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Bulk bill claims in Medicare 011-43030000



This process is impacted by the coronavirus (COVID-19) response. Read the Operational Messages:
Temporary Medicare Benefits Schedule (MBS) items in response to Coronavirus (COVID-19)

Functions of bulk billing control lines

Table 1

Control line

Topic

Function

DAPI

Pend

Use the A modifier after background assessing to add another voucher

DASI

Pend

Supervisor level for DAPI

DBEI

Claim entry

Used by branch office staff to key claims

DBGA

Background Assessing

Bulk bill processing - Background assessing. Can only be initiated in CICSQ environment

DBGB

Background Assessing

Bulk bill processing - Background assessing. Can only be initiated in CICSQ environment

DBPI

Pend

Browse Claims assessed with errors can be reviewed online

DCEI

Enquiry

Returns all unpaid claim status for health professional specified. Various modifiers may be added to refine the information returned

DCPI

Claim processing

Claims in progress for an operator

Changes the status of the claim

DDEI

Claim entry

Menu screen to access claims

DEAI

Pend

Used by branch office staff to add the A modifier after background assessing to add another voucher

DHCI

Claim

Mail room received claim status

DHDI

Claim Delete

Allows deletion of a header online

DHAI

Latter Day Adjustment

Bulk bill latter day adjustment assessment - recalls from Pend and reassesses the claim

DLBG

Latter Day Adjustment

Used to push a bulk bill latter day adjustment through background

DHRI

Latter Day Adjustment

Same day reversal of a bulk bill latter day adjustment

DHSI

Latter Day Adjustment

Bulk bill latter day adjustment

DOPI

Pend

Process a bulk bill scanning claim

DOSI

Pend

Process a bulk bill scanning claim at Supervisor level

DPPI

Pend

Pay claim with 'no error OK to pay'

DPSI

Statement enquiry

Can look at and request (or delete a request for) a duplicate health professional statement

DQAI

Enquiry

National Office level

DQOI

Enquiry

Display Claim Status

DQRI

Enquiry

Region level

DQSI

Enquiry

State level

DSDI

Same Day Adjustment

Same day reversal screen, can be reversed if assessed today

DXEI

Claim entry

Menu screen to key claims, and DUPE keying

DZOI

Claim Delete

Deletion of bulk bill claims in PEND/ASSESSED status

Resubmitting a voucher rejected from a bulk bill claim

Table 2

Resubmitted information

Mandatory paperwork

DB1 form with vouchers attached

Services Australia will accept a photocopy of the header originally submitted.

A new header is also acceptable for resubmitted vouchers. If a new header is submitted, the declaration on the DB1 form must:

  • be signed by the servicing health professional
  • include a witness signature

Health professional letter (acts as a DB1) with claim voucher information

Letter is acceptable for a resubmission, but must:

  • be signed by the servicing health professional
  • be on the practice letter head
  • be with the voucher(s)

Resubmitting a totally rejected bulk bill claim

Table 3

Resubmitted information

Mandatory paperwork

DB1 form

The agency will accept a photocopy of the header originally submitted.

The declaration on the DB1 form must:

  • be signed by the health professional
  • include a witness signature

Note: if the photocopied DB1 form does not have Resubmitted claims clearly marked, contact the practice to confirm resubmission prior to processing the claim.

Vouchers

Where the original vouchers are not available, copies are acceptable but copies of all the vouchers must be provided for the claim to be processed.

Voucher Count

The voucher count must be the same as the claim originally submitted.

Retaining assignment of benefit forms – health professionals

National Archives of Australia – Agency specific records authorities

Table 4

Document Type

Retention period

Claim forms for health and medical payments including:

  • Medicare claim forms
  • bulk billing forms
  • pharmaceutical benefits claim forms
  • authority prescriptions

Destroy 2 years after date of claim if not required for investigation

Forms

Application for bulk bill claim adjustment form (DB018)

Application for late lodgement of a claim for assigned Medicare benefits (DB019)

Assignment of benefit Medicare bulk bill Webclaim form (DB020)

Bulk bill voucher - electronically transmitted claims form (DB4E)

Medicare stationery order form (DB6Ba)

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Contact details

Assessing and Benefits

Bulk bill claims

My Health Record