From 1 July 2026, new Assignment of Medicare Benefits (AoB) requirements will come into effect for Medicare claims where Medicare benefits are assigned to another party, including private health insurers and approved billing agents.
While much of the discussion around these changes has focused on bulk billing, they are also highly relevant to anaesthetists who utilise simplified billing arrangements through ECLIPSE, gap cover schemes, private health insurers and approved billing agents.
The good news is that for most SPM members, the changes should require little or no adjustment to existing workflows.
What is an Assignment of Benefit?
An Assignment of Benefit (AoB) is the process by which a patient assigns their right to receive a Medicare rebate to another party.
Rather than Medicare paying the rebate directly to the patient, the Medicare benefit is paid to the party specified in the assignment arrangement. Depending on the billing pathway being used, this may be the treating doctor, a private health insurer or an approved billing agent.
Assignment of Benefit arrangements are a routine part of modern healthcare billing and allow Medicare claims to be processed on the patient’s behalf. Without an Assignment of Benefit, the patient would generally be required to pay the account themselves and then claim any Medicare rebate directly from Services Australia.
While Assignment of Benefit has been part of the Medicare system for many years, the rules governing how patient agreement is obtained and documented are changing from 1 July 2026.
Bulk Billing vs Simplified Billing
Bulk billing and simplified billing are often confused, but they are different claiming pathways.
Bulk billing generally applies to outpatient services where a doctor accepts the Medicare rebate as full payment for the service and receives the Medicare benefit directly from Medicare.
Simplified billing is the process commonly used for privately insured inpatients. Under this model, the patient’s Medicare benefit is assigned to a private health insurer or approved billing agent, allowing Medicare and private health insurance claims to be processed on the patient’s behalf without the patient having to navigate multiple claim pathways themselves.
Most anaesthetists working in private hospitals are therefore far more likely to be affected by the simplified billing requirements than the bulk billing requirements.
What Is Changing?
Historically, Assignment of Benefit requirements have largely relied on paper-based processes and were required for bulk billed accounts only. Approved forms were commonly used, signatures from both the patient and doctor were generally required, and verbal agreement could be accepted in some circumstances.
From 1 July 2026, the process becomes more flexible but also more clearly defined and will also apply to simplified billing.
Patients must provide written agreement before a claim is submitted, with electronic consent specifically permitted provided it is identifiable, auditable and compliant with the Electronic Transactions Act. Approved forms are no longer mandatory, doctors are no longer required to sign Assignment of Benefit documentation, and practices must retain appropriate records to demonstrate compliance if requested during an audit or review.
In short, the changes modernise the process while placing greater emphasis on having a clear and auditable record of patient agreement.
Why This Matters for Anaesthetists
For anaesthetists, obtaining Assignment of Benefit consent can sometimes be challenging because patient interaction is often brief and frequently occurs immediately before surgery.
This is one of the reasons Solo Practice Management has always incorporated informed financial consent and patient agreement processes into our workflows. While some billing providers focus primarily on obtaining the information required to submit a claim and not obtained Informed Financial Consent for no-gap accounts, we have long regarded comprehensive informed financial consent as good financial practice.
This approach provides benefits beyond regulatory compliance.
For example, if a private health insurer subsequently declines a claim due to policy exclusions, waiting periods, excesses, inadequate cover or other eligibility issues, clear documentation that the patient understood their potential financial responsibility significantly reduces billing disputes and improves collection outcomes.
Simply put, informed financial consent protects both patients and doctors.
The Good News for SPM Members
The new legislation recognises modern healthcare workflows and allows Assignment of Benefit agreements to be completed electronically before admission or treatment. For SPM members, this process is already built into Billumbra’s informed financial consent workflow. Patient agreements are collected electronically, securely stored and linked directly to the relevant episode of care.
This means SPM doctors already have a compliant process in place that aligns with the new requirements, without introducing additional paperwork, obtaining signatures on the day of surgery or creating new manual record-keeping processes, ensuring your practice remains compliant, efficient and protected as healthcare administration becomes more complex
The Bottom Line
The Assignment of Benefit changes do not fundamentally alter the way most anaesthetists bill their patients. However, they do reinforce the importance of having robust informed financial consent and Assignment of Benefit processes in place before claims are submitted.
As always, SPM members can be confident that we continue to monitor regulatory developments and implement the systems and processes necessary to keep your practice compliant, efficient and protected.
To get in touch with our friendly team members at Solo Practice Management please contact us here.