Access Gap Cover Forms

In this section you can find all the forms you require in relation to Access Gap Cover. 

AHSA administers Access Gap Cover on behalf of a number of participating Health Funds. Administration includes registering providers and amending billing and banking details. It is very important to make sure you complete all sections of the relevant form.

Should you have any queries please contact us.

  • Provider Registration

    This form is used by Doctors to register for participation in Access Gap Cover. It is essential that you register the associated Provider Number you are using when submitting claims. The Doctor must sign this form.
  • Additional Practice Location

    Use this form if you are adding additional provider numbers to an existing registration.
  • Change of Bank Details

    Use this form if you would like to update existing bank account information only. Please be aware that the Doctor must sign this form.
  • Account Summary

    The Account Summary Form acts as a batch header. This form must accompany all Access Gap Cover claims. Doctors and/or Practice Administrators need to forward claims directly to the patients' Health Fund for processing. Please refer to the Participating Funds Contact List for more details.
  • Doctor Account

    This form can be used for billing your patient.
  • Estimate of Fees

    This form may be used by doctors to provide patients with an estimate of medical fees prior to their procedure (or as soon as possible in cases of emergency).