2.1.3 Unpaid Patient claim
An Unpaid Patient claim exists when a claimant has not paid a medical practitioner’s
account.
Where Medicare Australia assesses that a rebate is payable, Medicare Australia will issue a
statement and a Pay Doctor via Claimant (PDVC) cheque, which is mailed to the claimant’s
Medicare address that is recorded with Medicare Australia. Where no benefit is assessed as
payable, only a statement will be forwarded to the claimant’s address that is recorded with
Medicare Australia.
The claimant is then responsible for forwarding the cheque, with any outstanding amount,
to the medical practitioner.
To process an Unpaid Patient claim, please refer to:
• Section 6.3 for General Practitioners
• Section 7.3 for Specialists, Allied Health and Dental providers
• Section 8.3 for Diagnostic Services
2.2 Bulk Bill claims
A Bulk Bill Claim is a claim made by a medical practitioner who undertakes to accept the
relevant Medicare rebate(s) as full payment for the service(s) provided by that medical
practitioner to the patient and where the right to that Medicare rebate(s) has been
assigned to the medical practitioner by the patient.
It is the medical practitioner’s discretion whether to bulk bill a Patient or not.
To process a Bulk Bill Claim, please refer to:
• Section 6.4 for General Practitioners
• Section 7.4 for Specialists, Allied Health and Dental providers
• Section 8.4 for Diagnostic Services
• Section 9.1 for Pathology Services
2.3 Medical Practitioner
For all patient claim types, the medical practitioner can be a General Practitioner,
Specialist, Allied Health Provider, Dentist, Radiologist or any other practitioner who
provides a medical service, which is covered by the Medicare Benefits Schedule.
For all Bulk Bill claims, the medical practitioner can be a General Practitioner, Specialist,
Allied Health Provider, Dentist, Pathologist, Radiologist or any other practitioner who
provides a medical service, which is covered by the Medicare
Benefits Schedule.
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