Simplified billing
Simplified billing is an initiative of the Australian Government Department of Health and Ageing. It aims to make private health insurance and the private health sector more attractive, more affordable and better value for consumers.
Quite simply, the goal of simplified billing is to reduce the number of accounts a private patient receives after being in hospital.
This requires a cooperative effort between Medicare Australia, private health funds and billing agents (usually a hospital or day surgery centre). By working together, these organisations can streamline the way patients pay their bills and claim benefits from Medicare and their private health fund, leaving them free to concentrate on recuperating.
Medicare Australia is required under legislation to consider applications for registration as a simplified billing agent and is also responsible for auditing them.
Individuals or companies wishing to establish a billing agency need to contact Medicare Australia for an application kit on 02 6143 7557 or email simplified.billing@humanservices.gov.au
Application for late lodgment of a simplified billing claim for assigned Medicare benefits
From 1 April 2007 you will need to complete a late lodgment form for all simplified billing claims lodged over 2 years after the date of service. This is in line with subsection 20B(2)(b) of the Health Insurance Act 1973. This form can be submitted to Medicare Australia through a nominated health fund or billing agent on your behalf.
Approved Billing Agents
The current list of approved billing agents and their contact details is attached below.
Simplified billing forms
- Simplified billing adjustment claim Form [PDF, 166Kb]
- Application for late lodgement of a simplified billing claim for assigned Medicare benefits [PDF, 135Kb]
Use these forms to register with Medicare Australia's Online Technical Support Helpdesk for:
- payment of Medicare benefits by electronic funds transfer for Simplified billing, and
- to participate in electronic data interchange with Medicare Australia for Simplified billing.
For further information or questions contact the helpdesk on 1300 550 115.
Billing Agents
- Billing agent - electronic transmission of Medicare claims agreement [PDF, 89Kb]
- Billing agent - electronic funds transfer (EFT) registration form [PDF, 82Kb]
Health funds
- Health fund - electronic transmission of Medicare claims agreement [PDF, 71Kb]
- Health fund - electronic funds transfer (EFT) registration form [PDF, 81Kb]
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Last updated: 3 May, 2013