Affiliated Provider programme
How does the Affiliated Provider programme work?
Affiliated Providers (APs) are doctors, specialists or medical facilities contracted to provide Southern Cross members with certain healthcare services at agreed prices.
Affiliated Providers take care of prior approval and claims for Southern Cross members through an online system. Southern Cross members just need to attend their appointments.
Most of our policies include some services that are ‘Affiliated Provider-only’, including specialist consultations. This means Southern Cross members are only eligible for cover if they visit an Affiliated Provider for their healthcare service.
Benefits of the Affiliated Provider programme - for you
Certainty of payment
Prices for services are agreed at the beginning of the agreement, so you know what you will be paid. You can use our online system to claim payment for an eligible service as soon as it has been provided.
Improved cash flows
The amount we pay is generally deposited within two days of requesting payment.
Online administration
The online transaction makes the administration of prior approval and payment easy.
Digital signing of agreements
All agreements can be digitally signed making the process easier for all parties.
Dedicated support
Partnership managers are your direct point of contact at Southern Cross, dealing with any queries you may have about your Affiliated Provider agreement and any other issues.
Promotion
Affiliated Providers can be identified through the Specialists & Referrals service (available via Medtech) and the online directory Healthpages. They may also be listed on Southern Cross’ online Healthcare finder tool.
Benefits of the Affiliated Provider programme - for your Southern Cross patients
Easy prior approval and claiming
As an Affiliated Provider, you take care of the prior approval and claiming processes on behalf of the member. This means the member does not have to submit a claim and is not out of pocket while the claim is being processed.
Certainty of cost
In most cases, agreed prices mean that members know up-front how much their contribution will be, if anything.
We encourage members to seek referral to an Affiliated Provider to help moderate claims costs in the long term. In all Southern Cross plans (apart from UltraCare), some services are Affiliated Provider-only.