Assignment of benefit Medicare bulk bill Webclaim form (DB020)

Use this form in conjunction with Medicare Bulk Bill Webclaims only. It cannot be submitted to us for manual processing.

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.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

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.

Page last updated: 10 July 2020