Ambulance: Victoria

AmbulanceVictoria COPY
ABN: 50 373 327 705 Invoice Number

6957213901
Tax Invoice
Amount Due
$1,306.00
Pay By
14-FEB-23
MR BADEN WEARNE
3 LIDDELL COURT
MOUNT WAVERLEY VIC 3149
Date of Service: 12-JAN-2023 Case Number: 10421 Invoice Date: 24-JAN-23
Services provided
Emergency Rate: Triple zero (000) call centre management and emergency medical triage. Ambulance vehicle allocation and travel to/from your
medical incident. Assessment and medical treatment with ambulance transport to appropriate destination.
MR BADEN WEARNE 3 LIDDELL COURT MOUNT WAVERLEY 3149

From: 3 LIDDELL COURT, MOUNT WAVERLEY
To: MONASH MEDICAL CENTRE CLAYTON
Total Amount (Excl. GST) $1,306.00

GST $0.00
Total Invoice Amount $1,306.00
Payment Options Total Amount Due $1,306.00

Online (Credit card / PayPal): Visit www.ambulance.vic.gov.au/transport and follow the
prompts to make your payment
BPAY: Phone your participating Bank, Credit Union or Building

Biller code: 205559
Society to make this payment directly from your cheque, savings or
Ref: 69572139017
credit account
Phone: Call 1800 990 029 and follow the prompts to pay by Visa or Mastercard
Mail: Send Cheque (in Australian Dollars) payable to Ambulance Victoria with your invoice
number, name, address and date of service on the back to Locked Bag 9000, Ballarat Vic 3354
Not sure if you need to pay? Visit www.ambulance.vic.gov.au/transport and follow the prompts to provide
information. Refer to the reverse side of this invoice for more detail.
For Information about how Ambulance Victoria respects your privacy please see the reverse side of this
invoice and our Privacy Policy at www.ambulance.vic.gov.au
2271975
MOTOR VEHICLE ACCIDENT*
If the service provided to you relates to a motor vehicle accident, it may be covered by the Transport Accident Commission
(TAC). If so, please contact them on 1300 654 329 to lodge a TAC claim. Once your claim has been submitted to TAC
contact us (see below) with your TAC claim number.
WORKPLACE INJURIES*
If the service provided to you relates to a workplace injury or accident, it may be covered by WorkCover insurance. If so,
please submit your claim through your employer and contact us (see below) with your claim details.
* If an ambulance transport is covered by either the TAC or Workcover it is your responsibility to claim. Your pension, health care card, DVA card
or Ambulance membership does not cover these transports.
PRIVATE HEALTH INSURANCE

If you are covered for ambulance services through your private health insurance, act promptly to lodge your claim with your
insurer to enable payment by the due date. Ambulance Victoria can not do this on your behalf. We recommend you contact
us (see below) to notify us once your claim has been lodged.
VETERANS AFFAIRS OR CONCESSION ENTITLEMENT

Please Note Commonwealth Seniors Health Cards, Seniors Cards and Medicare Cards do not entitle holders to free
ambulance services.
If you held any of the following at the time the service was provided to you contact us (see below) providing either a
Veterans Affairs Card Number or Centrelink Reference Number:
• A current Veterans Affairs Gold Card (White-card holders may be eligible in some instances. If unsure contact Veterans
Affairs directly),
• A current Victorian Pensioner Concession Card (includes dependent children listed on the card but not spouses),
• A current Health Care Card including dependents and spouses listed on the card (does not include Health Care Card for
carer allowance and foster care issued in the name of the child); or
• A child holding a current Child Disability Health Care Card or Foster Child Health Care Card, but not their
guardians/families listed on the card.
Special rules apply for children under care orders, compulsory mental health patients and asylum seekers. Please contact
us (see below).
AMBULANCE VICTORIA MEMBERSHIP

Ambulance Victoria has been unable to locate a valid membership record for this service. If you held an ambulance
membership which was valid at the date of the service, please contact us (see below) with the details. Please note that
dependent students aged 17 years and over are required to provide proof of full time student status.
INTERSTATE AMBULANCE COVERAGE

If you are covered for ambulance transport through another Australian ambulance service, please verify your entitlements
then forward this invoice to your service. We recommend you contact us (see below) to notify us of your entitlement under
these arrangements.
NEED ASSISTANCE?
If you're having difficulty paying, contact us by phone (see below) to discuss assistance options.
If you are hearing or speech impaired, call the National Relay Service on 13 36 77 or visit
https://internet-relay.nrscall.gov.au.
If you need an interpreter, contact the Translating and Interpreting Service (TIS National) on 13 14 50.
CONTACT US
Visit www.ambulance.vic.gov.au/transport and select "Provide Information". Follow the
prompts to provide us with your concession details, claim number, ambulance coverage or other
information.
Contact us by phone on 1800 990 029 between 9:30am and 4:30pm
Contact us by email at [email protected]
Ambulance Victoria is committed to protecting the privacy of your personal information in accordance with the Privacy and Data Protection Act 2014 (Vic) and the
Health Records Act 2001 (Vic). Details about the way in which personal information is handled can be found in our Privacy Policy at www.ambulance.vic.gov.au or
by contacting 9840 3501 and asking for our Privacy Officer. Please note that Ambulance Victoria may share information in regard to this invoice with Centrelink or
other third parties such as TAC, WorkCover, DVA and Victoria Police for the purpose of verification of entitlements. Where Ambulance Victoria holds your mobile
telephone number we may seek to communicate with you in regard to this invoice using SMS messaging.

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AmbulanceVictoria COPY

ABN: 50 373 327 705 Invoice Number

Date of Service: 12-JAN-2023 Case Number: 10421 Invoice Date: 24-JAN-23

MR BADEN WEARNE 3 LIDDELL COURT MOUNT WAVERLEY 3149

Total Amount (Excl. GST) $1,306.00

Payment Options Total Amount Due $1,306.00

BPAY: Phone your participating Bank, Credit Union or Building

PRIVATE HEALTH INSURANCE

VETERANS AFFAIRS OR CONCESSION ENTITLEMENT

AMBULANCE VICTORIA MEMBERSHIP

INTERSTATE AMBULANCE COVERAGE

Contact us by phone on 1800 990 029 between 9:30am and 4:30pm

Contact us by email at [email protected]

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