There are a few different ways that hospital claims can be claimed depending on what you've received from the hospital or specialist you went to.
If you've received a bill from your specialist
You'll need to first complete the below Medicare claim form and a Two-way claim form:
Once you have downloaded and completed the forms, you can:
- Submit the forms via Medicare. You can view instructions here.
- Medicare will process the forms and forward the claim to ahm on your behalf. We will pay your benefits where eligible, and there's nothing further for you to do.
If you've received a Medicare Statement of Benefits
This means Medicare has processed their part of the claim already, so there are 3 options for claiming a benefit through ahm:
- Log in to the app and select Claims > Make a claim > Medical services and follow the prompts to upload your Medicare Statement of Benefits.
- Log in to your online account at https://members.ahm.com.au, go to the Upload Documents page and upload your Medicare Statement of Benefits and ahm claim form under the Claims - Hospital option.
- By post - send your ahm claim form and Medicare Statement of Benefits to Locked Bag 4, Wetherill Park NSW 2164.
If you've claimed through Medicare but haven't received your Medicare Statement of Benefits yet
If you have claimed through Medicare with a Medicare claim form, or if the provider has submitted the claim on your behalf, the statement may be available in your MyGov inbox. You can also contact Medicare and request a Statement of Benefits or visit a Centrelink/Medicare Service Centre.
Medicare will put in a manual request for the statement which can take 10 days to process. You will then be able to download the Medicare Statement of Benefits by logging into your Medicare account online via MyGov. You can click here for more information on Medicare via MyGov.
Once you have the statement, you can claim via one of the below methods:
- Log in to the app and select Claims > Make a claim > Medical services and follow the prompts to upload your Medicare Statement of Benefits.
- Log in to your online account at https://members.ahm.com.au, go to the Upload Documents page and upload your Medicare Statement of Benefits and ahm claim form under the Claims - Hospital option.
- By post - send your ahm claim form and Medicare Statement of Benefits to Locked Bag 4, Wetherill Park NSW 2164.
If you've claimed through Medicare with a Two-way claim form
As you submitted a Two-way claim form, Medicare will contact us directly with the details and we will pay benefits where eligible. It can take up to 6-8 weeks for your claim to be processed and for your payment to be reimbursed.
There's nothing further you need to do with us for this claim.