How to make claims
It's easy to make claims when you're a GMF Health member. How you claim depends on whether you're making a Extras or Hospital claim, and the facilities available at your provider. Here's a simple guide to the three types of claims you can make:
Claim type #1: Electronic claims for Extras services
If your dentist, physio, chiro or other provider is registered with GMF Health and has electronic claiming facilities, you can make your claim on the spot. This means:
- You receive your benefit on the same day as your consultation and just need to pay any out-of-pocket costs.
- You don't have to pay the full consultation fee up-front and then wait to receive your benefit.
- There's no paperwork - you'll get a receipt for your claim, but you don't need to complete any forms to claim your benefit.
To find out if your provider has electronic claiming facilities, simply call them before your visit.
Claim type #2: Manual claims for Extras services
If you've been to your dentist or other provider and paid your account in full, you need to lodge your claim to receive your benefit. You'll receive your benefit by cheque or paid into your bank account. Here's how:
- Download, print and complete a claim form.
- If you've paid the account in full, you can use EasyClaim to have your benefit paid directly into your bank account (but not into your credit card account). To use EasyClaim, fill in the Direct Credit of Benefits section on your claim form. Otherwise we'll post you a cheque once your claim has been processed.
- Once you've completed your claim form, attach your accounts and receipts. Scanned, faxed and photocopied documents are acceptable.
- Post it to PO Box 513 Kalgoorlie WA 6433.
Claim type #3: Claims for Hospital services
Before you go to hospital for in-patient or day-patient services, get a quote for the services and submit the quote to us. We can let you know about the benefits you can receive before your treatment begins.
If you've been to hospital for treatment, here are some important things to know about your claim:
- In most cases hospital in-patient and day-patient accounts will be sent directly to us for payment.
- If you do receive an account, please print and complete a claim form, attach your original account and post to PO Box 513 Kalgoorlie WA 6433.
- Don't send your medical accounts for in-patient or day-patient hospital services to Medicare. Please send them directly to us so we can process any Gap Benefits for you. We'll claim your Medicare benefit electronically on your behalf.
For full details of our Medical Gap arrangements, please read our Important Information about your membership brochure or call one of our Member Service Consultants on 1300 653 099.