Suite 508 89 High Street

KEW 3101

Canada

(03) 9067 7582

ANAESTHETIC & MEDICAL BILLING SERVICES: REGISTRATION

Doctor Registration Form

Anaesthetic and Medical Billing Services

Suite 508, 89 High Street (PO Box 540), Kew, VIC 3101
Telephone: (03) 9855 2149 | Fax: (03) 8677 6907

Doctor's Medicare Provider Numbers


Doctor's Details


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Bank Details:


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DISCLAIMER:  It is the responsibility of the doctor to ensure his provider number is registered and he is able to claim for the services provided. It is also the responsibility of the doctor to inform patients of costs and get patients to sign consent forms unless otherwise arranged with AMBS. AMBS will not charge a commission until they get payment of an account unless the account is not claimable or the doctor decides to write the account off before AMBS have finished chasing it up.