Mixed billing

Mixed billing is a clinic billing approach in which some services or patients are bulk billed and others are privately billed. It is not a separate Medicare benefit. Whether you pay a fee depends on the clinic's policy, the appointment and any applicable Medicare eligibility rules, so check the arrangement before booking.

Why can two patients pay different amounts?

A practice may have different arrangements for particular appointment types, patient groups or times of day. The details are set by the provider within the applicable rules. A concession card or previous bulk-billed visit does not automatically establish that the next appointment will be free.

Ask the practice which policy applies to your specific booking. Explain whether it is a new-patient visit, a longer consultation, a procedure or telehealth. General wording on a homepage may not cover every service.

For the Australian guidance behind this explanation, see Healthdirect Australia: Bulk billing for medical services - Medicare benefit and gap payments.

What is the difference between the fee and the gap?

The fee is what the provider charges. If the service is eligible, Medicare may pay a benefit. The amount you ultimately pay yourself is the out-of-pocket cost. If no Medicare benefit applies, the full fee may remain your responsibility.

Ask whether payment is required upfront, whether a claim is submitted for you and whether extra services have separate charges. A stated rebate is not the same as a guaranteed refund to every patient. Eligibility must be established for the actual service provided.

How should I compare online services?

Compare the consultation format, total fee, follow-up arrangements and what happens if the doctor cannot provide the requested treatment. Do not compare only an advertised starting price. Tests, pharmacy costs or specialist care may be separate.

Doccio's supplied model is pay per consultation. Use its pricing page to confirm current fees and its online doctor information to understand the service. This general glossary definition does not mean Doccio uses mixed billing or provides Medicare rebates.

Related Australian guidance: Australian Government Department of Health, Disability and Ageing: Calculating BBPIP payments with practice model examples.

Where to go next

Read consultation pricing to understand the relevant service. A doctor decides whether a consultation, examination, referral or another pathway is appropriate for your situation.