Claim forms are available from the office or the website. Members also have the option to nominate a bank account and paid claims submitted by the member can be processed and directly credited into the account.

Hospital Claims

Hospital costs are usually billed directly to the Fund by the hospitals, so Members only need to pay applicable excess or co-payment (if any) on discharge.

Medical Practitioners bill their services separately and claims need to be lodged by Members through Medicare or by completing a two-way Medicare form with Transport Health. The two-way claiming arrangements between Medicare and Transport Health ensure that claims lodged with either will be processed and benefit cheques issued promptly for the appropriate amounts.

Medical Practitioners or doctors providing associated hospital services who participate in our Access Gap Cover Scheme will bill the fund directly. Members will only need to pay the doctor any agreed gap payment. This amount is usually billed by the doctor prior to treatment.

Extras Claims

Extras claims can be lodged in person at the office for an immediate cash benefit on presentation of a fully itemised and receipted account with a completed and signed claim form. Please note that cash claims are paid to a maximum of $200 and amounts over $200 will be paid by cheque. Unpaid accounts can also be lodged with a completed and signed claim form. Transport Health then issues the Member with a cheque payable to the practitioner. With postal claims, a completed and signed claim form must accompany the itemised account. Refund of claims can be directly credited into a nominated bank account.

HICAPS

HICAPS is available for selected Extras claims with many practitioners now offering this facility, making claiming quicker and easier. The practitioner swipes your plastic Membership card and the appropriate benefit for your level of cover is automatically credited to the practitioner. You only need to pay the difference (if any) between the service cost and benefit direct to the practitioner at the time of service.

Claim Form

Claim Forms can be obtained from the Transport Health office in Richmond. Or you can download a claim form HERE

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