Contracted Service Provider Notice
Tips for Improving Claiming
(CSPN - 202102)
Some common issues are being identified with claiming. Please find below some key tips in improving claiming accuracy.
Dates of Service
Clients are entitled to the services available on their current voucher. Services can be delivered and claimed only when the date of service is on or between the start and end dates of the client’s voucher that was current at the date of the service. Before providing services please check the client has a valid voucher. Before submitting claims please check that you are claiming against the client’s correct voucher and the date of service is between the start and end date of the voucher.
Timeframes for claims
It is important that all claims are submitted within 12 months of the date of service to ensure the client’s service history is up to date.
Monaural and Binaural Claim Items
Please remember to claim for the correct items which vary depending on whether the client is monaurally or binaurally fitted. For example, item 930 client review for monaurally fitted clients and item 940 for binaurally fitted clients.
Fitting and Follow-up Service
The date of fitting is the date the client received the devices. The follow-up must be at least seven calendar days after the date of fitting. The date of service is the date the follow-up occurred.
Audiological Case Management
Items 610 and 810 cannot be claimed when the associated assessment was completed by an audiologist. Items 610 and 810 are only claimable if an audiometrist sought additional audiological advice from an audiologist to complete a client’s assessment or re-assessment service.
Reimbursements
Section 23 of the Hearing Services Administration Act 1997 requires that all payments that do not meet the program legislative and contractual requirements to be reimbursed to the Commonwealth.
Invalid claims can be reimbursed by recovering the claim in the Hearing Services Online Portal. If the client is no longer linked to you please email hearing@health.gov.au for assistance. As part of the program’s compliance processes any invalid claims will be recovered.
Further information about the program requirements, including service requirements and program standards, is available on the program website.
Download this CSPN CSPN 2021-02 Tips for Improving Claiming