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 be claimed through HPOS Bulk Bill Webclaim capability.

This form is interactive. It has 2 copies, one for the health professional and one for the patient.

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: 21 September 2023.
QC 21606