Enduring Assignment of Benefit: What Reception Needs to Know

ByKatherine

From 1 July 2026, the way patients agree to be bulk billed changed. The paper DB4 signature pad era is ending, a 12-month transition period is running, and — the part most practices are still catching up on — eligible patients can now give enduring assignment of benefit: standing consent to be bulk billed, given once instead of at every visit.

The Department of Health, Disability and Ageing and Services Australia have released updated guidance through July 2026, including new FAQs and agreement templates for both episodic and enduring assignment. Here is what it all means in plain language, written for the people who actually run the process: reception teams and practice managers.

First, a recap: what is assignment of benefit?

Assignment of benefit (AoB) is the agreement where a patient assigns their Medicare benefit to the practitioner as full payment for the service — that is what bulk billing legally is. Without a valid assignment, a service cannot be claimed as bulk billed. The Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 modernised the process, and the new requirements commenced on 1 July 2026.

What changed on 1 July 2026

  • No more approved form. There is no mandatory DB4 or DB020. Any agreement is valid as long as it contains the information required by the Health Insurance Regulations 2018 — practices can use the Services Australia templates, forms built into their practice software, or their own.
  • Assignment can happen before or after the service. A pre-service assignment can be captured up front (in the waiting room, by SMS link, or ahead of a telehealth appointment) using a basic service description rather than exact item numbers. A post-service assignment works much like the old process and must list the items billed.
  • Electronic is fully supported. Digital signatures and SMS web forms are valid. The provider co-signature requirement has gone for bulk bill.
  • Records must be kept for 2 years. The practice must retain a copy of each completed agreement for at least two years from the date of claim, with a copy to the patient on request.

The 12-month transition period

On 18 June 2026 — after feedback from the AMA and others — the Government announced a 12-month transition period. The changes still commenced on 1 July 2026, but with important concessions for bulk billed services:

  • Verbal assignment of benefit remains available in all settings until 30 June 2027, including telehealth. To record it, the practice explains how the signature field will be completed, confirms the patient agrees, enters “assignor verbally agreed” in the signature field, sends the completed agreement to the patient electronically, and keeps a copy for two years.
  • Compliance is education-first. The Department has indicated compliance activity will not begin until the regulatory changes are complete, starting with prevention and education rather than enforcement.

The transition applies to bulk billing only — the new simplified billing requirements for privately insured services were not changed by the concessions.

Enduring assignment of benefit: the big change

Enduring assignment was originally flagged for 2027 but was brought forward to 1 July 2026. It lets an eligible patient give standing consent for ongoing bulk billed GP services — one agreement instead of a form at every visit. Three groups of patients are eligible:

  • MyMedicare-registered patients can make one enduring agreement covering all the GPs at their registered MyMedicare practice, where the practice offers it.
  • Residents of aged care homes can make multiple enduring agreements with different practitioners.
  • Patients of Aboriginal Community Controlled Health Organisations (ACCHOs) and Aboriginal Medical Services (AMSs) can make an enduring agreement with the organisation, and can hold agreements with more than one.

In each case the agreement can be made by the patient directly or by someone acting on their behalf. Services Australia has published agreement templates for both episodic and enduring assignment, and practice software vendors are building enduring assignment into their patient record workflows.

Two practical points reception teams should understand:

  • For a MyMedicare-registered patient, one enduring agreement can cover ongoing eligible GP services from all GPs at the registered practice, if the practice offers it and the agreement remains valid. It can reduce repeated episodic agreements, but it does not guarantee that every future service is bulk billed or covered.
  • An enduring agreement is not “set and forget” for the practice — it must be recorded, retrievable and terminable, and the claim still has to match a valid agreement.

Basic service descriptions: how pre-assignment works

Because a pre-service assignment is captured before anyone knows the exact item numbers, the Department has mapped roughly 4,600 MBS items into 28 basic service description categories — such as “GP – Standard”, “GP – Long” and “GP – Care Planning and Health Assessments”. A pre-assignment is valid if the service delivered falls within the agreed category. If the visit turns into something else — a standard consult becomes a care plan review, for example — a new post-service assignment must be captured before the claim goes in.

What this means at the front desk

The practice must assign clear responsibility for the consent workflow. Reception often supports it, but the practitioner and practice remain responsible for a valid assignment and claim. Common front-desk failure points include:

  • knowing which patients hold an enduring agreement and which need an episodic one
  • knowing when a changed service voids a pre-assignment and a new agreement is needed
  • recording verbal assignment correctly during the transition, every time
  • filing agreements so they can be produced for two years — the practice should be able to retrieve the agreement when required
  • explaining to patients, in plain language, what they are agreeing to — patients must be given enough information to understand the assignment before the claim is lodged
  • remembering DVA is unaffected — Veterans’ Affairs claiming has its own rules and does not use the Medicare AoB process.

If a patient does not agree to assign their benefit, the service cannot be bulk billed, and the billing conversation needs to happen before the claim — another moment that lands on the front desk.

A preparation checklist for practices

  1. Read the Department’s FAQs and treat the DoHDA Assignment of Benefit page as the source of truth.
  2. Decide your capture method(s): software SMS forms, printed templates, or your own compliant form.
  3. Switch on enduring assignment for eligible MyMedicare patients if your practice offers it, and record it in the patient file.
  4. Train reception on pre vs post assignment, basic service descriptions, and the verbal recording steps.
  5. Decide where signed agreements live for the two-year retention period and who can retrieve them.
  6. Set a review point during the transition to check rejection rates and fold in updated guidance.

Sources and further reading

Train the team that runs this process

The GP Receptionist Certificate covers Medicare and bulk billing from the front-desk side — including consent conversations, gap-fee communication and safe claim escalation — in Module 5, Billing Integrity. $20 per person, self-paced, written by a working Australian practice manager.

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This article is general information for Australian general practices. It is not legal, billing or compliance advice. Confirm current obligations against the Department of Health, Disability and Ageing and Services Australia guidance.

New to the front desk? The free medical receptionist induction checklist covers assignment of benefit alongside everything else a new receptionist needs in their first month.

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