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M3 Health Fees Explained

If you are unsure what Bulk Billing means or how it works and what the difference between ‘rebate’ and ‘out of pocket’ is, then you are not alone. It can all get very confusing. We want to make sure you know the fees before you come into your appointment. Here we explain some of the common terms you will hear in regards to health care fees.

Bulk Billing means that we (as a medical centre) submit the bill for your consultation directly to medicare on your behalf. When the doctor bulk bills you, it means they are accepting the minimum payment from the government for that service. You as a patient do not pay anything for this appointment. The term ‘Bulk’ refers to the batching process we use to send off the medicare claims (i.e. in bulk).

The term ‘rebate’ refers to the medicare rebate for a particular healthcare service. The medicare benefits schedule (MBS) is a list of the medicare services for which the federal government will pay a medicare rebate. The rebate is the governments way of contributing towards the cost of healthcare.

When you are Bulk Billed, the medical centre accepts only the rebate amount directly from the government on your behalf. When you are privately billed you, as a patient, can claim back the rebate amount from medicare, leaving you with only the ‘out of pocket’ or ‘gap’ fee to pay.

The ‘out of pocket’ fee, also referred to as the ‘gap’ fee, is the difference between the medicare rebate and the private fee charged. This is the amount you pay at the time of consultation. The term ‘out of pocket’ refers to the money it will cost you (as a patient) for the service.