HOW TO CLAIM YOUR CBHS COVER

HOW TO CLAIM YOUR CBHS COVER

Claim on the Spot

In case your service provider has HICAPS or iSOFT facilities, you just have to present your CBHS membership card and the benefit will automatically be adjusted with the fee. If you visit a Choice Network provider for dental or optical service, you may even have no out of pocket expense to pay.

Claim Online

If you’re planning to claim online, you will receive it in 1-2 business days. Claim online by logging on to the CBHS Member Centre and following these five easy steps:

  1. Enter the Provider Number and choose the Service Type
  2. Confirm your benefit payment details, so we know where to send the money
  3. Enter your claim and review the benefit amount (for web claimable items)
  4. Upload your receipts (even on most mobile devices!) 
  5. Submit your claim

The eClaims system will provide a benefit amount for web-claimable items and, once your receipts have been received, our claims team will confirm the exact benefit amount you will receive for other items.

Claiming rules

The CBHS claiming rules and the terms of use for online claiming are available during the eClaims process in the CBHS Member Centre. If you have any questions regarding claiming, please call our Member Care team on 1300 654 123.

  • You have to lodge the claim with CBHS within 2 years of the date of service provision.
  • Your receipts should be details and contain basic information, including the date, name, address, phone and a full description of the service/treatment/goods.
  • Discounted services cannot be claimed
  • Service fees that are raised for freight charges cannot be claimed for.
  • The feed should be paid in full. 
  • You can claim online for chiropractic, podiatry, pharmaceutical, dietary services, physiotherapy, occupational therapy, psychology, optical, dental, speech therapy and osteopathy services.
  • Any rejected HICAPS claim must be submitted manually to CBHS and cannot be submitted via CBHS eClaims. Please email details support@australiaoshc.com.au

Is your receipt insufficient? 

If in any case your receipt is not fulfilling the guidelines stated on the rules, the receipt may be returned to you and you’ll be asked for a more detailed receipt. If you’re unsure if the receipt is sufficient, you can still forward your claim to us manually. We will review it to see whether benefits can be paid, and proceed with the claim.

Complete a Claim Form

If you want to submit a manual claim, you have to complete a claim form, attach your fully itemized account/s or receipt/s and send for processing. Claims has to be lodged within 2 years of the date of service provision. The benefit will be deposited into your nominated bank account or as a cheque to your health care provider, which will be posted to you. You will receive confirmation of the benefit payment by email or post.

We aim to pay benefits within 5 days of receipt of your claim. We may not meet this service level if we need to contact you to clarify your claim or seek further information.

Other documentation

Artificial aids and health care appliances claims should be accompanied by a doctor’s referral, which will remain valid for 3 years.

Contraceptives and non-contraceptive purposes claims should also include a doctor’s referral, which will remain valid for 1 year.

Health management service claims (e.g. Gym Membership) should include a completed Health Management Authorization Form. You will have to ask your health care provider or GP to complete relevant sections of the form.

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Hospital and medical claims

If your medical specialist does not participate in an Access Gap Cover arrangement, you should submit your medical claim to medical care first.