Bulk billing a telehealth video consultation

Patients who have a telehealth video consultation with a specialist can assign their right to a Medicare benefit to the specialist.

Specialists, consultant physicians and consultant psychiatrists

Even though you and the patient aren’t at the same location during a telehealth video consultation, under section 20A of the Health Insurance Act 1973 the patient's signature is still needed on the General, Specialist and Diagnostic (assignment of benefit) form (DB4). You can get this form through Medicare Bulk Bill Webclaims using HPOS.

There are 3 ways you can get the patient's signature:

  1. you can send the completed General, Specialist and Diagnostic (assignment of benefit) form (DB4) to the patient to sign and return to you
  2. you can get an email agreement from the patient
  3. the practitioner supporting the patient during the telehealth consultation can ask the patient to sign the General, Specialist and Diagnostic (assignment of benefit) form (DB4) and return it to you. An example of this is where a patient is using the local GP’s surgery for the telehealth consultation - when the patient signs the (assignment of benefit) form, the GP sends it to the provider performing the telehealth service

Email agreement

For a patient to assign their right to a Medicare benefit to you by email, you must complete the following process.

For privacy reasons, don’t include the Medicare card number and provider number in the email.

Step 1

At the telehealth video consultation, tell the patient you wish to bulk bill Medicare for the service. To do this the patient will need to:

  • agree to the service being bulk billed
  • check the details in the email sent to their nominated email address, and
  • reply to your email, which will be considered a signature agreeing to assign the benefit

Step 2

Before submitting the claim, you need to send an email to the patient that includes all of the below:

  • the details of the service
    • item numbers or a description of the services
    • benefit amount for both the base and derived fee items
    • date and time of the services
    • patient's name (don’t include the Medicare card number)
    • practitioner's name (don’t include the provider number)
  • this statement
    'If you (the patient) agree to the assignment of the Medicare benefit directly to the provider (bulk bill), reply to this email including the following words:
    • Yes, I agree to the assignment of the Medicare benefit directly to the provider, and
    • your (the patient's) name'
  • this privacy note
    'Your personal information is protected by law, including the Privacy Act 1988, and is collected by the Australian Government Department of Human Services for the assessment and administration of payments and services. This information is required to process your application or claim. Your information may be used by the department, or given to other parties where you have agreed to that, or where it is required or authorised by law (including for the purpose of research or conducting investigations). You can get more information about the way in which the department will manage your personal information, including our privacy policy.'

Step 3

When you get a reply email from the patient with the required information:

  • complete a General, Specialist and Diagnostic (assignment of benefit) Voucher form (DB4)
    • for manually submitted claims write in the signature block ‘unable to sign, written email agreement provided’
    • for electronic claims, you don’t need to note the email signature but you must keep the patient's email consent on file
  • submit the claim to us in accordance with the Health Insurance Act 1973, 1975 Health Insurance Regulations and MBS
  • send a completed copy of the General, Specialist and Diagnostic (assignment of benefit) Voucher form (DB4) to the patient, and
  • keep the email with the patient's consent and email signature, in hard copy or electronic form for audit purposes for at least 2 years

    By noting 'email agreement' on the manual General, Specialist and Diagnostic (assignment of benefit) form (DB4), you acknowledge you’ve followed steps 1-3 above.

    This process complies with section 10 of the Electronic Transactions Act 1999, which outlines the steps to be taken for an electronic signature to be recognised.

    It also meets the legal requirement of needing a patient signature to assign a Medicare benefit.

Example email

Dear Mr Jones (patient)

Details of the telehealth consultation to be claimed with Medicare:

Item number: 104 Benefit amount: $71.35

Item number: 99 Benefit amount: $35.00

Date and time of consultation: 01.01.2015 10:30 am

Patient name: Peter Jones

Provider name: Jane Smith

Agreement

If you (the patient) agree to the assignment of the Medicare benefit directly to the provider (bulk bill), reply to this email including the following wording:

  • Yes, I agree to the assignment of the Medicare benefit directly to the provider
  • your (the patient's) name or the name of parent or guardian (where a child is the patient and unable to sign)

Regards
Dr Jane Smith

Privacy note: Your personal information is protected by law, including the Privacy Act 1988, and is collected by the Australian Government Department of Human Services for the assessment and administration of payments and services. This information is required to process your application or claim. Your information may be used by the department, or given to other parties where you have agreed to that, or where it is required or authorised by law (including for the purpose of research or conducting investigations). You can get more information about the way in which the department will manage your personal information, including our privacy policy.

Submitting Medicare Bulk Bill Webclaims using HPOS

A guide to help health professionals submit Medicare bulk bill claims electronically for real time assessment through HPOS.

Read more about submitting Medicare Bulk Bill Webclaims using HPOS.

Page last updated: 11 September 2017