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MBS offers several types of patient billing to doctors. Any of these Services could be for a particular patient, or for a particular group of patients (e.g. in the rooms or in a particular hospital), or for all the doctor's patients, according to preference.
1. Normal Billing
For doctors who may not wish to establish their own facility for patient billing, MBS offers a full billing service. This applies to any medical billing and may include both ambulatory patients and patients in hospital. The doctor is charged a small processing fee per invoice.
2. Simplified Medical Billing
Simplified medical billing refers to billing by a licensed agency (like MBS) for medical services, which have been provided to a patient in a private hospital and are billed on either a 'no-gap' or a 'known-gap' basis. The various medical accounts are consolidated and billed directly to the appropriate Private Health Fund and Medicare.
There may or may not be a patient co-payment (i.e. 'gap' payment by the patient), depending on the arrangement between the doctor and the individual patient. There are thus two forms of simplified medical billing (depending on the 'gap'") and both are offered by MBS.
The remittance of funds to the doctor immediately they are received by MBS and the small charge by MBS for its services, are the same as for normal billing (above).
3. No Gap
'No Gap' simplified medical billing occurs when:
 the doctor charges the CMBS fee, or
the doctor and the Private Health Fund (either directly or via a private hospital) have an agreement for payment above the CMBS fee and the doctor charges the agreed fee, or
the doctor uses an existing Private Health Fund 'product' (such as HBA's Ezyclaim or Medibank Private's GapCover) and does not charge the patient an additional amount.
4. Known Gap
'Known gap' simplified medical billing occurs when there has been an informed financial consent process between the doctor and the patient.
MBS collects:
75% of the CMBS fee from Medicare, and
25% of the CMBS fee from the Private Health Fund, and
any agreed premium above the CMBS fee from the Private Health Fund (if a specific process like HBA's Ezyclaim or Medibank Private's GapCover is being used), and
the balance (i.e. the previously agreed 'gap') from the patient.
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