The way a patient agrees to be bulk billed changed on 1 July 2026. For most practices the change has landed quietly, because clinical software handled the first step. It won’t stay quiet: the transition ends on 30 June 2027, and the practices that are comfortable on 1 July 2027 will be the ones that treated it as a workflow and a training job in 2026, not a software update. This is what changed, what is expected in 2026–27, and how to get your front desk, nurses and doctors ready.
What changed, in one paragraph
Bulk billing has always required the patient to assign their Medicare benefit to the practitioner. Under the modernised process, that assignment is captured as a recorded agreement — an electronic or physical signature from the patient or the person responsible for them, identifiable and auditable — rather than a paper form countersigned by the doctor. The practitioner no longer signs. Agreements are retained for at least two years and given to the patient on request. Assignment can be recorded before the service (pre-assignment, with a basic description of the service category) or after it (post-assignment, listing the actual item numbers), provided it happens before the claim is lodged. And for eligible patient groups, an enduring assignment allows the patient to consent once to ongoing bulk-billed services.
Why it matters more than it looks
Three reasons. First, evidence: a bulk-billed claim without a compliant recorded assignment is a compliance exposure, and Medicare compliance reviews look at exactly this kind of record. Second, revenue: every bulk-billed consultation now has an extra step at the front desk or in the consulting room, and a step that is clumsy costs seconds per patient, which across a day is a doctor’s session. Third, patient experience: done well — an SMS the patient taps, or a single enduring consent for regular patients — it is invisible; done badly, it is a queue at reception and a confused patient holding a phone.
What is expected in 2026–27
- Electronic first. Clinical software vendors have built assignment into their workflows — Best Practice, for example, requires the Oxford SP1 release, records the agreement against the patient, and can send it by SMS through Bp Comms or print it. Expect electronic capture to be the default and paper the exception.
- Verbal is a transition tool, not a plan. Verbal agreement is permitted during the transition where other options are not available, and it must be recorded. Practices should not be relying on it in mid-2027.
- Enduring assignment for regular patients. For MyMedicare-registered patients, aged care residents and ACCHO patients, one recorded consent covers ongoing services. This is the single biggest workflow saver and it rewards practices that have already registered their patients in MyMedicare. Confirm availability and start date with your vendor — sources currently differ on whether it is live from 1 July 2026 or commences in 2027 under final regulations.
- Records you can find. Two years for bulk billing, seven for simplified billing, and a copy to the patient on request. A record that exists but cannot be produced in a compliance review is not a record.
- Audits will follow. Our expectation — DocHelp’s view, not a published position — is that assignment records become a routine item in Medicare compliance activity once the transition closes, in the same way item-number substantiation already is.
Optimising the workflow
The practices that do this well make one decision per patient type and then automate it.
- Regular patients: enduring assignment. Register eligible patients in MyMedicare, record the enduring assignment once, flag it in the patient record, and stop asking. Review it on the schedule your software and the rules require.
- Everyone else: electronic pre-assignment at check-in. The SMS or on-screen agreement is sent when the patient arrives, using the basic service description, and is completed before they see the doctor. Reception owns this step.
- Post-assignment for the exceptions. Where the items are only known after the consultation, the agreement is recorded with the actual item numbers before the claim goes — a doctor-room or checkout step, and a daily check that nothing was lodged without it.
- Telehealth: digital by design. The interim digital solution for telehealth already existed; fold it into the same workflow so phone and video patients are not the gap.
- The daily reconciliation. A five-minute end-of-day report: claims lodged versus agreements recorded. Zero difference, every day. This is the control an auditor will ask about.
Getting your staff ready
The change is not a doctor problem. It lands on reception and the practice manager, and it only works if they understand why, not just what.
Reception
- Can explain assignment of benefit to a patient in one sentence without the word “Medicare” doing all the work.
- Knows the three capture routes — enduring, electronic pre-assignment, post-assignment — and which patient gets which.
- Knows how to send, resend and record the agreement in the clinical software, and what to do when a patient has no phone, no email or cannot sign.
- Knows the verbal fallback is transitional, how to record it, and that it disappears as an option.
- Runs the end-of-day reconciliation.
Nurses
- Understand that nurse-led bulk-billed services need the same agreement, and where it is captured in their workflow.
- Know the aged-care and home-visit process where enduring assignment and post-assignment do most of the work.
Doctors
- Know they no longer sign, what they are still responsible for — the claim — and what the post-assignment step looks like on their screen.
- Have agreed the practice policy on patients who decline to assign: private billing, not an unrecorded bulk bill.
Practice manager
- Owns the policy, the workflow document, the software configuration, the training records and the retention system.
- Has confirmed the software version, tested SMS delivery, and set where agreements are stored and how they are retrieved.
- Has MyMedicare registration running as a routine, because enduring assignment depends on it.
The evidence to have on file by 1 July 2027
- An assignment of benefit policy and a one-page workflow, dated.
- Training records for every reception, nurse and doctor user, with dates.
- Software configuration notes — version, SMS setup, storage location.
- Enduring assignments recorded against eligible patients.
- Daily reconciliation reports, kept.
- A patient-facing explanation — a line in the privacy statement and a reception script.
We build and train this for practices as part of practice manager and reception training and set the software side up through IT & systems. If you want it done before the transition closes, the time to start is this quarter, not next June.
- Department of Health, Disability and Ageing — Improving the assignment of benefit process
- Best Practice — Assignment of Benefit changes FAQ
- South Eastern Melbourne PHN — Updates to the assignment of benefit process
- Magentus — Assignment of Benefit changes 2026
General information for practice owners and managers. Requirements are set by the Department of Health, Disability and Ageing and Services Australia and may change; confirm the current position, especially for enduring assignment, before changing your process.
Quick answers
What is assignment of benefit?
When a practice bulk bills, the patient assigns their Medicare benefit to the practitioner, who accepts it as full payment. That assignment has always needed the patient’s agreement; the change is how that agreement is captured, recorded and kept.
Do doctors still have to sign the assignment form?
No. Under the updated process the practitioner no longer needs to sign the agreement. The patient, or the person responsible for them, gives an electronic or physical signature — or, during the transition period where other options are not available, a verbal agreement that the practice records.
When do the assignment of benefit changes take effect?
The updated process commenced on 1 July 2026 with a twelve-month transition period to 30 June 2027. From 1 July 2027 the new arrangements apply in full. Enduring (standing) assignment for eligible patient groups has been announced; sources differ on whether it is available from 1 July 2026 or from 2027 subject to final regulations, so confirm the current position with your software vendor and Services Australia before relying on it.
How long do we keep assignment records?
Completed bulk-billing agreements must be retained for at least two years, and a copy provided to the patient on request. Simplified-billing records are kept for seven years.
Which patients can give an enduring assignment of benefit?
The announced eligible groups are patients registered with the practice in MyMedicare, residents of residential aged care facilities, and patients of Aboriginal Community Controlled Health Organisations. An enduring assignment lets the patient consent once to ongoing bulk-billed GP services rather than at every visit.
Can reception still take a verbal assignment?
During the transition to 30 June 2027 a verbal agreement is permitted where the other options are not available, and it must be recorded — in Best Practice, for example, the signature field records that the assignor verbally agreed. Plan for the electronic and enduring options to be the norm from July 2027.
Fifteen years in medical practice operations. MBA, Melbourne Business School. Two medical centres built and sold; ten-plus centres overseen today. About Jamal →