What is the Difference Between Bulk Billing, Private Billing & Mixed Billing

Bulk Billing

A bulk billing GP is a doctor who provides their services at no cost to their patients. Instead of paying for the appointment, the GP bills Medicare directly. Medicare is Australia’s national health care system that works to provide affordable health care for Australians

Bulk-billing is a service that health professionals such as doctors, specialists, optometrists, dentists and other allied health practitioners can choose to offer.

If your health professional chooses to bulk bill, the full cost of your appointment is covered by Medicare

Private Billing

The patient is billed an out-of-pocket fee determined by the practice. If the patient is a Medicare card holder, they may be eligible to claim a rebate from Medicare. For those not eligible for Medicare may be billed privately.

Mixed billing

Both bulk billing and private billing is used in the practice.

Many practices have formal policies about which patients should be bulk billed, such as concession card holders and young people.

Many general practitioners also selectively bulk bill some patients, such as people who may not be able to pay a fee.

You should consider these variations in billing policies, and models should be flexible enough to allow for variations.

Other Commonwealth funding

General practice can access additional funding through the Commonwealth that may be applicable to service models, including:

  • The Practice Incentives Program
    The Practice Incentives Program (PIP) encourages general practices to continue providing quality care, enhance capacity, and improve access and health outcomes for patients
  • Service Incentive Payments (SIP) While PIPs are made to the whole practice, the Service Incentive Payments (SIPs) are made to the individual provider of the service, who is working with a practice that is enrolled in the PIP.
  • The Practice Nurse Incentive Program
    Provides incentives to general practices who employ nurses, Aboriginal and Torres Strait Islander health workers and practitioners, and allied health professionals.