Billing Policy – Bulk Billing Practices
1. Policy Statement
Shoalhaven Family Medical Centres (SFMC) is committed to providing equitable, accessible, and affordable healthcare to all members of the community. As a Bulk Billing General Practice, we aim to minimise financial barriers to care while remaining compliant with Medicare regulations and RACGP accreditation standards.
2. Scope
This policy applies to all patients, general practitioners, allied health professionals, nursing staff, and administrative staff at all SFMC clinics.
3. Bulk Billing Information
SFMC bulk bills all eligible Medicare card holders for standard medical services covered under the Medicare Benefits Schedule (MBS).
This includes:
- Standard GP consultations
- Chronic disease management plans (e.g. GPMP/TCA)
- Immunisations and wound care (where MBS item numbers apply)
- Mental health care plans and reviews
- Health assessments (e.g. 45–49, over 75s, Aboriginal and Torres Strait Islander health checks)
✅ Patients will not be charged an out-of-pocket fee for these services when a valid Medicare card is presented.
4. Services Not Covered by Medicare
Some services are not eligible for bulk billing under Medicare. These may include (but are not limited to):
- Pre-employment medicals
- Commercial driver’s licence medicals
- Insurance reports or forms
- Travel vaccinations and some immunisations not covered by the NIP
- WorkCover consultations (until a claim number is provided)
- Missed appointment fees (if applicable to the clinic’s policy)
⚠️ In accordance with RACGP and Medicare guidelines, patients will always be advised in advance if a service incurs a private fee.
5. Patient Informed Financial Consent
SFMC complies with the RACGP 5th Edition Standard C5.1 – Informed patient decisions.
Before any privately billed service is provided, the patient will be:
- Informed verbally and/or in writing about the cost
- Provided with an explanation of what the fee covers
- Asked to give consent before the service is delivered
A receipt will be issued for any privately charged service so patients can claim reimbursement if eligible.
6. Questions About Billing? Please Ask!
Please ask at reception — our staff are more than happy to clarify billing information.
We would much rather answer your question than have you surprised at the end of your visit.
7. Medicare and Identification Requirements
Patients must bring their valid Medicare card and photo ID to appointments. If your Medicare card is expired or unavailable, fees may apply until eligibility is confirmed.
8. Privacy and Security
All billing information is handled in accordance with the Privacy Act 1988 and SFMC’s Privacy and Confidentiality Policy. Patient information will never be shared with third parties without written consent unless required by law.