Simplified Billing manual claims batch header form (HW091)
Use this form to submit manual Simplified Billing claims only.
Download and complete the Simplified Billing manual claims batch header form.
Private health insurers or approved billing agents can use this 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/hw091. 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.