Client Registration

Choose your Synapse Services


Please confirm which services you would like to sign up for:
* Required field

{{client.phone_code}}
{{client.phone_code}}

* Required field

Synapse's details will automatically populate all of your registration forms. This enables us to help track the progress of your registrations with the health funds and Medicare. As confirmations come in, we will contact you by email to let you know that you can start billing.

* Required field

Terms and conditions:
Subject to this agreement, the cardholder specified below authorises Synapse to deduct from the cardholder's credit card {{client.fee}} (including GST) and any Send to Synapse fees as set out on this website, payable to Synapse by the cardholder or the Synapse client specified below
Subject to this agreement, the cardholder specified below authorises Synapse to deduct from the cardholder's credit card, the Percentage as agreed in writing between You and Synapse, with a minimum monthly fee of $273.90 (including GST) as set out on this website, payable to Synapse by the cardholder or the Synapse client specified below
Subject to this agreement, the cardholder specified below authorises Synapse to deduct from the cardholder's credit card 1% of receipted amount monthly plus GST, payable to Synapse by the cardholder or the Synapse client specified below
Subject to this agreement, the cardholder specified below authorises Synapse to deduct from the cardholder's credit card {{client.fee}} (including GST) and any other fees, payable to Synapse by the cardholder or the Synapse client specified below
View Terms and Conditions
Terms and conditions:
View Terms and Conditions and privacy policy.
Where did you hear about Synapse Medical Services?
If a website or other source, please specify:
Contact:
Initially we'll call you, but afterwards please let us know how would you prefer to be contacted?


Product Description Units Unit Price Subtotal

{{lineItem.product.name}} *

{{lineItem.subtotal | currency}} *

PAYMENT

Payment made on {{payment.payment_date | moment:"DD/MM/YYYY"}}

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-

* denotes GST free items

Subtotal

GST

Total

Total Outstanding

Please note a 1.5% credit card surcharge will be applied

* Required field

Now let's add your bank account/s (we will link them to your provider numbers next)
Bank * Address * Account Name * BSB * Account # * ABN * GST? *


Now let's link your bank account/s to your provider numbers
Bank * Provider # * Name * Address * Suburb * Telephone *

Tell us about your billing: *

Will you be claiming for private patients in public hospitals?
Would you like to backdate your NIB registration?
Do you want the health funds to publish or distribute information relating to your participation in their schemes?
Would you like to sign up for the BUPA Online Portal to view your remittance advice?
Do you want us to add you to our merchant facility so that we can accept credit card payments from your patients over the phone (addtional fees apply)?
(We will be in contact with you shortly to discuss)
* Required field

What device do you currently use to dictate?*
Do you have a letterhead?
(Please upload it in word or excel format to our website after you have compeleted the sign up process)
Do you want to use an electronic signature?
(Please sign a clean piece of blank white paper scan and upload it to the website after you have completed the sign up process)
Can you provide us with a sample of typed letter?
(please upload it to our website after you have completed the sign up process)
Can you provide us with a list of your referring doctors?
(please upload it in word format to our website after you have completed the sign up process)
What is the estimated volume of letters you predict you will send to Synapse?
Number of letters per week
Number of letters per month
* Required field

Please activate your account by clicking on the link we have sent to your registered email.