Hearing Services Program claim for payment form

Providers must have a digital or physical claim for payment form for every claim, and the form can also be used submitting manual claims.

Hearing Services Program Claim for Payment Form (March 2025)

This form is mandatory for every claim. Keep a copy of the completed claim form on the client’s record.

Hearing Services Program claim for payment form (effective from 1 July 2025)

Providers must use this updated form from 1 July 2025, however you can use this form sooner.

Hearing Services Program claim for payment form

Hearing Services Program claim for payment form – example

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