Bulk bill voucher - electronically transmitted claims form (DB4E)

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

Download and complete the Bulk bill voucher - electronically transmitted claims form.

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

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.

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.

Page last updated: 10 December 2021