Bulk bill voucher - electronically transmitted claims form (DB4E)

Use this form to claim assigned benefits for electronically transmitted claims.

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.

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.

Page last updated: 21 September 2023.
QC 21606