Applies to: Medicare Online, ECLIPSE and Easyclaim claiming through Tyro Health Online and integrated practice management systems (PMS).
Do you deliver bulk billed services? This guide explains how to obtain and record a patient's consent (the Assignment of Benefit) for every Tyro Health channel, across in-person and telehealth scenarios, and what is changing from 1 July 2026.
What's new: The way you obtain Assignment of Benefit is changing.
New requirements commence on 1 July 2026, with a 12-month transition period during which verbal assignment remains permitted until 30 June 2027.
This article covers what you need to do from 1 July 2026 onwards.
In a nutshell
To bulk bill a service, the patient (or a person acting on their behalf) must assign their Medicare benefit to you. In return, they pay no out-of-pocket cost.
From 1 July 2026 the patient (or assignor) must sign an assignment agreement - electronically or on paper. You (the provider) no longer need to sign it.
There is no longer a single approved form (previously called the DB4). An agreement is valid in any format - paper or electronic - as long as it contains the required information (the "data set").
You can capture consent before the service (pre-assignment) or after it (post-assignment).
During the transition period (1 July 2026 – 30 June 2027), verbal assignment is permitted in all settings. Even when consent is given verbally, you must keep a completed agreement on record.
You must retain a completed agreement for 2 years and provide a copy to the patient on request.
Tyro Health Medicare Easyclaim is already a compliant AoB solution, and Medicare Online bulk bill claiming through Tyro Health Online introduces electronic AoB support from 1 July 2026.
The exact steps depend on which channel you claim through and how you see the patient. Use the quick reference below, then jump to the relevant section.
Quick reference: What's required by channel and scenario
Channel | In-person | Remote / Telehealth | How consent is captured | AoB record |
Medicare Online | Patient/assignor approves via SMS link, or AoB is managed externally | Patient/assignor approves via SMS link (or verbal consent during transition) | Electronic approval (APPROVE) on the SMS-linked agreement, or AoB managed externally / in your PMS
| Completed agreement stored in Tyro Health Online - download it from the invoice screen |
ECLIPSE | Capture a compliant AoB using your existing process | Capture a compliant AoB using your existing process | Tyro Health optional electronic workflow being finalised - use your existing compliant process for now | Keep a copy of the completed agreement |
Easyclaim (Tyro EFTPOS terminal) | Patient (or responsible person) selects YES to "Do you assign your right to benefit?" on the EFTPOS machine | Not suitable for remote claims - the card and terminal must be present | YES/NO response on the EFTPOS machine (post-consultation agreement) | AoB agreement and receipt printed by the terminal - print practitioner and patient copies |
Tip: If your practice uses an integrated PMS that captures consent at booking or at the time of service, follow your PMS workflow - see Using an integrated practice management system below.
What is Assignment of Benefit (AoB)?
Under the Health Insurance Act 1973, the Australian Government subsidises the cost of health services and pays Medicare benefits to patients.
When a patient directs that benefit to you as full payment for a bulk billed service - so they have no out-of-pocket cost - they are assigning their benefit.
AoB itself isn't new: patients or an authorised representative acting on their behalf have always needed to assign their benefit when a service is bulk billed. What is changing is how that consent must be collected and managed.
An assignor is the person who would otherwise pay for the service if it were not bulk billed. This is often the patient, but for a child or a person who cannot consent it may be a parent, guardian, carer or attorney. A person employed by the rendering practitioner cannot be the assignor (unless they are the patient's own parent/carer).
What's changing from 1 July 2026 (and through to 1 July 2027)
These changes modernise how consent is captured. They do not introduce a new requirement to be bulk billed; assignment has always been required. What changes is how you record it.
From 1 July 2026:
Sign, don't just say.
The patient/assignor must provide a physical or electronic signature to confirm they assign their benefit. The provider no longer signs the agreement.
No mandatory form.
The concept of an "approved form" (DB4) is replaced by a required data set. Any format - paper, electronic vis SMS, or built into your PMS - is valid if it contains all the required information.
Pre- or post-assignment.
Consent can be captured before the service (pre-assignment) or after it (post-assignment), as long as it is in place before the claim is lodged.
Enduring agreements.
These become available for eligible patients (MyMedicare registered patients, residents of aged care homes, and patients of ACCHOs/AMSs) for ongoing GP bulk billed services.
Record keeping.
Keep a completed agreement for 2 years and provide a copy to the patient on request.
Transition period - 1 July 2026 to 30 June 2027
Verbal assignment is permitted in all settings during the transition. You must still create and keep a completed agreement for record-keeping (2 years).
The health department's compliance approach during early implementation prioritises education and prevention.
From 1 July 2027, the transition ends and verbal assignment is no longer permitted. Plan to have a signed (physical or electronic) agreement captured for every bulk billed claim.
