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Evolve Plastic Surgery & Skin Clinic

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RESOURCES

Forms & Downloads

For patients of Dr Namrata Anavekar FRACS

Forms you may need before or after your procedure. If you have any questions about a form, our team is happy to help.

MEDICARE

Medicare claim form

If your procedure has a Medicare item number, you may be able to claim a rebate on your account.

Procedures of $10,000 or more: if your procedure value is $10,000 or over and you have a Medicare rebate, we are unable to submit an electronic claim on your behalf due to Medicare software limitations. You will need to lodge a manual claim with Medicare directly, or through your myGov account, using this form and a copy of your surgery tax invoice.

Medicare claim (MS014)

Services Australia form for claiming a Medicare rebate on paid or unpaid accounts.

PDF · 2 pages · 104 KB
Download Form

How to lodge it

  • Fill it in on screen in Adobe Acrobat Reader, or print it and complete it by hand in black or blue pen.
  • Sign and date the form by hand.
  • Post it with your original invoices, and proof of payment if you have paid in full, to: Services Australia, Medicare, GPO Box 9822, in your capital city.

To claim online instead, log in to your Medicare online account through myGov (or the Express Plus Medicare app) and upload the form and your invoice. If you need help, please call us on 03 9075 0005.