Caretaking for Loved Ones: A Health and Medical Blog

Key Points to Understand about Bulk Billing

Bulk billing is a topic that you may have heard of, but you may not fully understand. In fact, most patients do not try to fully understand bulk billing until they are faced with it at a clinic, at a hospital or by their normal doctor. If you are facing bulk billing, here are a few key points that you need to know. These points will explain how it works, how it pertains to your medical bills and what to know about your part in the process.

Gap Payments

One of the first things that many patients question is their gap payment. You may wonder how to pay it, if you need to pay it or what the amount is that is still due. With a bulk billing option, there is no gap payment to pay. The doctor or hospital will take the Medicare benefit as the full payment. This means they will let the gap payment go and will show the bill as paid. This means you do not need to worry about having other insurance pick up that gap or making arrangements to pay that gap. You are paid for that bill in full by your current Medicare plan.


Questions may come up if you have a normal co-payment you pay. With the bulk billing option, you do not pay a co-payment. The co-payment you would normally pay is wiped out and is now covered under the bulk billing for the visit. If your doctor offers this as an option during your visit, you will be told at the time of your payment and you will pay nothing for that visit. You will receive a bill stating that your co-payment is zero and that the appointment or visit will be covered by Medicare benefit.

Physicians Choice

A key point to keep in mind with bulk billing is that it is largely up to the physician when it is used. The physician recoups the lost charges from gap payments and co-payments from Medicare. The physician may be limited to the number of times they can use bulk billing. This limitation may be for a day or for another specific time period. The physician will use that limitation to determine when and to who they will offer bulk billing options to and for what type of appointments it will apply to. 

Keep in mind that bulk billing is usually a service that is simply offered by your doctor, clinic or hospital. If you have questions about your bill, contact the billing department of the hospital or your doctor's office directly. They can explain the bill and the procedures covered on that billing receipt. They can also help you with any insurance questions you have regarding that particular bill.