Claiming on your Extras cover should be simple. Whether you claim on the spot using your member card or submit a claim through the Phoenix Health app, understanding how benefits are paid can help you get your money back faster.
Key Points
- Claim on the spot where you can. Simply swipe your Phoenix Health member card with participating providers and your benefit is applied instantly.
- No member card? No worries. You can easily submit your claim through the Phoenix Health App, Online Member Services or by using a claim form.
- Benefits are paid directly to you. Once your claim is approved, we’ll pay your benefit straight into your nominated bank account.
- Most claims are processed within two business days. After payment is made, allow 3–5 business days for the funds to appear in your account.
- Don’t leave it too long. Claims must be submitted within two years of the date you received the treatment.
What is the quickest way to claim?
The fastest and easiest way to claim for many Extras services is to use your Phoenix Health member card at the time of treatment.
On-the-spot claiming is available for most Extras services. Simply swipe your member card and your benefits will be deducted straight away; all you’ll have to do is pay the rest of the cost – if there is one at all!
This means you don’t need to submit a separate claim afterwards, making the process quicker and more convenient.
What if I can’t claim on the spot?
If on-the-spot claiming isn’t available or of you forget your member card on the day of your treatment, you can submit your claim using one of the following methods:
- The Phoenix Health Claiming App
- Online Member Services (OMS)
- A completed claim form submitted by email or post
The mobile app is the quickest and easiest option, allowing you to take a photo of your invoice and submit your claim directly from your smartphone.
What information do I need to provide when I submit a claim?
When you submit a claim manually, to assess your claim, you’ll need to provide a copy of the itemised invoice or receipt for your treatment showing:
- the date the service was provided;
- the name of the person who received the service;
- the item number(s) used for the treatment received;
- the name, address and provider number for the provider used;
- confirmation of whether the account has been paid or not; and
- any other supporting documentation required, depending on the benefit you are claiming.
Providing complete information when you submit your claim can help avoid processing delays, so you’ll get your money quicker.
How are Extras benefits paid?
Phoenix Health pays approved Extras benefits directly into your nominated bank account.
To receive your benefits, you’ll need to have your bank account details registered with us for payment of benefits. If you haven’t already done so, you can update your banking details through your Online Member Services (OMS) portal.
Once your claim has been assessed and approved, the benefit payment will be deposited into your account and you’ll receive confirmation that the claim has been processed – please allow 3-5 business days for the money to clear into your bank account.
How long does it take to receive my payment?
Claims will be processed by our team within 2 business days with the benefit credited into your bank account.
Once your claim has been assessed, your benefit will be paid directly into your nominated bank account and you’ll receive confirmation that your claim has been processed and of the payment you can expect to receive. Please allow 3-5 business days for the money to appear in your bank account.
Depending on the type of claim you are making, processing times may vary. This will depend on the information you’ve provided and whether additional documentation is required to complete our assessment.
Is there a time limit for submitting claims?
Yes. Claims must be submitted and assessed within two years of the date the service was provided.
Claims that are more than two years old cannot be paid, so it’s important to submit your claims as soon as possible after receiving treatment.
How do annual limits apply?
When your claim is processed, the benefit will be deducted from the annual limit that applies to the year in which you received the service.
For example, if you received treatment during a previous calendar year but submitted the claim later, the benefit will still count towards the annual limit for the year the service was provided.
Understanding this can help you keep track of your available Extras limits throughout the year.
Need help with a claim?
If you have questions about claiming, benefit payments or updating your bank account details, give us a call on 1800 028 817 our team is here to help.
You can manage many aspects of your membership through Online Member Services, including updating your payment details and tracking your claims history.
The sooner you submit your claim with the correct documentation, the sooner we can assess it and pay any benefits you’re entitled to receive.
