No more verbal consent: Navigating the changes to bulk billing with Medicare

"Are you happy for us to bulk bill your appointment to Medicare?” It’s a question that’s asked time and again by receptionists at healthcare clinics around Australia. And, until now, a simple “Yes” has sufficed in order for the receptionist to hit “send” on the payment. 

But this will all soon change. From 1 July 2027, new rules come into play that require healthcare providers to capture signed consent before services can be bulk billed. 

The good news? Getting patients to sign their consent for benefits to be paid doesn’t mean you need to print and physically store separate forms for every service delivered to every single patient. You’d drown in paperwork. Instead, you can easily update your workflows to stay compliant – without adding friction for your patients.

The better news? Getting started on your digitisation strategy now gives you plenty of time to iron out any kinks in your systems before the 2027 compliance deadline hits. More on that below, but first, let’s see what’s changing.

What’s changing in the bulk billing process?

When you bulk bill a patient, they “assign” their Medicare benefit to you as payment for the service. To do this legally, the patient must consent to that assignment. This has always been the case, and will remain so. But from 1 July 2027, the rules around capturing that consent get a major upgrade:

• No more verbal consent: It will no longer suffice to simply check a box in your practice management software indicating that verbal consent was obtained. Instead, you’ll need to capture that consent via physical or electronic signature.

• The two-year retention rule: Once you’ve got the patient’s signed consent, you need to securely store and maintain a record of it for a minimum of two years from the date of service.

• Retirement of old forms: Legacy manual processes, including the old DB4e and DB020 paper forms, are being phased out in favour of modern, streamlined data capture. With no mandatory form, it means you can capture consent in the format that suits you.

Just remember, if your practice is audited by Medicare, simply saying “We always ask the patient” won’t cut it anymore. If you can’t produce the signed, dated evidence for a claim within that two-year window, you risk penalties.

Who is affected?

The assignment of benefits (AoB) policy update applies to all Australian healthcare organisations that bulk bill Medicare services. While the change will be relatively straightforward for local GPs and small healthcare providers, things can get a little more complicated for:

• Corporate medical groups and “super-clinics”: Where high daily patient volumes make manual paperwork impossible to scale.

• Allied health and specialist networks: Especially those using telehealth or hybrid care models where the patient isn’t physically standing at a front counter.

• Aged care and community health services: Where mobile practitioners need to capture consent on the go.

How should your operations change?

Printing out more paper forms isn’t the best long-term solution. Think about what this would mean day-to-day: printing a form, handing it to a patient, waiting for them to sign it, scanning it back into the system, and manually filing it away. Multiply that by dozens or hundreds of patients a day across multiple clinics. The risk of lost forms, missing signatures, and sheer administrative burnout is incredibly high.

If you offer telehealth appointments, then a paper-based system is even more impractical. Putting the onus on the patient to print, scan, and email a form back to you before their consultation is a less-than-ideal experience.

So what’s the solution? You can turn a compliance headache into a seamless, automated background process simply by digitising your patient consent workflows with Docusign. Here’s how:

1. Capture eSignatures on any device

Whether a patient uses an iPad at your front desk or their smartphone at home ahead of a telehealth consult, they can review and sign their Medicare Assignment of Benefit electronically in seconds. No printing, no scanning, no fuss

2. Maintain bulletproof audit trails

Every document processed through Docusign automatically generates a secure, tamper-evident, and legally enforceable Certificate of Completion. This logs precisely who signed the document, when they signed it, and the IP address or device used. It is the ultimate, audit-ready proof to meet Medicare’s strict new compliance standards.

3. Automate the retention of records for two years

Forget about manual filing cabinets or messy desktop folders. Docusign securely stores your completed agreements in the cloud, or automatically routes them straight into your existing Document Management System. 

4. Seamless integration with patient systems

Docusign doesn’t sit in a silo. Through robust APIs and integrations, you can connect your consent workflows directly into your existing practice management software so that, when a booking is made, the consent form can be automatically generated, sent, and saved back to the patient’s file once signed.

Why prepare now if the decision has been delayed?

Even though the mandatory start date for Assignment of Benefit changes has shifted to 2027, waiting until the last minute is risky. Clinics that start digitising their consent workflows now can use the extra time to iron out processes, train staff and integrate systems – without the pressure of a looming compliance deadline. 

With time on your hands, you can adopt a crawl-walk-run approach, starting small and only scaling up once pilots have proven successful. This facilitates smoother transition and ensures organisational readiness.

The benefits of starting early go well beyond compliance with AoB rules:

• Future-proof consent collection: Use Docusign Web Forms to capture Medicare, treatment and financial consents in a single, mobile-friendly experience that works just as well at reception as it does for telehealth.

• Stronger identity assurance: For higher-risk scenarios – such as telehealth, high-value procedures or vulnerable cohorts – you can layer in Docusign Identify to verify patients in seconds and reduce the risk of fraud or misidentification.

• Smarter document preparation across the patient journey: With Docusign Agreement Preparation, you can auto-generate consent packs, new-patient registrations, payment authority forms and more from the same patient data, cutting down manual templating and re-keying.

• Reusable patterns for other use cases: The same digital workflow you design for the assignment of bulk billing benefits can also cover new patient registration, ongoing treatment consent, telehealth consent, research/clinical trial enrolment and aged-care admission packs – multiplying the ROI of the project.

By framing your AoB project as a broader patient consent and onboarding initiative, you turn a deferred compliance deadline into an opportunity to modernise your end-to-end patient experience and reduce admin load long before 2027.

Are your systems ready for the change? 

The countdown to signed consent has begun, and the time is now to re-engineer your billing workflows. Not only will you make the process smoother and easier for patients and staff, but you’ll be ticking a big compliance box, too. 

Get in touch, or chat with your account manager to learn how we can help you build an automated, auditable, and stress-free bulk billing consent process.