Forms
These forms (when completed) are used to support requests for additional funding consideration and assist various AHSA maintenance processes.
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High Cost Medical Device Request
This form is to be used to request funding consideration for a medical device not listed on the Ministerially Approved Prostheses List. -
High Cost Drug Request
This form is to be used when requesting payment for a very high cost drug which are not covered under other funding arrangements. -
Insulin Pump Replacement
This form provides confirmation of details relating to a Health Fund member applying for a replacement or upgrade of an Insulin Pump. -
Hospital Claim
The National Private Patient Hospital Claim form is the hospital claim form to be used for the payment of fund benefits for privately insured patients in private and / or public hospitals within Australia. -
EFT Banking
This is the hospital EFT banking form to allow AHSA member funds to directly deposit money into a hospital’s nominated bank account. -
Speech Processor Replacement
This form is used to ensure that all required information is provided to a health fund to enable a responsible funding decision to be made.