From 1 July 2026 every bulk-billed imaging service requires a signed Assignment of Medicare Benefits (AoB) agreement. If your practice bulk bills patients are required to provide their consent to assign their Medicare benefit to your department. The introduction of the Assignment of Benefit will mean a change in the reception workflow, and how Karisma RIS will assist in the process.
What Is an Assignment of Benefit?
An Assignment of Benefit is the formal process by which a patient agrees to assign their Medicare benefit directly to a healthcare provider, allowing the provider to claim that benefit as full payment for a bulk-billed service. Without a valid assignment, a bulk bill claim cannot be lodged.
What Is Changing from 1 July 2026?
The Australian Government is changing the Assignment of Benefit process under amendments to the Health Insurance Act 1973.
The key changes are:
- Verbal Assignment of Benefit is no longer valid. Every bulk-billed service requires a written or electronic patient signature.
- The DB4e and DB020 approved forms are no longer required.
- Practices can use any form that captures the required ‘data set’, including a Services Australia template or their own design.
- Patients can assign benefit before the service (pre-service episodic assignment) or after the service (post-service episodic assignment), as long as the agreement is in place before the Medicare claim is lodged.
- Completed agreements must be retained for two years from the date of the Medicare claim and provided to the patient on request.
For pre-service assignment, the form can reference a basic service description rather than a specific MBS item number.
For post-service assignment, the specific MBS item numbers must be referenced. Most practices will use pre-service assignment captured at check-in.
What Does a Valid Signature Look Like?
A physical handwritten signature or an electronic signature meeting the Electronic Transactions Act 1999 are both acceptable.
The signature needs to reliably identify the person, indicate their consent through a deliberate action, and be auditable.
A touchscreen signature at check-in, a patient portal checkbox, or a typed name in a digital form are all likely to qualify. A staff member noting verbal consent in the record does not.
Who Can Sign on Behalf of a Patient?
Not all patients can sign for themselves. Parents, carers, partners, relatives, friends, and individuals with Power of Attorney can all act as the authorised assignor for a patient who is unable to sign. Practice staff cannot act as the assignor due to conflict of interest, unless they are also the patient’s carer or parent in a non-professional capacity.
Reception teams will need to be briefed on this before the July deadline.
What this means for Kestral customers
Kestral is working to support customers through these changes and will align system capabilities with the updated compliance requirements. Further information will be provided directly to our customers. Templates from Services Australia are expected to be made available and may assist with formatting, although their use is not mandatory.
For more details see Assignment of Benefit Reform: Frequently Asked Questions