Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Claiming through the portal

Hearing Services Online (HSO) portal claims are usually submitted when claims are not able to be claimed through the Department of Human Services (DHS) e-Claim system, or you have been advised by a health departmental officer to do so.

Processing claims in the portal (portal claim)

Claim items that cannot be e-Claimed are submitted through the portal (portal claim). To process portal claims, the user must have ‘SP Claims’ access, which is arranged by their company’s SP Admin. Providers must keep the completed claim for payment form on the client file for audit purposes. The following services can only be claimed through the HSO portal

  • Fitting items with no follow up appointment (for example item 631, 641, 651 etc.)
  • A spare aid fitting (item 960)
  • Assistive Listening Device (ALD) fittings
  • Payment of client contribution for lost/Damaged Beyond Repair (DBR) device/s for exempt clients (item 555)
  • Aid returned for credit (item 1 or 2)
  • Dispensing fee for a hearing aid returned for credit (item 3)
  • Remote controls (item 4), or
  • Miscellaneous item (item 6, for example a split payment or non-scheduled device).

The conditions for claiming webpage provides more information on claiming for these items. Please see the user guide on submitting a claim through the HSO portal. Providers should also ensure they are familiar with the current Schedule of service items and the Schedule of fees 2018-2019.

Manual or exception claims

A manual or exception claim is a claim that cannot be submitted via the DHS e-Claim system or the portal. These claims must be submitted via e-mail to hearing@health.gov.au. Please ensure you attach the completed claim for payment form. Examples of exception claims include

  • Where approval for a non-scheduled device has been provided
  • claims for relocated clients who are no longer linked to your business and can’t be e-Claimed, or
  • Split payments.

Split payments

Split payments occur when the selling business has completed a fitting appointment and the follow up appointment is completed by the buying service provider.

It is recommended that providers who are selling their business do not proceed with fitting a client if a follow up appointment cannot be completed before the date of closure.

If the selling provider does complete a device fitting but cannot complete the follow up appointment, the selling and buying provider will need to submit split payment claims. For split payments the fitting date is prior to the date of transfer to the buying provider and no follow-up appointment has been completed.

The selling provider must e-mail us the claim for payment form for an item

  • 771 (subsequent initial fitting)
  • 651 or 821 for monaural fittings or
  • 661 or 831 for binaural fittings.

In order for the buying service provider to claim for the follow-up service, they must e-mail us a claim for payment form for an item 6. The follow-up date of service must be after the date of transfer. Please see the factsheet on claiming information for when selling or buying a hearing service business.

Initiating a recovery

Recoveries

A recovery occurs where

  • an incorrect claim has been submitted
  • the claim details are incorrect or
  • where a device is returned for a credit and the provider is required to reimburse a claim for payment.

A recovery can only be initiated if the submitted claim has been paid to the provider.

When you perform a recovery in the HSO portal a Tax Invoice will be generated and posted to your Head Office within 4-6 weeks from the initiated recovery date.  Payment will be due within 28 days from the date shown on the Tax Invoice.  Please do not pay this amount until you receive the Tax Invoice.

You will then need to submit the correct claim as a HSO portal claim (if appropriate) ensuring all the details are correct.

Please see the user guide on processing a recovery.

Adjustment notes

An adjustment note should only be initiated if advised by a Health departmental officer of the program.

Further information

For further information on how to claim for services provided, or to initiate recovery, please see the user guide or e-mail hearing@health.gov.au for advice.

 

Claiming through the portal (PDF 72 KB)

Conditions for Claiming

Quick Reference and User Guides

Provider Factsheet - Claiming information when selling or buying a hearing service business

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