How can I check my receipts are correct?
We know how important it can be to get your claims processed quickly and one of the easiest ways to make this happen is to ensure you have all the paperwork you need. While claiming some services is as simple as swiping your membership card, for others you may need to supply receipts or other documents.
Checking to make sure you’ve got the correct and valid details and documents can be confusing.
Luckily, there are a few simple checks you can make to ensure that your claims are processed as efficiently as possible.
Don't forget - if you're submitting your claim via mail, fax or email, you'll need to submit a claim form along with your receipts.
Is the document free of alterations?
We can’t accept documents if any type of alteration is visible. Alterations can include:
Whiteout and lines through information
Erasing or crossing out information
If you have a receipt with an alteration, please ask the provider to issue another receipt or invoice so we can process your claim.
Note: Initialling an alteration is not proof that the alteration is official
Does the document contain adequate information?
In order to pay a benefit for an extras service, the receipt must include the following information:
The name and provider number of the issuing provider
The date of issue of the invoice
The name of the patient (with the exception of Vitamins, Probiotics, Omega 3 and Cancer Council UV products)
Date of service
Description of service and any applicable item number. Services that require an item number include:
Dental
Optical
Physiotherapy / Exercise Physiology
Chiropractic / Osteopathic
Podiatry
Speech Therapy
Occupational Therapy
Clinical Psychology
Dietetics
Cost of services or services should be shown as individual amounts
Any amount paid to the provider and date paid, including any discounts given
Any amount outstanding
Any notations such as ‘Quote’ or ‘Duplicate’ where necessary.
When claiming for a prescription, vaccination or injection, you’ll need to provide an official pharmacy receipt.
In addition to the above information, these receipts must also include:
Prescription number
Prescriber name
Prescriber number
Indication that it’s a Private, Non-NHS or Non-PBS item
Read more about claiming for a prescription, vaccination or injection..
When claiming for an inpatient medical service, you'll need to submit your accounts to Medicare first. Your doctor or Medicare will provide you with a ‘Statement of Claim and Benefit Payment’ or ‘Statement of Medicare Benefits’ that can be used to process your claim.
The Medicare Claims History Statement does not provide sufficient information and cannot be used.
Read more about claiming doctor’s bills
Are there any other pieces of supporting documentation required?
In some cases, we may need some extra documents to pay a benefit towards your claims:
Benefit | Supporting documents |
Orthodontic | Additional information may be required where benefit is not accrued in full when orthodontic treatment commences. |
Prescriptions, Injections, Vaccinations:
| Must be accompanied with a letter by a medical practitioner detailing that the pharmaceutical is treating a specific health condition (letter is valid for lifetime of the membership).
|
Health Management:
| A letter of recommendation or Health Management Declaration Claim Form must be completed by a Medicare Registered Practitioner, detailing the specific health condition being treated (letter/form is required per calendar year).
|
Health Aids and Appliances:
| A letter of recommendation or Health Management Declaration Claim Form must be completed by a Medicare Registered Practitioner, detailing the need for the appliance to treat the specific health condition. Lifetime documentation required for:
Documentation required every calendar year:
|
Accommodation | Travel & Accommodation Claim Form (claim will be assessed once the hospital account is received) |
Inpatient Travel | Travel & Accommodation Claim Form (claim will be assessed once the hospital account is received) |
Outpatient Travel | Travel & Accommodation Claim Form and a receipt or letter of attendance from specialist |
Do I need to keep my receipts?
In the case of photocopied and emailed receipts (including app claims), you'll need to keep your original receipts for a minimum of 24 months from the date the claim is made. Westfund may request to sight the original receipts during this time.