What's new?

July 2014

Improvements will be made to the way some PBS medicines are processed under the Highly Specialised Drugs Programme from 1 July 2015.

Bulk billing - Frequently Asked Questions

What is bulk billing?

Bulk Billing is when a provider bills Medicare directly for any medical or allied health service that the patient receives.

Where a provider and a patient enter into a bulk billing arrangement, the:

  • Provider accepts the relevant Medicare benefit as full payment for the service, and
  • Patient assigns their right to a Medicare benefit to the servicing provider, allowing the benefit to be paid directly to the payee provider

If a practitioner bulk bills for a service, the practitioner undertakes to accept the relevant Medicare benefit as full payment for the service. Additional charges for that service cannot be raised.

You must lodge a claim for assigned benefits in accordance with the approved forms and within a period of up to two years from the date of service.

Further information about bulk billing can be found in Explanatory Note G7.1External link in the MBS Online.

How does a patient assign their right to a Medicare benefit?

A patient can assign their right to a Medicare benefit to the servicing provider by signing a completed approved assignment of benefit form for manual and online claiming. The patient or other responsible person must not sign a blank or incomplete assignment of benefit form.

With Easyclaim, a patient can assign their right to a Medicare benefit to the servicing provider by pressing the OK or YES button on the EFTPOS terminal in the practice.

What is the correct way to manually bulk bill?

To complete the Bulk Bill (Assignment of Benefit) form, you must:

  1. Enter all required details on the assignment form. You need to do this before you get the patient's signature.
  2. Have the form signed and dated by the patient.
  3. Give a copy to the patient (legislative requirement).

You must complete a DB1 header and submit it with the completed assignment of benefit form/s in order to make up a claim. The correct header must be completed for the type of assignment of benefit form being used.

Note: If you choose to bulk bill, the patient assigns their right to Medicare benefits to you as payment for the service they received.

How do I send claims electronically?

To submit bulk bill claims to us electronically, you can use:

What if the patient can’t assign their right to a Medicare benefit?

If the patient can’t assign their right to a Medicare benefit, for manual and online claiming, a signature from the patient's parent, guardian or other responsible person is acceptable on the assignment form. You must notate in the ‘Practitioner Use’ field the reason for the patient’s inability to sign (e.g. unconscious, injured hand, etc) and initial or sign the notation. If there isn’t a responsible person available, the ‘Patient signature’ field on the form must be left blank.

For Easyclaim, consent from the patient's parent, guardian or other responsible person to press the OK or YES on the EFTPOS terminal is acceptable.

Do I need to use different forms for different services when bulk billing manually?

Yes – there are different forms available for different services and it’s your responsibility to make sure the correct forms are used when claiming Medicare benefits.

  • DB1H – In-hospital Services Header
  • DB1N – Out of hospital Services Header
  • DB2-GP – General Practitioner Voucher
  • DB2-OP – Optometrist Voucher
  • DB2-OT – Other Practitioner Voucher
  • DB1N-AH – Allied Health Header
  • DB2-AH – Allied Health Voucher
  • DB3 – Pathologist Voucher
  • DB4 – General, Specialist and Diagnostic Voucher
  • DB4E – Electronically Transmitted Claims Voucher
  • DB5 – Pathology (continuation form) – carbon only
  • DB1-DP – Allied Health Chronic Disease Dental Scheme Header
  • DB2-DP – Allied Health Chronic Disease Dental Scheme Voucher
  • DB1N-DB – Teen Dental Header
  • DB2-DB – Teen Dental Voucher

Who can order Medicare stationery and how?

Providers who don’t have computer or internet access, or providers who undertake consultations outside of consulting rooms (i.e. nursing home visits, after hours consultations etc) can continue to order carbon bulk bill forms. To order bulk bill forms, complete the Medicare stationery order form [PDF, 209Kb]PDF reader required and:

  • mail to:

Department of Human Services
GPO Box 1909
Canberra City ACT 2601

If you have a special requirement or would like to follow up on your order, call Toll on 1800 067 307 (call charges may apply).

Note: A Business Development Officer may follow up with you after an order is placed to discuss other claiming options.

Can my locums sign their section of the DB1 form before they see their patients?

No. DB1 forms can only be signed by the servicing provider when the DB1 is completed and after the completed assignment of benefit forms are attached to the claim.

If they’re employed by a practice, we will pay the practice if the ’Payee Provider’ section has been completed.

Can I mix in-hospital and out of hospital services in one batch of bulk billed claims?

No. You will need to complete the DB1N header if you are claiming for out of hospital services, or a DB1H header if claiming in-hospital services.

For in hospital services, you need to write in-patient just before the description of the service on the assignment of benefit form, or put an asterisk directly after the item number. For more information, go to the relevant instruction sheets.

Can I use bulk billing facilities as a form of debt collection for unpaid accounts?

No. Settlement of accounts for a service provided by a doctor is a matter between the doctor and the patient.

Where the patient hasn’t paid the account in full, the unpaid account may be presented to Medicare with a completed Medicare claim form. In this case Medicare will forward to the claimant a benefit cheque made payable to the provider. It is the patient's responsibility to forward the cheque to the provider and make arrangements for payment of the balance of the account, if any.

Where can I find further information about the assignment of Medicare benefits?

Information about the assignment of Medicare benefits can be found in the General Explanatory Notes of the Medicare Benefits Schedule and the Health Insurance Act 1973, or by calling 132 150* (Local call rates, normal mobile and phone charges apply).

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Last updated: 1 May, 2014