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How to make a claim

Submitting a claim

Whether you submit a claim online, over the phone or through a Vitality GP, we’ll do our best to give you a decision as soon as possible and keep you updated throughout.

How to make a Health insurance claim

Before making a claim

In order to make the process as smooth as possible please make sure you have:

  • Checked your cover
    Log in to Member Zone and visit the ‘Notifications’ section to find details of your benefit limits and any excess that may apply
  • An open referral from a GP
    You’ll also need an open referral with details of your symptoms or condition. You can get an open referral via the Vitality GP app or your NHS GP, meaning you can choose the quickest and easiest route for you
    Alternatively, if you have selected a hospital list and want to see a specific consultant, you’ll need to provide details of a consultant or therapist who is registered with VitalityHealth. In many cases the GP or consultant will dictate which hospital they can see you at. However if you have a specific hospital in mind please check it’s included on your hospital list
  • Your Vitality membership number
    You can find this on your plan documents, on the Member Zone or on the Vitality Member app.

You have three ways to make a claim

1. Use our Vitality GP app

  • You can book a private video consultation with a Vitality GP within 48 hours, including evenings and Saturdays, instead of visiting your NHS GP. The Vitality GP app is compatible with Apple iOS8 and above or Android 5.0 and above
  • If they refer you for treatment, one of our partners will be in touch to arrange your appointment
  • Often this means you won’t need to contact us again for authorisation – the Vitality GP will manage your claim.

2. Use the secure Member Zone

  • Submit your claim online 24 hours a day, seven days a week
  • It only takes a few minutes and we’ll aim to get back to you by the end of the next working day.

3. Call us

  • Personal Healthcare: 0345 602 3523
  • Business Healthcare: 0345 602 3437
  • Corporate Healthcare: 0345 279 8865
  • Open Mon-Fri 8am to 7pm, Sat 9am to 1pm, excluding public holidays.

How the claims process works

1. Get your claim approved

Once your claim is accepted we’ll get in touch with our medical expert partners Alliance Health Group  – an independent doctor-owned organisation – to choose the best consultant for you, based entirely on your medical needs. You'll then get a call from Alliance Health Group to arrange all the details.

If you have a hospital list included on your plan and you had a referral to a named consultant we’ll let you know exactly what has been approved and send you a claim acceptance letter to take to your appointment.

Sometimes we may need more information from your GP or consultant in order to progress your claim, but we’ll let you know as soon as possible.

2. See the consultant

When you go for your appointment, give your consultant your claim acceptance letter. This will allow them to bill us directly.

If your consultant says you need hospital treatment as an in-patient or day-patient, or extra treatment sessions, you'll need to contact us again. It’s helpful if you have the following details:

  • The date of the treatment
  • The procedure code – this is called a CCSD code that your consultant can provide
  • The expected length of stay/number of extra treatment sessions
  • The hospital and consultant’s name.

3. Leave the bill to us

Normally, we’ll settle direct with the healthcare provider. If you’ve got an excess on your plan, you’ll have to pay this yourself and we’ll let you know who it needs to be paid to. If you do make a payment above your excess, send us the proof of payment with the invoice to the address below and we’ll pay you back.

Post: VitalityHealth Customer Services, Sheffield, S95 1DB
Fax: 0800 015 8700

Making a claim may increase your premium in the next plan year.