Download and complete the Assignment of benefit Medicare bulk bill Webclaim form.
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.
To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.
You can upload or complete this form online through HPOS. Read more about form upload in HPOS.
If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.