Get Au Form 514auh 2022-2025

Filling out the AU Form 514AUH online can be a straightforward process with the right guidance. This user-friendly guide will walk you through each step of the form, ensuring that you can complete it accurately and efficiently.

Follow the steps to successfully complete the AU Form 514AUH.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Fill in your membership details, including your membership number, type of cover, title, date of birth, surname, first name, and sex. If your contact information has changed, ensure to update your postal address, suburb, state, phone number, mobile, and email.
3. In the claim details section, provide the first name and date of birth of the patient, along with the date of service and the name of the practitioner or type of service. Indicate whether the account has been paid by selecting 'Yes' or 'No'. If paid, proceed to fill out Section 5.
4. Address the hospital details by confirming if you are claiming medical gap claims for services received while a private inpatient. Fill in the date range for your hospital stay and provide the hospital's name, address, suburb, state, and postcode.
5. Complete the accident declaration, indicating if your treatment is associated with an accident or if you have previously received compensation for the injury or ailment. Describe the nature of the ailment or injury you are claiming for.
6. For claim payment, provide your financial institution details, including the institution's name, branch, account holder name, BSB number, and account number. You must fill this out only if your account details differ from those Australian Unity holds.
7. Sign and date the declaration section, confirming that the information you provided is true and correct and granting permission for Australian Unity to access relevant records.
8. Once all sections are completed, you can save changes, download a copy, print the form, or share it as needed.

Complete and submit your AU Form 514AUH online to ensure your health cover claims are processed efficiently.