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You’ve just left your physio appointment and you’re about to pick up the groceries, but before you jump in the car, you upload your receipt to submit your claim on the nib app. You’ve got your life together, you’re feeling limber (thanks to the physio’s exercises) and you’re ready to move on to the next item on your (never-ending) to-do list.
But, while you wait for your benefit to be paid, have you ever wondered how it’s assessed?
We make it as easy as possible to submit your claim, but behind the scenes, our team is working to process your payments as fast as possible. We spoke with nib’s Head of Claims and Policy Admin, Bridget Wilks, about how your claim is assessed and what’s involved.
Firstly, let’s cover how you can claim. Many registered Extras providers will provide on-the-spot claiming facilities, so you can simply swipe your nib membership card and be on your way. If on-the-spot claiming isn’t available, we’ve also made easy photo claiming available through the nib app or Online Services – which can be accessed from your computer, phone or tablet. You can also lodge a claim at any nib Retail Centre or by mail.
You don’t generally need to submit a hospital claim if you attended an nib agreement hospital and used a doctor who participated in MediGap for your admission, however if you did receive a bill, head to our hospital billing and claiming page to find out more.
All you need to submit your claim is the official receipt from your visit to a specialist or health provider. The receipt should clearly include:
Once your claim has been submitted, we start working to process it straight away. We have a system that checks your claim alongside some of your policy details including:
Once you’ve submitted a claim with all the relevant information, we begin working to process it immediately and, if you use the nib App or Online Services to submit your claim, you can have benefits paid straight into your account within five working days.
There are a number of reasons why a claim may have been rejected and, according to our claims team, here are some of the most common1:
If you want to talk to someone about why your claim wasn’t approved, head to our Contact Us page. For more information, tips and tricks on your private health insurance, make sure you check out the Health Cover tab on The Check Up.
1Data from 1 January 2018 to 1 October 2018