Pre-assignment vs post-assignment
Two episodic agreement types are available under the Medicare changes. The information captured differs, so choose the one that fits your workflow.
Pre-assignment (before the service)
Captured before the appointment - for example at online booking, on a check-in kiosk, or at reception check-in.
Uses a basic service description (a category of services) rather than a specific MBS item, because the exact item may not be known yet.
The associated claim can only be submitted after the service is rendered.
If the service changes: if what's delivered falls outside the basic service description - or a different practitioner renders the service - the pre-assignment becomes void and you must capture a post-assignment agreement.
A pre-assignment can cover multiple known services for up to 6 months (e.g. dialysis, cancer treatment, palliative care) where each service, date and the same practitioner are specified.
At launch (1 July 2026), Tyro Health's electronic AoB is a post-service workflow. Manage pre-assignment through your PMS or your existing process for now - a downloadable PDF AoB agreement to support acceptance before claim submission is planned for a later release.
Post-assignment (after the service)
Captured after the service is delivered - the traditional approach, and the basis of Tyro Health's electronic AoB at launch.
The agreement must record the MBS item number(s) for the service(s) rendered.
Use this whenever the service differs from what was booked, or when pre-assignment doesn't suit your workflow.
Which should I use?
If service details often vary between booking and delivery, post-assignment is usually simpler. If you reliably know the service ahead of time, pre-assignment lets you capture consent at booking or check-in (via your PMS or existing process).
AoB by channel
Medicare Online (Tyro Health Online or via an integrated PMS)
From 1 July 2026, Tyro Health Online supports a new electronic AoB feature for Medicare Online bulk bill claiming, whether the claim is initiated from an integrated PMS or directly in Tyro Health Online.
You can either use Tyro Health's electronic (SMS) AoB workflow, or manage AoB externally - for example through your PMS or an existing pre-assignment process.
What your patient needs to provide: their full name, date of birth and Medicare card details - plus a mobile number if you use the SMS workflow.
Using Tyro Health's electronic AoB (SMS) workflow:
Initiate the Medicare bulk bill claim from your PMS or directly in Tyro Health Online after the service has been provided, and confirm the patient or assignor's mobile number.
Tyro Health Online generates a compliant AoB agreement and sends it to the patient or assignor by SMS. The claim stays Pending until it is approved.
The patient or assignor opens the SMS link, reviews the agreement and selects APPROVE to assign their benefit. The claim is then submitted automatically. If they don't approve, the claim is not submitted.
A completed copy of the AoB agreement is automatically stored in Tyro Health Online and can be downloaded from the invoice screen to give to the patient and to meet your 2-year record-keeping obligation.
Managing AoB externally:
If you capture consent another way (for example a pre-assignment in your PMS, or your own agreement), select the external option to acknowledge AoB has been obtained separately. The claim is submitted immediately.
ECLIPSE (Tyro Health Online or via an integrated PMS)
ECLIPSE is used for in-hospital and simplified billing claims, and the same assignment principles apply. Capture and retain a compliant AoB agreement (signed by the patient/assignor, or verbal during the transition) using your existing process, and keep a copy for 2 years.
The 1 July 2026 simplified billing requirements for privately insured hospital and hospital-substitute treatment (Schemes & Agreements) are a separate set of rules and are not changed by the bulk billing AoB updates described here.
Check your specific claiming scenario if you bill privately insured in-hospital services.
Easyclaim (Tyro EFTPOS terminal)
Tyro Health Medicare Easyclaim is already a compliant AoB solution and needs no changes for 1 July 2026. It is available for PMS-initiated bulk bill transactions on Countertop and Mobile EFTPOS devices (standalone and PMS-initiated transactions on the Tyro Health Pro Key are coming later in 2026).
Easyclaim is for in-person services only - the patient must be present.
How it captures AoB (a post-consultation agreement):
Initiate the bulk bill claim from your PMS or directly on the Tyro Health Pro Key after the service has been provided, using the Tyro Health EFTPOS machine with Medicare Easyclaim.
The EFTPOS machine prints the AoB agreement for the assignor to review.
The machine (and your PMS, so staff can prompt the assignor) shows "Do you assign your right to benefit?". Selecting YES proceeds with the claim and prints a patient receipt confirming the AoB; selecting NO cancels the claim and nothing is submitted to Medicare.
After the claim completes, print a practitioner and patient copy of the receipt to retain your AoB record for the 2-year requirement.
Easyclaim cannot be used for remote/telehealth claims because it relies on the physical terminal. For telehealth, use Medicare Online instead.
AoB by scenario
In-person services
Medicare Online: send the AoB agreement by SMS for the patient/assignor to APPROVE, or record that AoB was obtained externally (e.g. in your PMS).
