Claiming Medicare benefits online 133-02090040

Customers can claim a Medicare benefit if they have:

• current Medicare eligibility
• valid bank details recorded (for fully paid invoices)
• a valid address recorded
• a valid receipt/invoice that shows:
• patient name
• date of service
• MBS item number
• provider number
• payee provider number (if applicable)
• referral provider details (if applicable)
• referral date (if applicable)
• cost of service
• if the invoice is unpaid, partially paid, or paid in full
• if the invoice item was for an 'admitted patient' or 'in-patient'

Note: an account number is not required for an invoice/receipt to be valid. See Account and receipt documents for Medicare claims processing.

The Process page explains when customers cannot submit their claim online.

The quickest and easiest way for customers to receive their Medicare benefit is by asking their doctor to submit the claim for them. The customer will get their Medicare benefit paid into their bank account.

If this service is not available, the customer can submit their claim online. They can do this if they have set up access to Medicare self service (online account or app).

When claims over $9,999.99 have been submitted via digital self-service, see Process a claim with a minor difference table on Process digital self-service claims for processing information.

Note: tell customers that due to system limitations, claims for individual items with a charge greater than $9,999.99 must be submitted using the Medicare claim form (MS014). The Resources page has a link to MS014.

Customers can view the status of their recently submitted Medicare claims online (if they are the claimant) using their:

• Medicare online account, or
• Express Plus Medicare mobile app

See Track Medicare claims online.