Assignment of benefit

If a patient is unable to sign an Assignment of benefit form (DB020), 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 or 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.

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:

• Bulk bill voucher- electronically transmitted claims form (DB4E)
• Assignment of benefit Medicare bulk bill Webclaim (DB020).

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 (DVA).