Registering Providers with Medicare - Online Provider Agreement Form - HW027 and HW052

Registering Providers with Medicare - Online Provider Agreement Form - HW027 and HW052

Medicare/Bulk Bill and DVA claims will not be processed online if the Online Provider Agreement Form ( HW-027) has not been completed.  This allows for one provider number. 

If the provider has multiple provider numbers, these need to be added to the Online Claiming Banking Details Form ( HW- 052)

Please forward completed forms to the Services Austrailia email on the bottom of the form .

HW027

To complete the HW027 form:
1. Provider details
2. Provider Number 
3.  RA number - LEAVE BLANK 
12.  Minor ID: As advised when you signed up, starts with CUT
13 - 17 Complete your contact details
18-22 - leave blank
23.  Your Bank Details
24. Tick only Medicare/Bulk Bill and DVA
25-26 Tick: NO
28:  Sign and date.

HW052

To complete the HW052 form:
1.  Minor ID: As advised when you signed up, starts with CUT
2.  Tick No - Go To 4
3.  Leave blank 
4.  Practice or Doctors name
5.  Address that one of the provider numbers is registered to
6. Post address for correspondence
7.  Telephone number
8-12:  Leave blank
13.  Bank details and date effective from
14.  Leave blank
15.  Tick only Medicare/Bulk Bill and DVA
17.  Add the relevant provider numbers and get doctor to sign each one.










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