We will acknowledge receipt of your complaint within 48 hours and respond to your complaint within 10 business days.

Is your dispute with someone else?

If your issue is with a provider, speak directly with them. We recommend putting your complaint in writing. We're here to help, and if included in your correspondence with providers, we can assist in advocating on your behalf.

CC your email to: ask@healthpartners.com.au

You can speak with us or your provider about escalating your complaint or see the external bodies in Step 5 below.

Step 3: Escalation

If, once you have contacted us and despite our best efforts, you are not satisfied with the outcome, the matter can be referred to the Health Partners’ Manager Customer Relations.

Email
complaints@healthpartners.com.au

Phone
1300 113 113

Mail
Manager Customer Relations
Health Partners
Reply Paid 1493
Adelaide SA 5001

Step 4: Reaching resolution

The Manager Customer Relations will promptly respond to you within 10 business days and endeavour to resolve any issues or concerns.

If, after this, you are still not satisfied with the outcome, we may refer the matter to the Health Partners’ Chief Executive Officer.

Step 5: External Review

If you feel that your issue is still unresolved or that the complaint was not dealt with fairly, we encourage you to seek an external review. Depending on the nature of your complaint, we would suggest that you contact the following departments for free and independent advice:

Private Health Insurance Ombudsman (PHIO)

Phone
1300 362 072 (select option 4 for Private Health Insurance during business hours)

Website
www.ombudsman.gov.au

For general information about private health insurance, see www.privatehealth.gov.au

Procedures are in accordance with International Quality Standard ISO 10002–2014 (Quality Management — Customer Satisfaction).

State-based health complaints organisations accept complaints about hospitals, medical practices, and extras providers.

Contact your local health complaints organisation if you are raising your dispute for an explanation, an apology, a refund or compensation, access to your health records, or a change in policy at the place of health service.

South Australia
hcscc.sa.gov.au

Victoria
hcc.vic.gov.au

Queensland
oho.qld.gov.au

New South Wales
hccc.nsw.gov.au

Australian Capital Territory
hrc.act.gov.au/

Western Australia
hadsco.wa.gov.au

Tasmania
healthcomplaints.tas.gov.au

Northern Territory
hcscc.nt.gov.au

The Australian Health Practitioner Regulation Agency (AHPRA) accepts complaints about individual practitioners in the interest of public safety.

Contact the regulator if you believe a practitioner is placing the public at risk; they are performing their duties in an unsafe way, or you are concerned about a practitioner’s ability to make safe judgments because of their health.

Website
ahpra.gov.au

Phone
1300 419 495
Available Mon-Fri 9.00am to 5.00pm

If the complaint is about the pharmacy/premises itself or services delivered, contact your state-based authority.

South Australia
pharmacyauthority.sa.gov.au

Victoria
pharmacy.vic.gov.au

Queensland
health.qld.gov.au

New South Wales
pharmacycouncil.nsw.gov.au

Australian Capital Territory
health.act.gov.au

Western Australia
pharmacyboardwa.com.au

Tasmania
pharmacyauthority.tas.gov.au

Northern Territory
health.nt.gov.au

If the complaint is about the retail price or supply of goods under Consumer Law, you may wish to contact the Australian Competition and Consumer Commission (ACCC) or your state-based regulator. Visit consumer.gov.au for contact details.

On this page:
Talk with us Provider complaints Escalation External review

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