The Health Insurance Act 1973, section 20B(2)(b), states that a Medicare claim must be lodged with us within 2 years from the date of service.
The Health Insurance Act 1973, section 20B(2)(b),states that a Medicare claim must be lodged with us within 2 years from the date of service.
Lodging a Medicare claim also enables the Chief Executive Medicare or their delegate to consider applications from providers to extend this period with regard to all relevant matters, including any hardship that may be caused to the claimant if a longer period is not allowed.
An application to extend the 2 year lodgement period is known as a late lodgement.
The decision of the Chief Executive Medicare or their delegate is final.
Extensions to the 2 year lodgement period
The provider who rendered the Medicare eligible service can apply for late lodgement of their Medicare bulk bill claim.
Where the service provider is incapacitated or deceased, then the person who holds their legal authority, such as their power of attorney, can apply for late lodgement.
The Chief Executive Medicare or their delegate will consider applications to extend the 2 year lodgement period, where the service provider can provide evidence:
- of the circumstances that prevented the claim from being lodged within the 2 year period from the date of service, or
- that if a longer period is not allowed, it will affect the ongoing viability of the practice
The Chief Executive Medicare or their delegate will not accept claims that are late because of an administrative issue, including but not limited to:
- poor book keeping
- inadequate staffing, resources and training
- an issue with software
How to apply for late lodgement
To apply for late lodgement of a bulk bill claim, you must submit the following:
- application for late lodgement of a claim for assigned Medicare benefits form
Note: to get this form, you must contact us on 132 150
- correctly completed original Assignment of benefit forms, signed by the patient
- evidence to demonstrate the circumstances preventing lodgement within the 2 years
- evidence to demonstrate that if a longer period is not allowed, it will impact on the ongoing viability of the practice, such as certified copies of bank statements or tax returns
Applications for late lodgement must be sent to Bulk Bill late lodgement applications.
Note: Applications for late lodgement will not be accepted electronically.
The Chief Executive Medicare or their delegate will notify you of the outcome of your application in writing.
Approving the late lodgement application means we will accept the claim for processing outside of the 2 year claiming period. Late lodgement claims are assessed in the same way as any other claim.
For more information contact us at Medicare provider enquiries.