Who is ARHG?
ARHG is a boutique service provider whose purpose is to enhance the competitive success of our member funds. We do this through collaboration, centralisation, innovation and scale.
ARHG’s primary role is to negotiate and manage competitive hospital contracts reflective of the customer promise made by our member funds.
Underpinning negotiations is rigorous data analysis, industry experience and insight, and the development of productive relationships.
Importantly, our funds operate in different competitive markets, ensuring that each fund can steer the strategic direction for their area.
Where it is a suitable fit for our member fund’s strategies, we also identify and deliver additional services that add value through collaboration and specialisation.
ARHG represents and advocates for our funds at all levels of industry, leading the discussion on regional issues. We are part of the Members Health Fund Alliance; an alliance of health insurance funds that share the principle of putting members health before profits.
How we are different
Governance framework
Membership of ARHG entitles the CEO of each member fund to sit on the ARHG Board of Directors. The structure allows each fund to directly influence the strategic objectives and direction of the company.
Member engagement model
Collaboration and consultation occur at every level through our member engagement model. The model identifies the different cohorts of interest between ARHG and its member funds, and outlines a formal calendar of engagement.
Lead fund approach
Each hospital contract is allocated a 'lead fund' based on which fund is impacted most by the contract. Key decisions are always made in consultation with the lead fund during the contract negotiation process.Our key services
Contract relationship management
Our 'lead fund' approach to hospital contracting gives funds control over the contracts that impact them the most. It also creates a clear and effective escalation process if challenges occur during the negotiation. Our contracts are Eclipse-friendly and seamless for hospitals and funds to implement.Claims analytics and fraud detection
ARHG has sophisticated Business Intelligence technology and highly skilled data analysts with extensive experience across the Australian health care system. Member funds have access to business critical, current and targeted information, and work with ARHG on data interrogation and fraud detection intitiatives.Industry participation and advocacy
ARHG represents our member funds at industry forums and on specialist task forces. Our role is to advocate for a better future for regional members. We have a regional advocacy strategy with the objective of achieving improved access to affordable health services in regional areas.Ancillary provider accreditation service
ARHG's ancillary provider accreditation service provides funds with a list of ancillary providers that meet a set of agreed provider accreditation standards, ensuring funds pay benefits to providers in line with private health benefit rules. ARHG also conducts audits of general treatment providers to identify and prevent fraudulent activity.QualiPHI e-learning platform
ARHG operates an online learning platform called QualiPHI, providing funds with a suite of training modules on fundamental private health insurance topics. ARHG member funds also have access to use the MATRIX LMS system for their own L&D e-learning programs.Dental reasonability rules
ARHG maintains a schedule of dental reasonability rules, reviewed regularly by a qualified dental consultant. The file supports funds in the management of dental claims, and reduces the risk of fraud and inappropriate claiming behaviours through electronic claiming platforms.What our member funds say
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