If the patient does not agree to assign their Medicare benefit, they should be privately billed and provided with an invoice to enable them to claim their Medicare benefit from Services Australia. You must not bulk-bill without an AoB.
What is 'Implied' assignment?
Where a medical provider, has an agreement with an insurer, for example where a service is billed through a medical purchase provider agreement (MPPA), there are no requirements for signatures or approvals from the assignor or patient.
Providers who have agreements with BUPA or HBF for No Gap and Known Gap claims would fall under this heading. Strictly speaking, you would not be required to obtain an AoB for IMCs to these funds, however we recommend doing so to avoid potential issues.
For all other Health Funds (Medibank Private, NIB, all Australian Health Service Alliance (AHSA) and Australian Regional Health Group (ARHG) funds, etc) AoB must specifically be requested prior to submitting a claim.
Do I need AoB for Medicare Claims?
No, with Medicare claims (as distinct from Bulk Bill claims) the benefit never goes directly to the provider. Therefore no AoB is required.
Do I need AoB for Workcover or other third-party Claims?
No, only claims with a Medicare benefit require AoB.
How does AoB work in aged care and nursing home settings?
An AoB for bulk billed services is required in aged care settings. Where a patient lacks mental or physical capacity to make their own financial or health decisions, an assignor can do so on their behalf. Under the Health Insurance Act 1973, an assignor is a person who would otherwise meet the cost of medical expenses. In practical terms this is usually a carer, partner, parent, or a person with Power of Attorney.
The department is working to finalise regulations to support enduring AoB for patients who are registered in MyMedicare or receive services from an Aboriginal Community Controlled Health Organisation (ACCHS) or Aboriginal Medical Service (AMS). Enduring AoB will require an agreement to be signed once (by a patient or their assignor), for ongoing and future services from a preferred clinic/practice. The use of an enduring assignment will have a post-service notification requirement. This will require providers to send a notification to patients after a related service. Enduring assignment will commence in 2027.