Bulk Billing FAQ
- What is the correct procedure for bulk-billing?
The practitioner enters details relating to the professional service on the assignment form before seeking the patient's signature. The form is then signed and dated by the patient. A copy of the assignment form must be given to the patient. If a practitioner chooses to bulk-bill, the patient 'assigns' their right to Medicare benefits to the practitioner, as full payment for the medical service received.
The forms are printed in triplicate for use where the claim is not transmitted electronically. The original is sent to Medicare Australia (where not transmitted electronically), a copy is provided to the patient after the service, and the third copy is for the practitioner's records.
- What if the patient is unable to sign the form?
Where a patient is unable to sign the assignment form, the signature of the patient's parent, guardian or other responsible person is acceptable. The reason the patient is unable to sign should also be stated.
In the absence of a 'responsible person' the patient signature section should be left blank and, in the section headed 'Practitioner Use', an explanation should be given as to why the patient was unable to sign eg. unconscious, injured hand etc. This also needs to be signed by the doctor. A recent survey showed that up to 20 per cent of bulk bill claims returned to practices were a result of patient details not being included on the assignment form.
- If I wish to send claims electronically what do I do?
Details of Medclaims, the electronic claims submission option are available by calling 1800 700 199.
- Is the same form used for pathology?
Different assignment forms exist for pathology services. These forms enable patients to 'offer to assign' benefits to the pathologist who will conduct their pathology test. If the pathologist accepts the offer to assign, the service details are entered on the assignment form and the 'offer' attached.
- How do I reorder stationery?
Medicare stationery is available from Leigh Mardon, Medicare Australia's printing contractor. Send a stationery reorder form (DB6B) to Leigh-Mardon fax 02 6230 0477 or mail to Leigh Mardon, Medicare Australia, Locked bag 4444, Tuggeranong ACT 2901.
Imprinters are available from Leigh Mardon by phoning 1800 067 307 (free call).
- Can my locums sign their section of the DB1 form before they see their patients?
No. A claim for Medicare benefits can only be signed by the doctor who provided the service after the completed assignment forms are attached to the claim. Where a locum is employed by a practice, payment can be made to the practice principal by using the section on the lower right hand side of the claim form.
- Can I mix hospital services and non-hospital services in one batch of bulk-billed claims?
No. When claiming for hospital in-patient services doctors should use the DB1H hospital form and ensure that services provided in a hospital are indicated by the words 'in-patient' immediately preceding the description of the service, or an asterisk directly after the item number.
- Can I use the bulk-billing facility as a form of debt collection for unpaid accounts?
No. Settlement of the account for a service provided by a doctor is a matter between the doctor and the patient. They can agree that the patient will assign the benefit to the doctor, but this can only occur when the doctor accepts the Medicare benefit as full settlement of the account. When a patient account has been issued, a valid assignment can only be made if the patient is released from their indebtedness, and personally presents to sign the bulk-bill form. This should be explained to the patient at the time of the assignment of benefit and the account should be returned to the doctor for cancellation.
Penalties may be imposed on any person who obtains a patient's signature on a bulk- billing form (assignment of Medicare benefits form), without the necessary details having been entered on the form before signature, or who fails to cause a patient to be given a copy of the completed form.
Compliance with these requirements is routinely monitored as part of Medicare Australia's source-based audit program.
Information about the assignment of Medicare benefits may also be found in the General Explanatory Notes, at paragraphs 7.5 – 7.10 (pp 11 – 13) of the Medicare Benefits Schedule Book; and also in the Medicare Australia publication Mediguide a guide for practitioners and practice staff; and the Health Insurance Act 1973; or by calling 132 150* and asking for a medical advisor (*Local call rates, normal mobile and phone charges apply).
Last updated: 28 July, 2008