Bulk billing

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Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. It can cover a prescribed range of health services as listed in the Medicare Benefits Schedule, at the discretion of the health service provider.[1] The health service provider, usually a Doctor is paid 85% of the scheduled fee directly by the government by billing the patient via their Medicare card. The service provider receives only 85% of the scheduled fee but avoids the costs and risks of billing and debt collection. It could be described as a form of factoring.

The alternative to bulk billing is for the service provider to collect the fee directly from the patient (there is no restriction on this fee, which is determined by the provider). The patient may then claim the rebate online, over the telephone, by mail, at a Medicare office, or some service providers offer electronic lodgement at the practice using EFTPOS.[2] That rebate is generally 75% of the scheduled fee (100% for general practitioner services).[3]

Previously under Medicare, it was not permissible to charge the patient a co-payment with bulk billing (although this was previously permissible): a service provider who bulk bills for a service may not charge the patient further for that service. However under reforms initiated by the Abbott Government in 2014, it was announced that a new provision would be introduced in the 2014 budget to include a $7 co-payment for all bulk billed GP and medical test visits. The co-pay measure was initially recombined by the Commission of Audit and adopted as a measure in the federal budget, to be implemented from the start of the 2015 finical year. The co-payment has been described rationing measure to decrease the frequency of unnecessary GP visits however the exact reasons for this measure have not been fully explained. The funds gathered from this measure are to be designated to funding a new national medical research fund. The co-payment works by reducing the medicare rebate available to providers by $5 with the extra $2 profit going to providers. Several GP clinics have indicated that they will weather this loss of revenue in order to continue providing free GP visits.

Service providers may choose whether or not to use bulk billing. Most general practitioner services are bulk-billed, but less so in more affluent areas and in rural, regional and remote areas of Australia where there is a greater shortage of doctors and health care services. The key purpose of bulk billing is to provide an economic constraint on medical fees and charges.


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