Question
A patient's appointment should have triggered a Bulk Billing Consent request, but they haven't received one – or the request isn't showing as sent in the Dashboard. Why is this happening, and how do I fix it?
| This article covers troubleshooting for Bulk Billing Consent requests that appear not to have sent. If you haven't set up Bulk Billing Consent yet, or need a refresher on how the feature works day-to-day, see: How do we capture patient consent for bulk billing appointments? (From 1 July 2026) |
Solution
Check your Bulk Billing Consent settings
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Go to Medicare Hub > Bulk Billing Consent > Settings and confirm Post-assignment is switched on. If it's off, no request will send automatically after an appointment is billed.
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Check whether Post-assignment is enabled for Telehealth, face-to-face, or both. If only one is ticked, appointments of the other type won't trigger a request – see Check whether the appointment was classified as telehealth or face-to-face below.
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If you expected a pre-assignment request rather than a post-assignment one, remember these are always sent manually. Enabling Pre-assignment only makes the Send a Pre-assignment Consent button available in the Dashboard – it doesn't send anything on its own. Confirm a staff member actually sent the request.
Check how the appointment was invoiced
A post-assignment request only sends once the invoice is created and finalised in a specific way. This step is different for each practice management software.
Select the tab below for your practice management software
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Confirm the invoice's Bill to field was set to Medicare Direct Bill, and was
finalised with Store (or Print) – not left on Hold. Hold is the only action that prevents a request from being sent.
- Confirm a valid MBS item was added to the invoice before it was stored.
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Confirm the visit was finalised by clicking Voucher (or Claim) – saving the visit without vouchering it won't trigger a request.
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Confirm Invoice to was set to Bulk Bill, with the relevant MBS items added.
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Confirm Remove from Waiting Room was ticked in Visit options.
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Confirm the invoice's Payer was set to Medicare, and that Suppress was clicked on the invoice, with the relevant MBS items added.
- Remember Bulk Billing Consent for Zedmed is currently in trials. If your practice hasn't been activated, no request will send regardless of how the invoice was processed – contact support to check your activation status.
| Regardless of practice management software, a request will never send for an invoice billed to DVA – only Medicare Direct Bill invoices trigger a consent request. |
Check whether the appointment was classified as telehealth or face-to-face
An appointment is classified as telehealth when either:
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the appointment type has Telehealth settings enabled in HotDoc; or
- the appointment type name in your clinical software includes one of these terms: Telehealth, Telephone, Phone call, Phone consult, Teleconference, Video, Tele health, or Phone – consult.
If neither of these criteria are met, it will be treated as face-to-face even if it was actually a phone or video consult.
If Post-assignment consent is only enabled for Telehealth and the appointment was classified as face-to-face (or vice versa), that mismatch is why the request didn't send.
Check the patient's contact details
If the request was unable to send because the patient's contact details were missing or invalid, this will be shown in the Dashboard with the status Action Required - Unable to send:
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Confirm the patient has a valid email address on file. Face-to-face requests only send by email and push notification – a patient with no email and no HotDoc app has no way to receive one.
- Confirm the patient's mobile number is correct if you were expecting an SMS (telehealth appointments only).
Once the contact details have been updated, you can resend the request.
Check the request hasn't expired or already been resent
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Requests are removed from HotDoc 30 days after creation. If it's been longer than this, the original request will no longer be visible or actionable.
- Each request can only be resent once. If it's already been resent and the patient still hasn't responded, the status will show as Requires action rather than sending again automatically.
Check for an archived or duplicate practitioner link
If you've worked through the checks above and the request still doesn't appear anywhere in the Dashboard, the cause may sit at the practitioner level.
A post-assignment request can only be sent when the PMS practitioner is linked to exactly one active HotDoc doctor.
A request will not be sent if:
- The linked HotDoc doctor is archived in either HotDoc or your PMS. See How to archive or reactivate a Practitioner.
- The same PMS practitioner is linked to more than one HotDoc Dashboard. This can occur when multiple locations share the same database. See How do I set up a Practitioner in HotDoc that works across multiple locations?.
Other things to check
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If a pre-assignment request was already sent and completed for this appointment, and the item billed falls within the Basic Service Description that was selected, HotDoc won't send a second, post-assignment request – this is expected behaviour.
- Best Practice only: if Best Practice's native Assignment of Benefit feature is enabled with Managed externally selected, HotDoc will still capture consent as normal, but this is a separate workflow from Medicare batching – it won't affect whether the consent request itself sent. See: Should I enable Best Practice's native Assignment of Benefit (AoB) feature?
I still need help
Been through the steps above and still not sure why a request didn't send? Reach out to the HotDoc Support team with the patient name and appointment date, and we'll help you through the next steps.