If you are a mixed or private billing practice, understanding your bulk billing rate is crucial to determining your current performance and how you can work towards a better business strategy
To navigate to this cabinet, go to Clinic Insights > Past Clinic Metrics > Bulk billing percentage
The sections included in this article relating to the Bulk Billings calculator are:
- Bulk billing snapshot
- Bulk billing by total amount billed
- Private billing opportunities
- Billing breakdown
Bulk billing snapshot
These metrics show you at a glance the Percentage of Bulk Billing based on Billings, Items and Invoices.
Use the tabs on the page to get a breakdown of your bulk billing data via each category (total amount billed, items, invoices). The example of the breakdown on this page is shown by looking at the total amount billed tab.
Percentage of billings bulk billed
This figure is the percentage of total billings that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
Percentage of items bulk billed
This figure is the percentage of eligible items that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
Percentage of invoices bulk billed
This figure is the percentage of eligible invoices that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
NOTE: These figures may appear differently because the different items attract different fees and invoices may have more than one item listed.
You could have 50% of your billings, bulk billed- where you had $400 in total billings and bulk-billed $200.
For the $400 of billings, 8 items are billed but only 3 items were bulk-billed would mean 37.5% of your items were bulk-billed.
Over those $400 billings, if you raised 6 invoices, of which only 1 was bulk-billed, your invoice's bulk-billed percentage would be 16.6%.
Bulk billing by total amount billed
- Percentage of billings bulk billed
- Bulk billing by eligibility type (by total amount billed)
- Total billings by payer (by total amount billed)
- % by MBS item of eligible billings bulk-billed (by total amount billed)
- % by Practitioner of eligible billings bulk-billed (by total amount billed)
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Trend of bulk billing by total amount billed (by total amount billed)
TOP TIP! Use the tabs on the page to get a breakdown of your bulk billing data via each category (total amount billed, items, invoices). The example of the breakdown on this page is shown by looking at the total amount billed.
Percentage of billings bulk billed
This figure is the total bulk billed percentage (calculated by either the total amount billed, items or invoices depending on which tab you are viewing) for the time period selected for all Medicare/DVA items that are eligible to be bulk billed.
TOP TIP! Use the filter Exclude COVID-19 vax services to view your bulk billing percentage excluding Covid 19 vaccine item numbers.
Bulk billing by eligibility type
This chart shows the proportion of total billings that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing, by eligibility type (calculated by either the total amount billed, items or invoices depending on which tab you are viewing).
Eligibility types:
- Aboriginal and Torres Strait Islander
- 15 years and under
- Health care card
- Pension concession card
- Commonwealth seniors card
- DVA card (Gold/White)
- DVA card (Lilac/Orange)
- Others
TOP TIP! Use the filters on the page to break down all data and see a list of bulk-billed patients by eligibility type.
If you are trying to reduce bulk billing in the practice and move towards more private billing this metric is a good indication of what is being bulk-billed outside of general bulk billing eligibility (concession cardholder or 15 years and under. Use the filters on the page via eligibility type and select "Others", this will formulate a list of all patients bulk billed under this eligibility- here you can see exactly what is being bulk billed and determine eligibility. You can track this percentage over time as you move towards mixed/ private billing.
Refer to our "Private billing opportunity page" to see the opportunity for the practice should bulk billed services be Privately billed.
NOTE: A patient is assigned eligibility, in the following order (if more than one is listed):
pension_code = 3 then 'Health Care Card'
pension_code = 4 then 'Commonwealth Seniors Health Card'
patient_age < 16 then '15 years and under'
dva_code in (1, 2) then 'DVA card (Gold/White)'
dva_code in (3, 4) then 'DVA card (Lilac/Orange)'
ATSI_flag = 1 then 'Aboriginal and Torres Strait Islander'
Total billings by Payer
This chart represents the percentage of total billings attributed to each Payer type. This metric is only available to view under the Bulk Billing by total amount billed tab.
NOTE: See our Billing Breakdown tab for a more comprehensive breakdown of Billings by Practitioner.
% by MBS item of eligible billings bulk-billed
This figure is the proportion of total billings that have been bulk billed for item numbers that are eligible to be billed to Medicare, split by item number (calculated by either the total amount billed, items or invoices depending on which tab you are viewing).
NOTE: Item numbers with a value of 0% during the date period were either never claimed or were claimed but 100% privately billed.
TOP TIP! Use the "Select Item" filter to review specific MBS Items that your practice routinely does or does not bulk bill.
Do you bulk bill your Care Plan reviews? Do you have a policy to privately bill Pregnancy Tests to ensure the consumable costs are covered?
% by Practitioner of eligible billings bulk-billed
This figure is the proportion of total billings that have been bulk billed for item numbers that are eligible to be billed to Medicare, split by Practitioner (calculated by either the total amount billed, items or invoices depending on which tab you are viewing).
Trend of bulk billing by total amount billed
This figure is the proportion of total billings that have been bulk billed for item numbers that are eligible to be billed to Medicare over the selected timeframe (calculated by either the total amount billed, items or invoices depending on which tab you are viewing).
TOP TIP! You can use this metric to see how a clinic's seasonal change impacts the bulk-billing rate. For example, a mixed-billing clinic during the COVID-19 vaccines or Fu vaccine season might see the bulk-billing rate increase over this time.
List of patients bulk-billed
This table details the patients who have been bulk-billed in the selected timeframe. You can filter this table by practitioner, by the patient, bulk-billing eligibility, or MBS item to see how much each patient has been bulk-billed. 
TOP TIP! If you are transitioning to private billing, you can use this list to communicate to patients previously bulk billed to advise of the changes.
For more information about exporting .CSV file from Cubiko refer to our help article HERE.
Private billing opportunity
This section looks in detail at the potential private billing opportunity for billings that were bulk billed over the selected date range.
Full details about this section are available in Private Billing Opportunity
Billing breakdown
Billings by Practitioner and Payer
This figure breaks down total billings by each practitioner and who the billing's Payer is. This can be filtered by item number or role using the above filters.
Billings by Payer
This figure represents the proportion of total billings attributed to the different type of Payers.
List of billings by Payer
This table lists each Practitioner's billings to Medicare, DVA and private billings. If you select a weekly, monthly, quarterly or yearly time period you can also see how this compares to the same time last year. Using the dropdown above you can view this table by $'s billed or as a % of total billings.
List of patients bulk-billed
This table details the patients who have been bulk-billed in the selected timeframe. You can filter this table by practitioner, bulk-billing eligibility or MBS/DVA item to see how much each patient has been bulk-billed.
