Bulk bill voucher - electronically transmitted claims form (DB4E)

Use this form to claim assigned benefits for electronically transmitted claims.

These services can also be claimed through HPOS Bulk Bill Webclaim capability.

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: 2 July 2018

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This information was printed 20 July 2019 from https://www.humanservices.gov.au/organisations/health-professionals/forms/db4e. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.humanservices.gov.au/individuals/site-notices when using this material.