If a claim is submitted to Sector Operations, the general practitioner cannot charge the patient for the service that was provided.
Submit your claim online
To submit your claim online you will need to contact a Practice Management System (PMS). These vendors supply practice management software. Errors relating to the format of the claim file may need to be referred back to your vendor.
How long your online claims payment will take
Online claims will be paid no later than 10 business days from the date of receipt at Sector Operations.
Submit your claim manually
You may be able to submit your claim manually if we have given you approval. If you cannot claim online you may:
- be able to get approval to claim manually for a specific period of time
- need to obtain approval each time you submit claims.
Approval will depend on your funding. Contact Sector Operations on 0800 855 066 and select Option 2: Claims. They will keep a record of online claim exemptions.
Claims over 6 months old
The most common claims we receive manually are ‘stale claims’. These are claims that are submitted more than 6 months after the Date of Service.
Written approval for stale claims must be received from the Funding / Portfolio Manager. They usually require a manual claim and a letter explaining the delayed timeframe. If approval is granted, the approval letter should be sent to Sector Operations with the claims.
How long your manual claims payment will take
Manual claims will be paid no later than 20 business days from the date of receipt at Sector Operations.
Where to send your manual claim
Send all completed manual claim forms to:
PO Box 1026
How to order more claim forms
Claim forms are available free by calling 0800 855 066. You will need to provide your payee number.
Call the Sector Operations Contact Centre to find out more:
0800 855 066 – Option 2:Claims
Mon, Tue, Thu, Fri: 8am – 5pm
Wed: 9.30am – 5pm