Bulk Billing for Australian Specialists

Bulk billing is a Medicare payment arrangement, not a synonym for outpatient care. A specialist may bulk bill an eligible service in an outpatient setting and bulk billing can also be relevant in hospital settings for private patients where the Medicare rules allow it.

What bulk billing means

When a patient is bulk billed, the Medicare benefit is assigned to the servicing provider as full payment for the Medicare service. The patient has no out-of-pocket cost for that service. Services Australia: assignment of benefit.

Bulk billing can be inpatient or outpatient

The Department of Health's current assignment-of-benefit guidance specifically refers to bulk-billed services provided in primary care and hospital settings for private patients. That distinction matters: inpatient/outpatient describes where care is delivered, while bulk billing/private billing describes how an eligible Medicare service is billed. Department of Health: assignment of benefit process.

Public patients are different

Public patients in public hospitals receive public hospital treatment under public funding arrangements. A service is not turned into a public-patient service simply because a doctor bulk bills it. Medicare claiming rules for public hospitals and private patients must be applied correctly.

DEVZ bulk-billing support

DEVZ can process eligible bulk-billed specialist services as part of an outpatient or inpatient billing workflow, subject to the correct assignment-of-benefit and claiming pathway. Our core specialty remains the more complex inpatient environment.