Assignment of benefit

Signature requirements when a patient assigns their Medicare benefit to the servicing provider as full payment for health services.

If a patient is unable to sign an assignment of benefit form, you can get a signature from any of the following:

  • the patient’s parent
  • the patient’s guardian
  • another responsible person.

In the absence of a parent, guardian or responsible person, leave the ‘patient signature’ section blank.

Where the signature space is either left blank or another person signs on the patient’s behalf, the assignment of benefit form must include the following:

  • the notation ‘Patient unable to sign’
  • in the ‘Practitioner’s Use’ section, the reason why the patient was unable to sign. For example, use ‘unconscious’, ‘injured hand’ or ‘verbal consent obtained’.

If you’re submitting a claim using Medicare Easyclaim, you can get consent for assignment of benefits from the patient, the patient’s parent, guardian or other responsible person using the EFTPOS terminal. Press the OK or YES button on the EFTPOS terminal.

Responsible person

‘Responsible person’ refers to an adult person accompanying the patient or in whose care the patient has been placed.

A responsible person can include someone who is any of the following:

  • the parent or guardian
  • holds power of attorney
  • holds a guardianship order
  • the next of kin.

This does not include the:

  • health professional who rendered the service
  • health professional’s staff
  • hospital proprietor or staff
  • aged care home proprietor or staff.

Patient unable to sign - sensitive issue

If you assess the reason a patient is unable to sign is of a highly sensitive nature, write in the ‘Practitioner’s Use’ section either:

  • ‘due to medical condition’
  • ‘due to sensitive condition’.

Only do this if revealing the reason would:

  • mean an unacceptable breach of patient confidentiality
  • unduly embarrass or distress the recipient of the patient’s copy of the assignment of benefit form.

This should not be routine practice. You can’t use ‘extenuating circumstances’ as a reason for no patient signature.

Patient unable to sign - deceased

You and the patient must have entered into a bulk bill agreement at the time of service. This must include having the patient sign the assignment of benefit form.

If the patient has not signed the form, a signature from a responsible person is acceptable.

A responsible person can be either:

  • the executor of the will
  • an appointed administrator.

You must not write ‘patient deceased’ as a reason for not getting a signature on the assignment of benefit form.

Email agreement

Follow the steps in the table below when a patient assigns their right to a Medicare benefit to you by email.

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

StepActions
1. Tell the patient you’re bulk billing

At the telehealth 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
  • reply to your email, which will be considered a signature agreeing to assign the benefit.
2. Send email to the patient

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

  • the details of the service
  • customer statement
  • privacy notice.

The details of the service should include all of the following:

  • item numbers or a description of the services
  • benefit amount for the items
  • date and time of the services
  • patient’s name (don’t include the Medicare card number)
  • health professional’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 health professional (bulk bill), reply to this email including the following words:

Yes, I agree to the assignment of the Medicare benefit directly to the health professional, 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 Services Australia 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 agency, 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 agency will manage your personal information, including our privacy policy.’
3. Submit the claim

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 ‘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.

You must then:

  • submit the claim to us in accordance with the Health Insurance Act 1973, Health Insurance Regulations 2018 and MBS
  • send a completed copy of the General, Specialist and Diagnostic (assignment of benefit) Voucher form (DB4) to the patient.

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

We recommend you keep a copy of all emails, claims and forms for at least 2 years. This is for auditing purposes if you are subject to a compliance review.

This process complies with section 10 of the Electronic Transactions Act 1999. This act 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: 91822

Benefit amount: $78.05

Date and time of consultation: 01.07.2022 10:30 am

Patient name: Peter Jones

Health professional name: Jane Smith

Agreement

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

  • ‘Yes, I agree to the assignment of the Medicare benefit directly to the health professional.’
  • 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 Services Australia 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 agency, 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 agency will manage your personal information, including our privacy policy.

Assignment of benefit and signature requirements for telehealth services

You need your patient’s agreement to bulk bill the items before we can pay you the Medicare benefit, or the agreement of a responsible person for the patient. For example, a responsible person could be a child’s parent.

You can obtain a patient’s agreement in writing or by email for telehealth services. You’ll need to complete an approved assignment of benefit form. You must give the patient a copy of the completed approved form.

Read more about how you can get a patient’s agreement for a telehealth service by email.

Verbal assignment of benefit for telehealth services

If you can’t get patient agreement in writing or by email for telehealth services, you can get verbal agreement from your patient during the telehealth consultation.

You must complete the form approved for the purposes of s 20A of the Health Insurance Act 1973 electronically. You can use these approved forms:

Explain to the patient how you’ll fill in the Patient signature field in the approved form and confirm that the patient agrees. If the patient agrees, you need to type patient verbally agreed in the Patient signature field. You must send the completed form electronically to your patient.

If the patient doesn’t agree to assign their benefits, you can send them a private bill for the service.

You should keep a copy of all correspondence, claims and forms for at least 2 years. This is for auditing purposes if you are subject to a compliance review.

Getting verbal agreement is a temporary measure.

These requirements are not applicable to patients accessing health care funded by the Department of Veterans’ Affairs.

Page last updated: 15 June 2024.
QC 74298