Assignment of Benefit Medicare Bulk Bill Webclaim form (DB020)

Use this form in conjunction with Medicare Bulk Bill Webclaims only. It cannot be submitted to us for manual processing.

This form is not interactive. It has 2 copies, 1 for the health professional and 1 for the patient.

Health professionals will need to print the form and complete both copies by hand, before that patient assigns their benefit to them.

This form can be completed online. Read more about HPOS.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 27 August 2017