Copy Remittance Queries | Contact Us

Healthcare Providers

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Provider specific information

Additional information

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Please note

Complete the form below if you wish to receive a copy of remittance for one or more payments you have received.

Provider name

Email address

Contact name

Do you require a remittance for multiple received payments?

Yes No

Payment date

Payment reference

Amount

Please select which best describes your organisation:

Individual practitioner Group practice or therapy clinic Hospital Outpatient clinic

You need to download the template spreadsheet to provide all of your remittance files. Then upload the completed spreadsheet below.

Supporting documents

Please choose your zone

Please choose a product

Private healthcare and help to cover costs

Private healthcare and benefits for your company

Payouts if you get sick, injured, or pass away