What is Bulk Billing?

Bulk billing is when a provider bills Medicare directly for any medical or allied health service that the patient receives and accepts the Medicare benefit as full payment for their service. There are no out of pocket expenses for the patient in a bulk billing arrangement.

How does it Work?

The best way to explain how bulk billing works is to give a practical example of a simple doctor’s surgery transaction.

A transaction using the Bulk Billing payment system:

1. A doctor charges a consultation fee which is an amount determined by Medicare.
2. The patient presents their Medicare card to the receptionist.
3. Medicare deposits the set amount directly into the doctor’s account.
4. The doctor is not allowed to charge any additional fees to the patient.
5. The patient has seen the doctor at no cost whatsoever.

A transaction using the public Medicare payment system:

1. A doctor sets their consultation fee, say $75.
2. The patient pays the receptionist $75 and is issued a receipt.
3. The patient goes to their nearest Medicare office (or completes an online claim) and Medicare reimburses the patient a set amount, currently around $36.
4. Some doctor’s surgeries have the ability to swipe the Medicare card or enter the card details on the spot and only charge the patient the out-of-pocket cost – the consultation cost less the Medicare rebate.