Bulk Billing

What is Bulk Billing?

We find that a lot of the time when people ask to be bulk billed they don’t know what it means other than they don’t have to pay anything for their appointment.  Sometimes people can be annoyed if the doctor does not agree to bulk bill.  Deciding on which patients to bulk bill is something we give a lot of consideration to because we want to make health care accessible to everyone that needs it, but we also want to provide a high quality service.  For this reason we provide the following information so that our patients have an idea of what bulk billing is so that when people ask to be bulk billed, they understand what they are asking for.

The Australian government introduced Medicare in 1984 as an equitable and efficient means of providing health insurance coverage for all Australians.  In its simplest form, Medicare is a compulsory, government operated health insurance scheme.  Each year, all eligible Australians pay a Medicare Levy through their taxation return that is based on a percentage of their income.  The funding from this is distributed via a Medicare rebate that each Australian is entitled to claim for eligible medical services.  This is known as the Medicare rebate.

How does this relate to bulk billing?  When you visit a doctor, like any other service-based business you go to, it attracts a fee.  Let’s for example, take the standard consultation private fee of $81.  That means if you are privately billed you are charged $81 at the end of your consultation.  The Australian Medical Association determines this fee after consideration of the costs involved in providing the service.

Under the Medicare Benefits Scheme you are entitled to a Medicare rebate for this service of $37.60 which means that after you have claimed the rebate the service has cost you $43.40.  So at the end of the appointment, the fee received is $81.  The government provides you with $37.60 of this and you have to pay $43.40.

When you asked to be bulk billed, you are asking the doctor to accept the Medicare rebate for the service provided so that you do not have to make any contribution for the service.  If the doctor agrees, the fee received is $37.60, which is all paid by the government and none by the patient.  So asking to be bulk billed is the same as asking the doctor to discount the fee by 53%.

When a doctor bulk bills a child under 16 years old or a patient with a government Health Care Card, Medicare provides an extra $9.50 for the consultation as a bulk billing incentive. This means that for a standard appointment the fee received is $47.10.  This is still only 58% of the private fee but we absorb this reduction so that people that the government deems as requiring added financial assistance do not miss out on accessing health care.

The following table helps to simplify the explanation:

Standard Consultation Billing Type Patient Contribution Medicare Rebate Fee Received % of Patient Contribution to Fee % of Private Fee Recd
Private billing $43.40 $37.60 $81 53% 100%
Bulk Bill (no Health Care Card and 16yo +) $0 $37.60 $37.60 0% 47%
Bulk Bill (under 16yo and/or HCC holder) $0 $47.10 $47.10 0% 58%

Please see our Billing Policy Section for an explanation of our bulk billing policy.