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An Australian dental receipt documents a patient's visit to a dental practice, listing each treatment performed, the item numbers from the Australian Dental Association fee schedule, the fees charged, any health fund rebate applied, and the out-of-pocket gap. Patients recreate these receipts for private health insurance claims, tax returns, Medicare Chronic Disease Dental Scheme submissions, or employer health benefit reimbursements.
| Section | Details |
|---|---|
| Practice Header | Dental practice name, ABN, address, phone number, and provider number |
| Patient Details | Patient full name, date of birth, and Medicare or health fund membership number |
| Treating Dentist | Dentist name, provider number, and AHPRA registration number |
| Date of Service | Date each treatment was performed |
| Item Numbers | ADA item codes (e.g. 011 for examination, 114 for scale and clean) identifying each procedure |
| Fee and Rebate | Gross fee charged, health fund benefit paid, and patient gap amount per item |
| Payment Method | How the account was settled: HICAPS, EFTPOS, cash, or invoice |
| Totals | Total charged, total rebated, and total paid by patient |
| Receipt Number | Unique transaction or invoice reference number for record-keeping |
