Medicare Bulk Bill Assignment of Benefit – Updated Requirements (AUS Only)

Important

From 1 July 2026, Services Australia requires all bulk bill claims submitted through the online claiming channel to include a recorded Assignment of Benefit agreement prior to the claim being submitted and a record kept for two years. See details of this change from the Department of Health here.

Zanda has updated its Medicare integration to meet these requirements. No action is needed on your part to receive the update - it will be applied automatically to your account.

Here is what is changing to support this change:

When you click Send or Save and Send Later on a bulk bill claim, a new Assignment of Benefit window will appear displaying the Assignment of Benefit agreement (DB4) form for the patient to review and confirm.
The patient can now confirm their agreement digitally by tapping Assign benefit - this records a timestamped assignment against the invoice.
You cannot submit a claim (or toggle Approved for Submission to on) without a valid assignment being recorded.
The DB4 form has been updated to meet Services Australia's current requirements.

What is changing and why

When you bulk bill a patient, Medicare requires the patient to formally assign their right to the Medicare benefit to you as the health professional who provided the service. This is called an Assignment of Benefit.

This has always been a requirement when bulk billing, typically fulfilled by having the patient sign a paper DB4 form. From 1 July 2026, Services Australia has updated the DB4 form with revised wording and fields, and requires that software supporting online claiming is capable of capturing the assignment digitally - i.e recording the patient's agreement with a timestamp against the claim.

Both paper and digital signatures are still permitted. Zanda now supports the digital workflow, which is the most practical option for most in-clinic situations.

The assignment recorded in Zanda is a post assignment - the patient confirms their agreement at the time you are preparing the claim (after the service has been delivered), before it is transmitted to Medicare.

Services Australia requires the provider to store a copy of the signed DB4 form for two years after the claim date.

How the new workflow works

When you create a bulk bill claim and click Send (or Save and Send Later), Zanda will check whether a valid Assignment of Benefit has already been recorded for that invoice.

If no valid assignment exists: An Assignment of Benefit window will open, displaying the DB4 form for the patient to review. The patient confirms their agreement by tapping Assign benefit. The date and time of that tap is recorded and stored against the invoice.
If a valid assignment already exists: The claim proceeds directly - the window will not appear again unless the service details or MBS items on the claim have changed since the prior assignment was recorded.
If claim details have changed: The window will reopen so the patient can review and confirm the revised claim before it is submitted.

The Approved for Submission toggle on the bulk bill claim reflects the assignment status:

Off (untoggled): No assignment has been recorded for this invoice yet.
On (toggled): A valid assignment has been recorded and the claim is ready to submit.

Recording the assignment: step by step

Recording Assignment with the patient present:

From the appointment panel or edit invoice view, click the M / Medicare & DVA button.
Click Create Bulk Bill.
Review the claim details, then click Save and Send Later or Send.
The Assignment of Benefit window will open. For digital assignment, hand your device to the patient, or turn the screen so they can read the form.*
Scroll through the DB4 form with the patient so they can review the claim details, privacy notice, and authorisation statement.
Once the patient is satisfied, they tap Assign benefit.
- The date and time is recorded against the invoice.
- The Approved for Submission toggle is set to on.
- The claim proceeds to Medicare.

If the patient does not wish to proceed, tap Cancel or the × button to close the window. No assignment will be recorded, the claim will not be submitted, and you will be returned to the bulk bill claim form.

Recording Assignment when the patient is not present:

From the appointment panel or edit invoice view, click the M / Medicare & DVA button.
Click Create Bulk Bill.
Review the claim details, then click Save and Send Later or Send.
The Assignment of Benefit window will open.
Click either Print or Email to provide a copy to the patient to review.
The patient can either sign the paper form, sign it digitally, or write back to an email to agree to the assignment.
In Zanda, open the claim and click Save and Send Later or Send.
Tap Assign benefit to confirm the patient has assigned their benefit.
- The date and time is recorded against the invoice.
- The Approved for Submission toggle is set to on.
- The claim proceeds to Medicare.

