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Assignment of Benefit (AU)

From 1 July 2026, the Medicare Assignment of Benefit (AoB) process will undergo a major digital transformation, supported by legislative changes and the need for more secure and efficient healthcare billing. Assignment of Benefit (AoB) refers to the process by which a patient authorises Medicare to pay their benefit directly to the healthcare provider, rather than reimbursing the patient.

In Bp VIP.net, new radio buttons have been included to indicate Implied or Requested Assignment of Benefits for IMC claims, and the DB4 Bulk Bill Assignment of Benefit Agreement form has been updated to include the new required fields.

IMPORTANT   These changes will not be enabled in Bp VIP.net until the changeover date of 1 July 2026.

NOTE  For more information see the Australian Government Department of Health, Disability and Ageging (DoHDA) website.

Implied (I) or Requested (R) Assignment of Benefits

In Bp VIP.net Topaz SP4, radio buttons in the Provider Setup and In-Patient Medical Claims screens have been introduced to indicate Implied or Requested Assignment of Benefits for IMC claims.

Assignment of Benefit Work Type Definition

Implied (I)

If the Work type is Scheme/Contract (SC) or Agreement (AG), then the default Assignment of Benefit value is Implied (I).

Implied assignment applies if a health professional has an agreement with an insurer (e.g., Medical Purchaser Provider Agreement or Gap Cover Agreement) and it applies to the service assigned/to be assigned. The terms of each insurer agreement may vary depending on each insurer and health provider.

Requested (R) 

If the Work type is None, the default Assignment of Benefit value is Requested (R).

A Requested assignment (R) may be required:

  1. Where the patient is covered by a complying health insurance policy, but the provider does not have an agreement (e.g. Private patient in public hospital). In this scenario, the PHI would still need to pay 25% (as Medicare has paid the 75%).

  2. Where the provider chooses to charge above what is in the agreement (e.g. More than 300% of item – more than permissible gap).

  3. Where the provider chooses to bill an item that is not in the agreement.

Assignment of Benefit for In-Patient Medical Claims

Implied or Requested Assignment of Benefit radio buttons are set as defaults in the Private Fund Details section of the Provider Setup screen and used in the In-Patient Medical Claims screen.

To view the Assignment of Benefit default value for a Health Fund: 

  1. Go to Setup > Providers > This Clinic.
  2. Select the Provider record to edit and click Modify.
  3. Select the Online tab.
  4. Select the Private Fund you wish to view contract details for.
  5. Click Modify.

  6. The Private Fund Details screen will open for the selected Health Fund.

Defaults set in the Private Fund Details screen per provider will be used in the In-Patient Medical Claims screen when sending claims.

If no Assignment of Benefit options is selected when clicking Send Claim a warning will appear to prompt the user to make a selection.

NOTE  When the Claim Type is Patient Claims (PC) the Assignment of Benefit options will be unchecked and disabled.

Updates to the Assignment of Benefit DB4 printed form

The existing DB4 Bulk Bill Assignment of Benefit Agreement form has been updated to include new required fields including:

  • Updated Form Identifier and Header
  • Agreement Date field
  • Is the assignor the patient? field
  • Updated Privacy Notice.

Bulk Billed consultations with Print Form (0) on the Consultation screen ticked will launch the Report preview screen for the form when finalising the invoice.

Sending Batched Bulk Bill Claims

The Batch Preview screen (accessed from File > Accounts > Subsidiser Batching) will display a disclaimer when the Create/Send Batches button is clicked to prompt the user to confirm that by clicking Create/Send Batches, they have ensured that the patients included in the batch have given consent to assign their Medicare benefits to the specialist.

IMCW Patient Claim and Consent Declaration

When sending IMC-PC claims the IMCW Patient Claim and Consent Declaration has been updated with new wording in compliance with the Assignment of Benefit reforms from Services Australia.

Online Eligibility Check (OECW) Report Updates

The Online Eligibility Check (OECW) Report has been updated to include two new fields in compliance with the Assignment of Benefit reforms:

  • Additional Clinical Categories
  • Product Tier.

Frequently Asked Questions

Assignment of Benefit (AoB) refers to the process by which a patient authorises Medicare to pay their benefit directly to the healthcare provider, rather than reimbursing the patient. This arrangement streamlines payments to providers and reduces administrative effort for both patients and practices.

Bulk Billed consultations with Print Form (0) on the Consultation screen ticked will launch the Report preview screen when finalising the invoice with the updated DB4 Post-Assignment of Benefit form.

Providers will be required to retain the completed/signed agreement for 2 years for each Assignment of Benefit consent request. This retention period is essential for meeting audit and compliance requirements.

Not all patients will be able to complete an assignment themselves. The new forms ask the question, ‘Is the assignor the patient?’, to capture when the assignment has been completed by somebody acting on the patient’s behalf.

This can be done for children/minors or patients who lack the capacity to complete this independently.

 

Last modified: 23 April 2026