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 and Omega 3)
  • 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

Prior to your first claim, a treatment plan must be submitted. For progress payments, a certification of work completed must be provided.

Prescriptions, Injections, Vaccinations:

  • Contraceptives
  • Anabolic steroids
  • Cosmetic injections

Must be accompanied with a letter by the prescribing Medicare Registered Practitioner detailing that the pharmaceutical is treating a specific health condition (letter is valid for 12 months).

 

Health Management:

  • Aquatic Programs
  • Fitness Centre
  • Virtual Gastric Banding
  • Weight Loss Programs

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 is required per calendar year).

 

Health Aids and Appliances:

  • Artificial Limbs
  • Braces
  • Burns Suit
  • Compressions Garments
  • Devices for Sleep Apnoea and Diagnosed Snoring
  • INR Monitor
  • Low Vision Aids
  • Mammary Prostheses and Brassieres
  • Mobility Aids
  • Orthopaedic Boots (custom made)
  • Orthotics (custom made/preformed)
  • Oximeter
  • Oxygen and Accessories
  • Repairs to Devices
  • Respiratory Aids
  • TENS Machine
  • Wigs

 

 

 

 

 

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:

  • Artificial Limbs
  • Compression Garments
  • Devices for Sleep Apnoea and Diagnosed Snoring
  • INR Monitor
  • Low Vision Aids
  • Mammary Prostheses and Brassieres (no letter is required if a hospitalisation for a mastectomy is recorded with Westfund)
  • Oximeter
  • Oxygen and Oxygen Accessories
  • Repairs to devices (unless initial purchase is recorded with Westfund)
  • Respiratory Aids
  • TENS Machine
  • Wigs (no letter required if a hospitalisation for a medical condition is recorded with Westfund)

Documentation required every 12 months:

  • Braces
  • Burns Suit
  • Mobility Aids
  • Orthopaedic Boots
  • Orthotics

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.