Medicare online account help - Submit a claim

Learn to submit a claim using your Medicare online account.

 

You can use your online account to claim all Medicare services that aren’t bulk billed.

With your claim you need to submit details of:

  • the services you’re claiming for
  • how much you paid.

You’ll find this information on the account or your receipt from your health professional.

You also need to send us a copy of your account and receipt with your claim. To do this, scan or take a photo of these documents and save them.

Upload your files as a PDF, JPG, GIF, PNG or BMP format less than 5MB in size.

Take extra care if you’re using a public computer to scan and upload your documents. After you complete your claim, delete your documents from the public computer.

We’ll need your bank account details to pay you your Medicare benefit. Find out how to update your bank account details.

Step 1: sign in

Sign in to myGov and select Medicare.

Select Make a claim.

Make sure you have details of the service, cost and amount paid to continue your claim.

Select Make a Claim.

Read the important notice. You can then either:

  • Select Accept, if you accept the notice and submit your claim
  • Select Decline, to return to the homepage.

Check if your account or receipt says Statement of claim and benefit payment.

If it does, your claim is already being automatically processed, and you don’t need to make a claim again. Select:

  • Yes then Next, this’ll stop you from submitting another unnecessary claim.
  • No then Next to continue your claim.

Step 2: confirm patient details

If you have multiple people listed on your Medicare card, select who received the service, then Next.

Step 3: confirm payment details

Tell us if the service has been paid in full. Select either:

  • Yes if you’ve paid the service in full, then Next
  • No if you haven’t, then Next.

Upload your document with details of the services, cost and your payment. We accept PDF, JPG, GIF, PNG, or BMP files less than 5MB.

Select Attach a document, locate the document in your files, then select Next.

If you need to upload another document, select Attach another document.

Once all documents are attached, select Next.

Step 4: add provider and item details

Tell us the doctor’s provider number.

You can find this on the account or receipt. It’s a combination of letters and numbers up to 8 characters long.

Add the provider number, then select Next.

You need to tell us about the treatment you got. You can find the item number on the account or receipt. It’s set of numbers and can be up to 8 numbers long.

Enter the:

  • Item number
  • Date of service
  • Amount you paid.

Then, select Add item.

You can claim multiple items. Select Add another item and enter the details.

Select Remove to correct any errors.

Once you’ve added all items, select Next.

You may need to provide referral details. These are details of the health professional who referred you for the service. Add their provider number and the Date of referral, then select Next.

You need to tell us what type of patient you were during the treatment.

If your treatment was in-hospital your account or receipt may have the following after the item number:

  • admitted patient
  • in-patient
  • H
  • *.

To tell us if the services were in hospital items, select either:

  • Yes
  • No.

Select the item numbers provided in-hospital or in a day surgery from the list of item numbers.

Step 5: review and submit

Review your claim details.

If the details are wrong, select Edit to make changes.

When the details are correct, select either:

  • Submit to declare the information and documents are correct and submit the claim
  • Cancel to stop the claim.

You’ll get a Claim ID when you submit your claim. Record this number for future reference.

It can take us up to 7 days to process your claim.

When you’ve submitted your claim, you can select:

  • Download claim summary to view a PDF of the claim you just made
  • Make another claim.

To return to the homepage select Home.

Step 6: sign out

From your homepage you can complete other transactions.

Select myGov to go to your myGov account.

For your privacy and security, sign out when you’ve finished using your myGov account.

Page last updated: 16 March 2020