Provider Forms

HELPER Registration Form Used for hospital and medical service providers who would like to register for CBHS 24/7 free online patient eligibility checking system in order to provide Informed Financial Consent to patients.
Hospital Request for Direct Credit of Payments With CBHS Health Fund you can choose to have provider benefits paid directly into a nominated account. Complete this form to register for this service.
Provider Recognition Application Form If you are an Extras provider and are not registered with an Association, Board or Medicare Australia, you can apply to become a recognized provider with CBHS. Complete this form attaching specified evidence and forward to CBHS for assessment.
Authorisation to Release Information Form If you are a hospital performing a patient eligibility check using HELPER and the member has not served appropriate waiting periods for the condition requiring hospitalisation, this form must be completed by the patient's doctor who they first consulted for the condition requiring hospitalisation.
Certificate for Medical Practitioner Form This form accompanies the Authorisation to Release Information Form and is used to provide CBHS with clinical information in order to review if the reason for the patient's hospital admission is for a pre existing condition.
Accident Injury Condition Form This form is used to provide information regarding the circumstances of an accident/injury or condition that may be subject to compensation from another source.