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Request billing approval

Please note

You'll find most of the items we cover in our Fee Finder, along with what we expect to be charged for these.

For anything not usually covered by Vitality, please complete the form below.

This refers to the practitioner, clinic or hospital you are contacting on behalf of

Please provide the name of the person filling in the form

Please select the billing query
Please confirm member consent

If supplying multiple procedure codes, please separate with a comma.

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Supporting Documents

Please provide a copy of a clinic letter. This needs to explain why this item should be covered and explain any additional complications.

  • A maximum of 5 files can be uploaded
  • Acceptable file formats include PDF, JPG, JPEG, PNG, XLS, XLSX, DOC and DOCX
  • Files must be 5MB or less
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