How should the patient be informed?
How you choose to inform patients of the likely costs and payment procedures is ultimately a decision for you. Reception staff can have preliminary conversations, for example about whether you bulk bill and the cost of examinations. If it suits you, reception staff can also finalise the consent paperwork. Patients will still need to be informed of any treatment identified in the chair and the associated costs, and consent must still be obtained prior to providing the services.
It is not required, but you may choose to summarise this information in writing and provide it to the patient or the patient’s parent/guardian for consideration before treatment.
Regardless of what arrangements a practice puts in place to manage the Child Dental Benefits Schedule consent process, it is the responsibility of the billing/claiming dentist that the consent requirements are met.
How does patient consent need to be recorded?
Consent to treatment and costs must be recorded in writing by the patient or the patient’s parent/guardian by signing a patient consent form. Consent forms are available for download from the Department of Human Services’ Medicare website (http://www.humanservices.gov.au/health-professionals/services/child-dental-benefits-schedule/)
There are different forms for bulk billed and non-bulk billed services.
If you privately bill the patient, you need to obtain a signed consent form each day that you provide a service to the patient. If you bulk bill, you only need to obtain a signed consent form on the first visit in the calendar year.
When and what Patient Consent Form needs to be used?
You must use the Non-Bulk Billing Patient Consent Form in instances where you bill the patient for services under the Child Dental Benefits Schedule.
In such instances, you must ensure the patient or the patient’s parent/guardian is aware of and agrees to the likely out-of-pocket costs they will be charged at each dental appointment for Child Dental Benefits Schedule services.
The Non-Bulk Billing Form must be completed on each day of service provision under the program.
See Attachment A at the back of this guide for an example of a Non-Bulk Billing Patient Consent Form.
When you choose to bulk bill Child Dental Benefits Schedule services and the patient or the patient’s parent/guardian signs an ‘assignment of benefit form’, you must record consent through the Bulk Billing Patient Consent Form on the first day of service in a calendar year.
For each day of service provision thereafter in the calendar year, you still have to advise the patient or the patient’s parent/guardian of the likely treatment and that services will be bulk billed before commencing treatment. However, it is not mandatory for you to record this consent through a patient consent form. The patient consent form from the first visit will apply for the entire calendar year as long as the patient is bulk billed.
See Attachment B at the back of this guide for an example of a Bulk Billing Patient Consent Form.
The Non-Bulk Billing and Bulk Billing Patient Consent Forms have now been translated into 20 community languages and are available on Health’s website at http://www.health.gov.au/internet/main/publishing.nsf/Content/childdental
How do I charge, and bill/claim for dental services?
Deciding what to charge the patient
Like providers under Medicare, private dentists are free to set their own fees for services. You may choose to either:
bulk bill the patient (see ‘Bulk billing’ section below); or
charge the patient (dentist sets their own fee and charges the patient directly).
If you directly charge the patient an amount above the Child Dental Benefits Schedule benefit for a service, additional charges have to be met by the patient.
How to seek payment for a service
You can bill Child Dental Benefits Schedule patients in the following ways.
In the case of bulk billing, you accept the relevant Child Dental Benefits Schedule benefit as full payment for the service.
By law, you cannot charge the patient a co-payment of any kind for a bulk billed service.
At the end of a visit, you can request the patient to pay, in full, for the services provided. You will need to provide the patient with an itemised account/receipt containing all of the necessary details (see ‘What information must be included in billing for services?’ section on page 16) so that they can claim the benefit from Medicare.
Your patient can then claim the relevant benefits under the Child Dental Benefits Schedule by visiting a Service Centre or sending the itemised account/receipt to the Department of Human Services for payment.
At the end of a visit, you can provide the patient with an itemised account (invoice) for the services provided. The account must contain all of the information listed in the ‘What information must be included in billing for services?’ section on page 16.
In this case, the patient does not pay for the service at the time of the visit. Instead, the patient takes or sends the unpaid account to Medicare for a benefits cheque to be issued in your name (for the total benefit payable to the patient for the service).
It is then the patient’s responsibility to provide the Medicare cheque to you and pay the balance of the account, if any. When the patient presents your cheque and any balance and you issue a receipt, you should indicate on the receipt that a ‘Medicare cheque for $…. was included in the payment of the account’.
Dentists can lodge claims electronically with the Department of Human Services.
The claiming channel you choose can make a big difference to your practice’s productivity, cash-flow and patient service. The many benefits associated with moving from manually lodging claims to using electronic claiming include:
less paperwork and faster payment;
streamlined billing processes;
greater patient satisfaction; and
processing both Patient and Bulk Bill claims.
The Department of Human Services offers a choice of:
Medicare Online; and
To discuss electronic claiming options that would suit your practice or to organise a visit from a Business Development Officer, you can contact the eBusiness Service Line on 1800 700 199 (calls from mobile phones may be charged at a higher rate). The eBusiness Service Line is available Monday to Friday, between 8:30am and 5:00pm, Australian Eastern Standard Time.
More information about the different types of online claiming and the benefits is available at the Department of Human Services website (www.humanservices.gov.au), then Health professionals > Services > Medicare Easyclaim
If you are unable to submit an electronic claim, approved bulk billing/Medicare claim forms can be obtained by visiting the Department of Human Services website (www.humanservices.gov.au), then Health professionals > Forms > Forms by Code:
DB1N-DB: Dental Provider Header form (DB1N-DB)
DB1N-DB(i): Instruction Sheet Dental Provider only form (DB1N-DB(i))
DB2-DB: Dental Provider Voucher form (DB2-DB)
DB2-DB(i): Instruction sheet Dental Provider only (DB2-DB(i))
It is recommended that you submit manual claims as soon as possible after the patient visit.