What is Medicare Assignment of Benefit? A Guide for GPs

The Mechanics of Section 20A

Bulk billing is a fundamental part of the Australian healthcare system, but many practitioners don't fully understand its legal basis. Under Section 20A of the Health Insurance Act 1973, a Medicare benefit is technically the property of the patient. When a GP "bulk bills" a service, they are not billing Medicare directly; they are agreeing to accept the patient's Medicare benefit as full payment for the service.

For this transaction to be legal, the patient must assign that benefit to the GP. This transaction is called the Assignment of Benefit (AoB). Because it involves the transfer of a financial benefit from the patient to the practitioner, the patient must formally consent to it.

The Rise and Fall of Verbal Consent

For decades, physical signatures on DB4 forms were the only approved method. During the COVID-19 pandemic, verbal consent options were introduced to support telehealth. Unfortunately, this led to a drop in record-keeping quality across the sector. Many practitioners stopped collecting signatures altogether, relying on shorthand notations in their clinical software. The 1 July 2026 changes restore the original intent of the law: that a patient must explicitly approve the transfer of their Medicare entitlement for every individual service.

What Happens if You Don't Collect Consent?

If you bulk bill a patient but fail to obtain a signed Assignment of Benefit consent, you have technically billed without authority. During an audit, Services Australia can demand that you produce the consent record. Without it, the claim is rejected, and the practice is liable to repay the bulk-billed fee in full. This is why having an automated, structured consent collection process is essential for any modern bulk-billing practice.