Claiming
This section provides information for Contracted Service Providers (providers) on submitting claims for services provided within the Hearing Services Program (the program).
There are three avenues available for providers to process claims for payment.
- Portal Claims - via the Hearing Services Online (HSO) portal, including the processing of claims for payment, adjustments and recoveries.
- e-Claims (electronic claims) – these are uploaded to HSO in batches, utilising Practice Management Software to generate the e-Claim batch file.
- Exception (or ‘Manual’) Claims – any claim which cannot be processed by either of the two primary submission platforms (portal/e-Claims) can be sent as a (manual) claim exception, using the Claim for Payment paper form emailed directly to hearing@health.gov.au.
Portal claims
Portal Claims are submitted for processing and payment through the HSO portal. Claims for payment under the program are normally made electronically. However, in some cases the automated electronic claims payment process cannot be used, for example when submitting a claim after an adjustment note has been initiated. In such cases, a portal claim should be submitted by clicking on the manual claim button in the HSO portal. Learn more about online processing of claims.
e-Claiming
Electronic Claims are uploaded to the HSO portal in batches, utilising Practice Management Software to generate the e-Claim batch file.
Historically, e-Claims were uploaded to Medicare / Department of Human Services via a (now defunct) DHS web-based electronic claiming platform hosted on Health Provider Online Services (HPOS).
The program utilises a web-based electronic claiming (e-Claiming) system that allows contracted service providers to lodge e-Claims with Medicare using Simply Hearing, Fitting Wizard or Hear Aid software or payment within 24 hours of their submission.
More information about the new HSO payment system can be found on the following webpages
Please note, it takes two business days for an e-Claim to appear in the Claims History accordion on the HSO portal.
Exception Claims
Exception claims relate to any claim that are not able to be submitted using the DHS e-Claim System or through the HSO Portal e.g. client relocation or business transfers.
These claims should be attached to an e-mail and sent to hearing@health.gov.au. One e-mail per client should be submitted. The subject line of the e-mail should be displayed as: contract number – voucher number – client name – item number/s – Relocated Away or SP Business Transfer.
Conditions for claiming
This webpage should be read in conjunction with the Schedule of Service Items and Fees.
CROS and BiCROS devices
Contralateral Routing of Signal (CROS) and Bilateral CROS (BiCROS) devices are non-standard devices that are fitted when a client may not benefit from a traditional hearing aid. For claiming purposes please ensure you understand the requirements for fitting either a CROS or BiCROS device.
Claiming Information
The claiming information webpage provides answers to common claiming enquiries about rechargeable batteries, audiological case management, correcting errors on submitted claims and more.