How to claim Extras
With the majority of extras claims such as dental and optical, health providers can process your claim on the spot using EFTPOS-style claiming facilities provided by HICAPS and iSOFT HealthPoint.
These are often referred to as "On the spot" claiming. On the spot claiming has become the preferred option for most policyholders, with more than 85 percent of eligible claims being processed this way.
All you have to do is swipe your membership card and sign to validate the service. Your claim will be automatically lodged with Emergency Services Health and we pay the provider directly.
There is no need to pay the full consultation fee up-front and then wait for reimbursement of your benefit. Just present your Emergency Services Health membership card, pay any out of pocket gap and you're done.
Who offers on the spot claiming?
To find out if your health provider offers on the spot claiming simply look for the HICAPS & iSOFT logo or contact your health provider.
While Emergency Services Health accepts most claims on the spot, the service is not available for pharmacy, health appliances (including hearing aids), counselling and eye therapy.
By handling these claims manually, we are able to deliver better and fairer benefits to our members for these services.
There may also be situations where benefits cannot be processed on the spot, or where there is no benefit entitlement. In these situations, you will be asked to contact Emergency Services Health on 1300 703 703.
Claiming time limits
Please note, claims must be lodged with Emergency Services Health within two years of date of service.
Emergency Services Health Mobile Claiming App
As a member of Emergency Services Health, we’ve got your back. Our Emergency Services Health App lets you manage your health cover 24/7. Use the app to:
- Easily make a claim for you or your dependents
- Access benefit limits and cover details
- View your claims history
- Update your contact details
Who can use the Emergency Services Health App?
Anyone can access general fund information via the app, but to use features relating to your membership, you must be a Emergency Services Health Member and have registered your online membership account.
Online Member Portal
If you don’t want to use the app, you can now submit Extras claims through our online Member Portal. Simply follow these steps;
- Login to our Member Portal
- Click on ‘Claims’ from the menu
- When the drop-down options open, click on ‘Submit claim’
- Follow the onscreen prompts
Want to receive your benefits faster?
Make sure you provide us with your bank account details so your benefit is paid directly to your bank account.
Set it up today by calling 1300 703 703.