Application for late lodgement of a Simplified Billing claim for assigned Medicare benefits form (HW026)
Use this form to apply for late lodgement of a Simplified Billing claim for assigned Medicare benefits if you are a health professional, billing agent or private health insurer.
Download and complete the Application for late lodgement of a Simplified Billing claim for assigned Medicare benefits form.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
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Page last updated: 20 February 2020
This information was printed 5 January 2021 from https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw026. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.