Who can sign the assignment?

Where the patient is unable to confirm the assignment themselves, the person who would otherwise meet the cost of the service if it were not being bulk billed (e.g. patient's parent or guardian) is able to assign the benefit on their behalf.

Note that the treating practitioner or their staff are not acceptable alternative signatories

This is noted on the DB4 form itself.

Saving a claim for later

If you click Save and Send Later, the Assignment of Benefit window will still appear. In this case, the window includes an additional option:

Save without Assignment - saves the claim in a prepared (unsent) state without recording an assignment. The Approved for Submission toggle will remain off. You can record the assignment when the patient is available and you are ready to submit.

When you later go to submit the claim from the batch submission view, the window will appear again if no assignment has been recorded.

Printing or emailing the DB4 form

You can print or email the DB4 form for any bulk bill claim - including claims that have been saved but not yet submitted. This can be useful if a patient would like a copy of what they agreed to.

If an assignment has been recorded, the printed form will display the date and time the agreement was confirmed.
If an assignment has not been recorded, the printed form will not include an agreement date.

To print or email the form for a stored claim:

Go to Tools > Medicare.
Locate the claim and click the Claim ID.
Use the Print or Email buttons at the top of the claim view.

Frequently Asked Questions

Do I need to do anything to set this up?

No. The updated Assignment of Benefit workflow will be applied to your Zanda account automatically before 1 July 2026. There is nothing to configure.

Where can I find information on this from Services Australia?

Details of the changes can be found on their website here: https://www.health.gov.au/our-work/improving-the-assignment-of-benefit-process, or you can view this FAQ document provided by them here: https://www.health.gov.au/sites/default/files/2026-06/assignment-of-medicare-benefits-for-bulk-billing-frequently-asked-questions_1.pdf.

Does the patient need to be present when I submit the claim?

No. The patient (or an acceptable alternative signatory) only needs review and agree to the assignment of benefit. Once this has been recorded, you can submit the claim at any time.

Can the patient still sign a paper DB4 form instead of signing digitally?

Yes. Services Australia permits the assignment of benefit agreement to be completed on paper - printed, signed by the patient, and a copy offered to them to keep. The digital workflow in Zanda is an alternative to this, not a replacement for it.

If your patient is unable to confirm the assignment digitally (for example, they are not present at the device), you can use Save and Send Later to save the claim, then print or email them the DB4 form and have the patient sign it on paper. You would then submit the claim when ready.

Note that if you use the paper process, the digital assignment will not be recorded in Zanda - the Approved for Submission toggle will remain off, and you will need to use Save without Assignment to save the claim and later submit it after assignment has been received and recorded on the claim by tapping Assign Benefit.

Do I need to keep a copy of the signed DB4 form?

Yes. Services Australia requires providers to retain a copy of the assignment of benefit agreement for two years from the date the claim is made. This applies whether the agreement was completed digitally or on paper.

For digital assignments recorded through Zanda, the record is stored against the claim in your account. For paper-signed forms, you are responsible for retaining a physical or scanned copy for the required period. These can be uploaded in the patients files under Records > Files.

What happens if I try to submit without recording an assignment?

The Assignment of Benefit window will appear automatically when you click Send or Save and Send Later for any claim that does not have a valid assignment recorded. You cannot submit the claim without the patient completing the assignment.

What if the claim details change after the assignment is recorded?

If you edit the service details or MBS items on a claim that already has an assignment recorded, the assignment will be invalidated and the window will reopen the next time you attempt to submit. The patient will need to review and confirm the updated form.

Does this affect DVA claims or patient claims?

No. These changes apply to Medicare bulk bill claims only.

What is a post assignment?

A post assignment means the patient assigns their right to the Medicare benefit after the service has already been rendered, at the time the claim is being prepared. This is the assignment type used in Zanda's bulk billing workflow.

- - Submitting a Bulk Bill (AUS Only)
  - Generating Medicare Invoices & Receipts (AUS Only)