Updating or changing a claim
You can fix small errors in a claim form after you've submitted it. You can also change the initial diagnosis or add a new one.
On this page
Fix a small error in a claim form
If you submit an ACC45 for your patient and notice a small error in the information you submitted, you can send us a correction. Examples of errors you can fix:
- giving the wrong side of the body for the injury
- a typo in the date of the accident.
To fix the error, call or email us. If you've sent us a paper version of the ACC45 and we haven't received this yet, you can email us a scanned copy of the form.
Changing a diagnosis
You can request a change in diagnosis if:
- there was an administrative error, eg you submitted an incorrect diagnosis code
- you've obtained the necessary information to confirm injury diagnosis which is different to what you've previously submitted.
Adding a diagnosis to a claim
While treating your patient, you may find another injury at a later stage. You can request to add a new diagnosis if:
- the new diagnosis relates to the initial injury
- the new diagnosis is caused by the same event, ie accident, you have previously submitted to us on ACC45.
For example, you're treating a shoulder injury from a fall and later find the patient injured their knee in the same fall.
How to add or change a diagnosis
You can submit your request to add or change a diagnosis through the 'Change in diagnosis' functionality available in your practice or patient management system.
You can submit a request to add or change a diagnosis together with a request for treatment or support. The request for treatment or support must be for the diagnosis you're changing to or wanting to add:
- on ACC18 medical certificate with incapacity
- on ACC554 medical certificate with permanent impairment
- on Approval for prior treatment – surgery
- on ACC2152 treatment injury claim
- on ACC2302 dental claim
- on ACC32 approval for prior treatment – allied health professionals.
If you're updating a sensitive claim, ask your patient to contact us. We'll talk them through the process. They may need another assessment.
When filling out the form, make sure you've provided the following information about the injury you want to change to or add:
- diagnosis code and description
- body site of the injury (if applicable)
- date of accident or event (in which a person was injured)
- short description of why you're adding or changing a diagnosis.
After you've requested to add or change a diagnosis
We'll assess whether changed diagnosis or added injury can be accepted for cover. We might need clinical records to help us make that decision.
If you have any questions or want to fix a small error, contact us.