Easyclaim: the patient (or responsible person) selects YES to "Do you assign your right to benefit?" on the EFTPOS machine.
ECLIPSE: capture a compliant AoB using your existing process (Tyro Health electronic workflow to come).
Remote / Telehealth services
Use Medicare Online - Easyclaim is not available remotely.
Collect the patient's name, DOB and Medicare card details over your telehealth channel, and confirm their mobile number.
After the service, raise the bulk bill claim and send the AoB agreement by SMS; the patient or assignor selects APPROVE to assign their benefit and the claim is submitted automatically.
During the transition period only (until 30 June 2027), verbal assignment is also acceptable - but you must still create and retain a completed AoB agreement (stored in Tyro Health Online) for 2 years.
From 1 July 2027, capture an electronic approval (or other signature) for telehealth bulk billed claims rather than relying on verbal consent.
Using an integrated practice management system (PMS)
If you claim through a PMS integrated with Tyro Health, your AoB workflow may be handled within the PMS rather than in Tyro Health Online.
Depending on how your PMS is configured, when you raise a Medicare Online bulk bill claim you (or your PMS) can:
Use Tyro Health's electronic AoB - send the agreement by SMS for the patient/assignor to approve; or
Manage AoB externally - for example via a pre-assignment captured in your PMS, or your own agreement - and acknowledge that AoB has been obtained separately so the claim submits immediately.
Your PMS may also capture consent at the time of booking (pre-assignment) or at the time of service (for example on a check-in kiosk or tablet). Follow your PMS provider's workflow for capturing and storing the assignment. The same legal requirements apply regardless of where consent is captured.
Capabilities vary between PMS partners. If you're unsure whether your PMS captures AoB consent (and at which point in the workflow), check with your PMS provider or contact Tyro Health Support.
To check whether your software supports Medicare Easyclaim or Medicare Online bulk billing with Tyro Health, see the PMS integrations directory.
Enduring agreements (eligible patients)
From 1 July 2026, eligible patients can make a single enduring agreement for ongoing GP bulk billed services, instead of assigning for each service.
Enduring agreements are available to:
Patients registered with MyMedicare (one agreement covering GPs at their MyMedicare practice, if offered);
Patients of an ACCHO or AMS (can hold multiple agreements with multiple ACCHOs/AMSs);
Residents of a residential aged care home (can hold multiple agreements with different practitioners).
Key points:
Only GPs in these settings can enter an enduring agreement (not consultant physicians or other specialists).
An enduring agreement can be terminated by either party with written notice; it ends 2 business days after notice is given. It also ends automatically in certain circumstances (e.g. the patient leaves the MyMedicare practice, the practitioner leaves, or the patient turns 14).
For MyMedicare enduring agreements, the provider must notify the assignor in writing within 24 hours of making a claim (including the practitioner's name, patient's name, date of service and benefit amount). Post-service notifications are not required for aged care or ACCHO/AMS enduring agreements.
Once agreed, the provider must bulk bill all in-scope services until the agreement is terminated.
Record keeping and copies
Retain every completed AoB agreement (electronic or hard copy) for 2 years.
Provide a copy to the patient if they request one.
AoB agreements are not submitted to Services Australia (except for manual claims) - they are held by you as evidence of a valid bulk billed service for compliance or audit purposes.
Things to watch
Service or practitioner changes after a pre-assignment: if the rendered service falls outside the agreed basic service description, the date changes, or a different practitioner delivers the service, the pre-assignment is void - capture a post-assignment agreement instead.
Patient declines to assign: bill privately and give them an invoice so they can claim their benefit from Services Australia. In a pre-assignment scenario a patient can decide after the service; if they ultimately decline, they're responsible for the out-of-pocket payment.
Penalties still apply: for example obtaining a signature before the required details are entered, or failing to give the patient a copy. Make sure the agreement is complete before it's signed.
Pathology: has its own transitional arrangements (request forms issued before 1 July 2026 remain valid for AoB for up to 12 months). Check the FAQ if you handle pathology requests.
Do you need to do anything before 1 July 2026?
If you already use Tyro Health Medicare Easyclaim for bulk bill claiming, no action is required - it is already compliant.
If you submit Medicare Online bulk bill claims through Tyro Health Online, electronic AoB support is available from 1 July 2026. Decide whether you'll use Tyro Health's SMS AoB workflow or manage AoB externally (e.g. in your PMS).
If you use an integrated PMS, check with your PMS provider about how AoB can be captured in your workflow.
Useful links
Assignment of Medicare Benefits for Bulk Billing – Frequently Asked Questions (https://www.health.gov.au/sites/default/files/2026-06/assignment-of-medicare-benefits-for-bulk-billing-frequently-asked-questions_0.pdf).
Assignment of benefit - signature requirements and exemptions - Services Australia.