Incomplete or incorrect Medicare claims forms 011-43010050

"Do you declare that you have incurred the expenses for the services for which you are claiming and that they are not for the purposes of superannuation or provident account schemes, admission to a friendly society, life insurance, mass immunisation, or health screening and are not connected with the patient's employment?

Do you declare that the services were not provided by or on behalf of the Australian Government, a state, territory or a local governing body or an authority established by a law of the Australian Government, a state or territory?

Do you declare that you have not claimed for dental expenses through private health insurance?

You are aware that the Agency’s Privacy notice is available on our website, www.servicesaustralia.gov.au.

To the best of your knowledge and belief, is all the information disclosed true and correct and you are aware that giving false or misleading information is a serious offence?

Do you authorise Medicare to contact the referring practitioner or the health professional for assessment purposes?"

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VG4 form

Services Australia has endorsed the letter or electronic message for use. It is the latest version. Do not use locally produced letters or electronic message.

Service Officers can start the following letter from CDMS or DMC. See Digital Messaging Capability (DMC) to create and send letters.

Z0828 - Medicare claim needs more information

Medicare Claim form (MS014)