Medical Billing Outsourcing Companies

A Guide on Bulk Billing vs Private Billing for Medical Billing Outsourcing Companies

Are you new to medical billing outsourcing companies in Australia? Then you must probably be aware of two kinds of billing payments, Bulk Billing and Private Billing.

These are challenging and have many common misconceptions about the differences. For a clear idea on the process and how medical billing works in Australia, learning about Bulk Billing and Private Billing will tranquilize your thoughts and have significant bearing on the healthcare practice.

What is Bulk Billing?

  • Medicare is a government operated healthcare insurance scheme that aims to provide access to efficient and equal health insurance to all the citizens of Australia.
  • All Australians are eligible for Medicare and Medicaid services that can be claimed out of it.
  • When medical billing outsourcing companies are ready to bill for Medicare patients for the services rendered by the healthcare professionals, the payment will be processed through the Medicare card.
  • Later on, the government will reimburse the payments’ full fee with percentage of 65 to 70 where it can also be negotiated.
  • Bulk Billing is where Medicare is responsible for payments those are directly sent by the healthcare professionals.
  • Bulk Billing= patients will assign the bills with a right for refund. The healthcare professionals without any additional charges will bill the amount for the services rendered.

What is Private Billing?

  • Private Billing which is also known as mixed billing is where patients who repay their medical services on their own and can split or divide the payments and cover them through insurance companies.
  • Private Billing means patients paying their services fee in advance by collecting the receipt from the provider and takes it to Medicare and get the money back.
  • Private Billing= healthcare professionals set a price for the services rendered; patients pay the amount from their pocket, get a receipt from the healthcare professionals and submits for reimbursement.
  • Healthcare professionals can assist or help with electronic claim and make it a continuous process which is not compulsory.

The Common Misconceptions:

  1. The Bulk Billing practices attract lower socio -economic patients:

  • This is false. To the matter of fact, bulk billing practices deal with opulent patients due to suitable ‘no appointments’ system.
  1. Private Doctors deal with more minor medical cases:

  • This is merely a misconception. Healthcare professionals experience a wide range of patient conditions.
  1. Private healthcare professionals earn more compared to Bulk Billing professionals:

  • The stereotypes of healthcare professionals in private, earning less than Bulk Billing is inaccurate.
  • The medical practices involve all kinds from all over the country and there is no evidence to prove the claim.
  • Medical billing outsourcing companies will have the chance to hear all these misconceptions and inaccuracies about billing practices that must be ignored.

Advantages of Bulk Billing:

  • Healthcare professionals who have more number of patient consultations and prescribe more number of medicines are considered to be skillful. So, Bulk Billing medical work is based on CV and is well reputed.
  • In case of unusual expenses or complicated consultations, healthcare professionals charge additionally to their patients. This can be reclaimed by the patients from Medicare for the amount charged by the healthcare professional.

Advantages of Private Billing:

  • As medical billing outsourcing companies, it’s important to understand the advantages of Private Billing and Bulk Billing to excel in the industry with vast opportunities.
  • Private healthcare professionals will have more patients repeatedly visiting for consultations and helps to develop a good rapport and gain better knowledge about patients’ medical history.
  • Healthcare professionals those are habituated with Private Billing often have lower daily patient intake and healthcare professionals will get to spend more time with their patients and a chance to improve patient responsibility.

5 Important things Medical Billing Outsourcing Companies must know about Private Billing:

  1. The mix:

  • Many general healthcare professionals choose to bill a percentage of their patients through Bulk Billing and rest of the percentage through Private Billing.
  • However, the charge varies depending on the patients ready to bulk bill or private bill.
  • Children and OAPs are mostly bulk billed while patients pay on top of rebate.
  • General healthcare professionals choose to add additional charges for the appointments those exceed working hours.
  • The patients can take the receipt to Medicare or sometimes healthcare professionals will submit them for reimbursement.
  1. Time Pressure:

  • One of the main and extremely important benefits of Private Billing is that it allows a smooth in and out for the patients without any pressure and as quickly as possible.
  • It also gives an opportunity for the healthcare providers to develop better patient responsibility with good patient care.
  1. Less number of Patients:

  • General healthcare professionals usually show the data of small reduction in patient numbers after initiating private fees.
  • From a financial perspective, the healthcare professionals would maintain lower patient base with those patients who pay higher charges.
  1. Increasing Popularity:

  • The ongoing Medicare freeze is letting many healthcare professionals introduce Private Billing.
  • A survey stated that more than 500 healthcare professionals by RACGP found 29% we’re changing from Bulk Billing to Private Billing as they find it more productive.
  1. Bulk Billing Indicators:

  • While it’s often considered that Bulk Billing rates have continued to increase but some healthcare professionals comment that bulk billing is mostly misinterpreted.
  • Usually, the bulk billing rate is based on the services than at a patient level for which 84% of services are bulk billed and 84% of patients aren’t bulk billed.
  • This could indicate the broadened access and healthcare growth.

Hope you got the information on Bulk Billing vs Private Billing for medical billing outsourcing companies. For suggestions, please comment below. We will surely consider them. For more queries and updates on healthcare, please subscribe to our blog.

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