Health professionals seeking recoveries from patients
Bulk billing is when your doctor (or dentist) bills Medicare directly for any medical or dental service you receive. If your doctor (or dentist) bulk bills for a service, you have agreed to assign your right to the Medicare benefit which is payable in relation to the service to the doctor or dentist, and the doctor or dentist has agreed to accept that assignment in full payment of the service.
What should I do if my doctor (or dentist) bulk bills me under Medicare for a medical or dental service I received but then asks me to pay a bill in relation to this service?
Medicare Australia considers it inappropriate for any doctor or dentist to ask a patient to pay fees in relation to a medical or dental service after they have bulk billed the patient for that service.
If you receive a bill or invoice for fees from your doctor or dentist in relation to a service—after you have been bulk billed for that service under Medicare—it may be reasonable for you to refuse to pay the bill or invoice.
Refusal is considered reasonable on the basis that you have already paid for the service by assigning your right to the Medicare benefit payable in relation to the service to the rendering doctor.
My doctor (or dentist) says I need to pay a bill in relation to this service because Medicare Australia refuses to pay their claim for the service, or is seeking to recover the Medicare benefits which were paid to the doctor or dentist. Do I have to pay this bill?
If Medicare Australia has refused to pay the doctor’s (or dentist’s) claim under Medicare or is seeking to recover the Medicare benefits which were paid to the doctor or dentist in relation to the claim, it is generally the result of the doctor (or dentist) failing to have met legal requirements.
It may be reasonable for you to refuse to pay the bill or invoice on the basis that you have already paid for the service by assigning your right to the Medicare benefit payable for the service to the rendering doctor (or dentist).
If Medicare Australia has identified a problem with your doctor or dentist’s claim for payment it does not affect your original agreement with your doctor (or dentist)—the assignment of your right to a Medicare benefit in relation to the service as full payment for the service.
Medicare Australia takes the view that once a doctor (or dentist) has agreed to bulk bill a patient under Medicare for the service, the doctor (or dentist) can only seek payment for that service from Medicare Australia.
Note: this also applies in circumstances where Medicare Australia is seeking to recover the Medicare benefits paid to the doctor for the claim.
My doctor is threatening to take me to court if I don’t pay this bill. What should I do if my doctor does take legal action against me?
In the unlikely event your doctor (or dentist) did seek to take legal action against you in these circumstances, you may wish to consider obtaining your own independent legal advice on the matter.
More information
Email—medicare@medicareaustralia.gov.au
Write—Medicare Australia
GPO Box 9822
in your capital city
Call—132 011*
TTY—1800 552 152** (hearing and speech impaired)
TIS—131 450* (Translating and Interpreting Service)
* Call charges apply
** Call charges apply from mobile or pay phones only
Health professionals seeking recoveries from patients [PDF, 161Kb]
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Last updated: 25 February, 2011