On the spot claims on extras services

Lodging claims with Police Health is easy.

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 CSC HealthPoint HealthPoint.

These are often referred to as "On the spot" claiming. On the spot claiming has become the preferred option for most Police Health policy holders, with more than 85 per cent 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 Police 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 Police 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 & CSC Healthpoint logo or contact your health provider.

You can also search online for health providers that offer HICAPS.

While Police Health accepts most claims on the spot, the service is not available for orthodontic, occupational therapy, psychology and complementary therapies. 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 Police Health.

  

Other extras services claims

Not all extras claims can be lodged on the spot. For extras claims that cannot be lodged on the spot simply fill out a Police Health claim form and send it with the relevant accounts and receipts to any of the three options:

  • Mail: Police Health, Reply Paid 6111, Adelaide SA 5000
  • Free Fax: 1800 008 554.

Alternatively if you are happy for the money to be paid into your nominated contributor account you can download the           Police Health Mobile Claiming App.

To make your claim simply:

  • Download the free App to your smart phone.
  • ​Register your details in the App.
  • Photograph your account items.
  • Submit your claim, no claim form required!

For more information on the Police Health Claiming App, click here.

Hospital claims

Hospital claims generally come directly to us from the hospital and we send the claim payment back to the hospital. This means you don't have to make a claim.

Medical claims

Access Gap Cover
Doctors billing under our Access Gap Cover will normally forward their account directly to Police Health. We then claim your Medicare entitlements and pay that, together with your Police Health benefit, directly to the doctor.

Payments

Cheques covering medical or extras services are made payable to you if you've paid the account or, if you haven't, to the provider of the service. In both instances the cheques are sent to you (naturally if the payment is in your favour you can elect to have the payment direct credited to your financial insitute).

If the account has not been paid, forward the cheque to the provider together with your portion of the payment.

How to fast-track your claims payments

If you have already paid the invoice from your medical or extras provider, Police Health offers PromptPay to ensure fast payment of your claim. With PromptPay your benefit is paid directly to your financial institution account as a direct credit.

Download the claim form, simply write "YES"  in the box `PromptPay to Bank Account' and then fill in your nominated financial account details.

Lodgement of claims

Claims must be lodged with Police Health within two years of the date of service. Claims older than two years will not be accepted.