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 > Billings Tab > Bulk billing percentage
The sections included in this article relating to the Bulk Billings calculator are:
Bulk billing snapshot
These metrics show you at a glance the Percentage of Bulk Billing based on:
- Total billings: This figure shows the proportion that bulk billings makes up against all overall billings at the practice by service date, including all custom items and not limited to just MBS or DVA items.
- Eligible billings: This figure is the percentage of eligible billings by service date that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
- Eligible items: This figure is the percentage of eligible items by service date that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
- Eligible invoices: This figure is the percentage of eligible invoices by service date that have been bulk-billed by MBS/DVA item number, for services which are eligible for bulk-billing.
TOP TIP! 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 eligible billings, bulk billed- where you had $400 in eligible 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 analysis
Use the tabs on the page to get a breakdown of your bulk billing data via each category (eligible amount billed, items, invoices). The example of the breakdown on this page is shown by looking at Bulk billing by eligible billings.
Here you will find key metrics to help you understand your bulk billing data:
- Percentage of eligible billings bulk billed: This figure is the percentage of eligible billings by service date that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing.
- Bulk billing by eligibility type: This chart shows the proportion of eligible billings by service date that have been bulk-billed by MBS/DVA item number, for patients who are eligible for bulk-billing, by eligibility type.
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 eligible billings attributed to each Payer type.
- % by MBS item of eligible billings bulk billed: This figure is the proportion of eligible 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).
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?
Note: Item numbers with a value of 0% during the date period were either never claimed or were claimed but 100% privately billed.
- % by Practitioner of eligible billings bulk billed: This figure is the proportion of eligible 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 eligible bulk billing by total amount billed: This graph is the proportion of eligible 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! Use the filter "Compare to the same range in the last:" to view the Trend of eligible bulk billing by total amount billed over multiple previous periods.
Use this filter to compare how incentives and budget changes have impacted your bulk 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.
Private billing opportunity
Refer to our "Private billing opportunity page" to review your potential earnings if you were to privately bill items you bulk-billed and understand the impact of this on your practice billings.
Billing breakdown
Use this tab for a breakdown of billings via:
- 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 types 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 period, you can also see how this compares to the same time last year. Using the dropdown, 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.