The National Private Patient Public Hospital Claim Form is the nationally standardised form used for the submission of claims for the payment of benefits by health funds for all admitted privately insured patients in public hospitals across Australia.
This form was reviewed and updated by Private Healthcare Australia in 2026, incorporating input from health funds, the Australian Government Department of Health, Disability and Ageing, state and territory health departments, public hospitals, and other relevant stakeholders prior to finalisation.
The revisions ensure compliance with current legislative and regulatory requirements, including the National Health Act 1953, the Health Insurance Act 1973, applicable privacy and veterans’ legislation, as well as alignment with the current nomenclature of the International Classification of Diseases, Australian Modification (ICD-AM) and definitions contained within the National Health Data Dictionary. The form also incorporates elements specified in the National Health Reform Agreement 2026–2031.
The revised Claim Form is scheduled for implementation from 1 July 2026.
To download this document, click on the link below and save to a local drive.
National Private Patient Public Hospital Claim Form (PDF 849 KB)