Medicare DB4 online claiming form

The Medicare DB4 form is a printed version of claims lodged electronically. To view or print a claim go to the patient record. How to open the patient record.

Click copy at the top of the screen and select the invoice so that it is highlighted.

Select screen or printer at the bottom of the screen and OK to view the invoice on the screen or print the invoice.

 

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Patient # is assigned by eClaims and cannot be manually entered.

File/MRN can be added automatically or manually.

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