Claiming made easy

Four tips to get it right the first time

We work hard to make claiming your extras straightforward, but sometimes, small details can get in the way, causing delays or even rejected claims. To help make the process smoother for everyone, here are four of the most common claim issues we see, and how you can avoid them.

Extras (or ancillary) health insurance is something many of us use regularly – for things like dental check-ups, new glasses, or physiotherapy. As these services are part of everyday healthcare it's important that claiming for them is simple and hassle-free.

There are several ways you can submit your extras claims with Doctors’ Health Fund. The most popular and convenient way to claim is through HICAPS or HealthPoint. If your provider is connected to HICAPS or HealthPoint, they can process your claim on the spot, and you can now claim using a HICAPS QR code with your Doctors’ Health Fund app.

You can also submit a claim by simply scanning your receipt and sending through Online Member Services, or via our Mobile App.

Below are four tips for making sure your extras claims are processed as quickly as possible.

1. Skip the EFT receipts and bank statements

We understand the temptation to send through payment receipts – but unfortunately, EFT receipts or bank statements don’t contain enough detail for us to process a claim.

Instead, be sure to upload the official invoice from your provider which should clearly display:

• The patient’s name,
• the provider’s details,
• the service description,
• the relevant item number(s),
• date of service, and
• the fee(s) charged.

2. Take a clear photo of your invoice

Taking a quick snap on your phone is fine – but make sure that the image is:

• Not blurry,
• only contains the invoice (as much as possible), and
• not cropped or obscured where important details listed above are missing.

3. Claiming bulk passes

Purchasing a multi-pass, such as 10 physiotherapy sessions, is a great way to save. However, when claiming, please remember that we cannot pay claims for services which have not yet occurred. Once you have attended some, or all the classes you have paid for, you can then claim them following the procedure outlined in the above tips.

4. Aids and appliances need supporting documentation

If you’re claiming an aid or appliance – such as a CPAP machine or walking aid – we usually need a doctor’s letter recommending the item.

In some cases, we may also refer to a recent hospital admission to confirm whether the aid relates to a procedure, so it’s worth noting if you have had any recent treatment that supports your claim.

For further information on claiming extras with Doctors’ Health Fund, click here.

Private health insurance products are issued by The Doctors’ Health Fund Pty Limited, ABN 68 001 417 527 (Doctors’ Health Fund), a member of the Avant Mutual Group. Cover is subject to the terms and conditions (including waiting periods, limitations and exclusions) of the individual policy, available at doctorshealthfund.com.au/our-cover