How to claim

What you need to know before making a claim

Medical claims

To make a claim for medical expenses, you will need to send through your receipts along with a Frank claim form to [email protected]. If your claim is related to an inpatient hospital admission, will need a corresponding hospital account. We will usually be able to get this directly from the hospital.

GP's and Outpatient Medical Specialists

Where covered on your policy, if your claim is relating to an outpatient consultation with either a General Practitioner (GP) or Medical Specialist, these benefits will be paid directly into your nominated bank account.

In order for benefits to be paid towards your claim, you must submit an invoice which includes the provider number of the GP or Medical Specialist who treated you, and a Medicare Benefits Schedule (MBS) item number for the service/treatment that was provided. You will have to pay the claim before sending through your invoice.

We cannot pay a claim if the invoice submitted does not include a provider number and an MBS item number. When booking your appointment, you should check to make sure that you will be provided with these details prior to your visit.

Just keep in mind that we cannot pay claims where you are receiving benefits from a third party i.e. compensation claims.

Hospital claims

In order to receive maximum benefits, you'll need to ensure you are either admitted to one of Frank's participating private hospitals or a public hospital.

For hospital expenses claims, we can arrange payment directly to providers. Please request the receptionist or hospital admissions officer to call us on +61 3 5202 8770 and provide details of the account.

Extras claims

Where covered under your policy, when you go to an extras provider such as a dentist, you can simply swipe your frank membership card and the benefits will be deducted at the time of claim, this is called HICAPS. That way you only have to pay the difference to the provider. If the provider does not have HICAPS, you can send your claim through to frank as we will pay the benefits directly into your nominated account.

Paying Providers

Most Medical and Extras Practitioners will require payment at the time of consultation. Once a provider is paid by you, Frank will then reimburse any benefits you are entitled to.

If a provider is happy to be paid directly by Frank, we will pay them directly by cheque or direct deposit. They will then send you a bill for any outstanding amounts (if there are any).

Time limits

Please note that benefits are only paid if the claim is covered under the terms of your cover and made within 12 months of when you received the service or treatment.

How to make a claim

Process for claiming at hospital

If you go to the doctors and need to be admitted to hospital, show them your frank membership card so they can record your member number. You’re covered for treatment in a Frank participating private hospital and your doctor can help book you in.

Before going into hospital

The hospital admissions department will contact Frank to make sure your insurance is paid up and that you’re covered for the treatment you are receiving.

You may also be required to pay your excess ($500 per person per year). The hospital will contact you directly if they have any questions.

When you are admitted to hospital

If you haven’t already, you’ll be asked to pay your excess when you’re admitted.

After leaving hospital

The hospital will send their bill to Frank. We’ll cover the cost of the hospital admission as per your policy fact sheet.

The doctors will send you their medical bills. Send them into Frank along with a Frank claim form, so we can pay the entitled benefits. Depending on what your doctor charges, Frank’s benefits may not cover the full cost and you’ll have to pay the difference.