Bulk billing

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Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. 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). In order to claim the Medicare rebate, the patient then has to visit a Medicare office, fill out a claim form (for unpaid claims and claims where cash is not being refunded) and claim 75% of the scheduled fee from the government (100% for general practitioner services).[1]

Under Medicare, it is 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.

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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