Bulk billing versus Mixed Billing

Checking out the chart

We’re often asked a) what does this mean and b) which is is the best one to go for, if you’re UK or Irish GP

Here’s a quick guide.

Bulk-billing.This is where the practice accepts patients with Medicare cards and agrees to bill the government for the treatment the practice provides. Each patient is logged in, their card checked and then, when the patient has had a consultation or chargeable treatment, the practice bills the government for the time spent. The bills are sent in to the government in “bulk”, hence the name. Charges are fixed (though depend on the location and time of day / day of the week). Typically, a standard consult will be charged at $40. More for procedures / longer consult / evenings / weekends / rural area

Mixed-billing. This is where the practice does not accept patients on medicare bulk-billing terms. Usually, the practice wants to charge more for each consult. In these instances, patients (with or without Medicare cards) have their appointment and then pay the practice directly. Medicare card holders can then claim an amount back (I think $35) from the government towards their treatment.

Some practices operate both Bulk-Billing and Mixed-Billing. For example, all children and OAPs may be bulk-billed and all others mixed-billed. Alternatively, appointments between 09:00 and 17:00, Monday to Friday might be bulk-billed, with mixed-billing outside of this time.

Benefits of mixed-billing.

• Higher consult fee gives more income for the practice and the doctor per patient seen
• Potentially a longer consult for the patient, means more time and less pressure
• Allows variable pricing – so more charged during “unsocial” hours

Benefits of bulk-billing

• Bulk-bill services are free at point of use for the patient, so given the choice (and all other things being equal), patients will opt for a bulk-billing practice
• As you’re likely to see more patients as consults tend to be slightly shorter, the potential is there to build up your patient list more quickly

Our view is that while a mixed-billing practice looks to be the best option on paper, on the ground, it’s not so clear cut. There are now more doctors in Australia and in suburban areas at least, patients are beginning to get a choice of which practice they go to. There’s quite a bit of anecdotal evidence that patients are moving over to a bulk-billing practice when available. So, in suburban areas at least, a bulk-billed practice may well be the best option.