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 PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 13 November 2018

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