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 following steps:

Step 1: Contact us

We are committed to discussing and addressing your concerns promptly. Please contact us by:

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

Mail
Health Partners
Reply Paid 1493
Adelaide SA 5001

Online
Send us a message online via the contact page

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

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. Once you have explained your concern, we will work toward resolving the matter to your satisfaction.

Step 2: 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’ Dispute Resolution Officer, by:

Phone
1300 113 113

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

Email
complaints@healthpartners.com.au

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

Step 3: 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:

Membership and Fund related disputes

Private Health Insurance Ombudsman (PHIO)

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

Internet
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).

Health Partners Dental, Optical and Preferred Providers: general service disputes

(ie if you are raising your dispute for: an explanation; an apology; a refund or compensation; access to your health records; a change in policy at the place of health service)

Health and Community Services Complaints Commissioner (HCSCC)

Phone
(08) 8226 8666
1800 232 007 (Toll free from Country SA landline)

Available Mon-Fri 9.00am to 5.00pm

Fax
(08) 8226 8620

Email
info@hcscc.sa.gov.au

Post
HCSCC
PO Box 199
Rundle Mall SA 5000

Internet
hcscc.sa.gov.au

Health Partners Dental, Optical and Preferred Providers: disputes regarding practitioners and their conduct

(ie 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)

Australian Health Practitioner Regulation Agency (AHPRA)

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

Online Enquiry
ahpra.gov.au/About-AHPRA/Contact-Us/Make-an-Enquiry

Post
AHPRA
GPO Box 9958
Adelaide SA 5001

In Person
Level 11
80 Grenfell Street
Adelaide SA 5000

Internet
ahpra.gov.au