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What is a Medicare Assignment of Benefit?

When you bulk bill a patient, you accept the Medicare rebate as full payment for a service.

To do this, the patient must agree to assign their Medicare benefit to you. This is called an Assignment of Benefit (AoB). Once assigned, the patient does not pay anything out-of-pocket (in line with their rebate entitlements).

This does not apply to patient-paid claims, where the patient pays upfront and claims the benefit themselves.

Why are the rules changing?

During COVID-19, temporary arrangements allowed verbal consent to assign benefits in some cases.

A later review in 2023 identified risks with this approach, including:

  • Invalid claims
  • Repayment (clawback) risk
  • Fraud or non-compliance concerns

The requirements are being updated so patient consent is clear, properly recorded and easier to verify.

What's changing?

From 1 July 2027:

  • Verbal consent will no longer be accepted
  • Patients must provide a signature (including digital)
  • A specific form is no longer required, but the minimum required information for an Assignment of Benefit must be captured and reported
  • Consent can be collected before or after the service, but before the claim is submitted
  • AoB records must be stored and aligned to the claim data

Who is responsible for an AoB?

The practice submitting the Medicare claim is responsible for meeting Assignment of Benefit requirements.

This includes:

  • Obtaining a valid patient agreement to assign the Medicare benefit
  • Capturing that agreement correctly (including a signature and required data)
  • Keeping records of that consent
  • Only submitting a claim once valid assignment has been completed

How Smart Health supports compliance

Smart Health helps support the updated Assignment of Benefit requirements by capturing and storing the required information as part of the Medicare Bulk Billing claiming workflow.
This helps reduce manual effort and supports a more consistent consent process. Practices remain responsible for meeting Medicare requirements and should seek independent advice where needed.

If you use Smart Health for bulk billing

(standalone or integrated bulk billing where your PMS supports it, e.g. PPMP, Dental4Windows, Core Practice)

Your current workflow already aligns to the new requirements. Services Australia has confirmed that this workflow is accepted for capturing an Assignment of Benefit.

How it works:

  • The patient reviews the invoice at the terminal
  • The patient selects “I accept the benefit”
  • A digital record of consent is captured and stored

This captures:

  • The patient’s electronic signature
  • Assignment of Benefit
  • Approval to submit the claim

Record keeping:

  • Receipts are securely stored in Smart Health Hub (up to 7 years)
  • This meets AoB storage requirements

What this means for you:

  • No change to your workflow
  • Minor wording updates will be made to receipts

If you use a PMS without integrated bulk billing via the Smart Health terminal

(e.g. Optomate Touch, Best Practice (Bp Premier), Principle Theorem)

In this setup:

  • Bulk billing is completed within your PMS
  • AoB capture also happens within your PMS workflow

What this means for you:

  • Smart Health is not involved in bulk billing in this scenario
  • You should make your own enquiries directly with your PMS to ensure compliance with updated AoB requirements

Will anything change for patients?

Receipts and invoices will be updated slightly to better reflect patient consent.

Patients will continue to:

  1. Review their service details
  2. Confirm acceptance of the Medicare benefit

Want to learn more?

Things you should know

  • This information is provided for general guidance only and should not be relied upon as legal, tax or financial advice.