We will pay for hearing services and devices that you provide to eligible clients as long as they comply with the:
- provider contract
- schedule of service items and fees, including the minimum hearing loss threshold guidelines and eligibility criteria for refitting.
Read more about how to use the portal to make claims.
How to claim
Before delivering services to a client, ensure they are linked to your business.
The schedule of service items and fees lists all fitting items and the conditions for claiming.
Previous schedules of fees are available from the National Library of Australia's web archive.
You can use your vendor or bespoke software to create a csv batch file and upload it to the portal.
You can batch claim most items, except for items 1, 2, 3, 4 and 6.
Claim through the portal:
- for items 1, 2, 3, 4 and 6
- for approved revalidated service claims
- if you don’t have an e-claim software
- any other claims that can’t be e-claimed.
If you can’t submit a claim through the portal or e-claim, program staff can submit the claim for you as an exception. This includes:
- approved non-scheduled devices
- claims for relocated clients who are no longer linked to your business
- split payments following the sale of a business.
Email us one client per email with a completed claim for payment form, and the subject line stating ‘exception claim – voucher number – client name – item number(s)’. You have 20 days to submit a claim this way.
Keep the completed claim for payment form on the client file for audit purposes.
Both providers must submit split payment claims when a hearing service provider business is being sold, if the:
- selling provider completes a fitting
- buying provider does the follow-up appointment.
The selling provider must email us the claim for payment form for either:
- item 651 or 821 for monaural fittings
- item 661 or 831 for binaural fittings
- item 771 (subsequent initial fitting).
The buying provider must email us the claim for payment form for item 6 to cover the follow-up service.
Claiming for CROS and BiCROS devices
If you fit a contralateral routing of signal (CROS) device or a bilateral contralateral routing of signal (BiCROS) device, you will be maintaining 2 devices. You can claim for services, batteries and maintenance for both devices.
If you are claiming for one component of a CROS or BiCROS device, submit the claim through your e-claiming system.
For BiCROS devices, you can also claim a spare aid (item 960) through the portal. You can only claim for one component of the BiCROS device (either the receiver or transmitter, but ideally the receiver component).
See the fully subsidised device schedule for a list of approved CROS and BiCROS devices.
Claiming over 2 financial years
We will use the fitting and follow-up rates from the schedule of service items and fees for the relevant financial year if you have:
- fitted a device on or before 30 June
- completed the follow-up appointment on or after 1 July.
You must reimburse any Hearing Services Program payment if:
- you made an incorrect claim – either because it does not meet the program requirements or has no evidence on file that it meets them
- you entered wrong information in your claim
- a client returns a device to you and you have previously claimed that service.
You can reimburse the program by recovering the claim in the portal. The amount you owe will come out of your next payment. You must then submit the correct claim in the portal. If you have a large number of recoveries, contact us to discuss a payment plan before processing them in the portal.
Read more about the program’s compliance monitoring and support.