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How do we capture patient consent for bulk billed appointments?

Last updated 17 June 2026 05:47   ∙   ~ minute read
Best Practice - Medical Director (Pracsoft) - Zedmed (currently trialing)

This article explains how you can capture patients' written consent in order to bulk bill their consultation, as well as view a list of patients that have received a request in the Bulk Billing Consent section of the HotDoc Dashboard.

If using Best Practice and Medical Director, a copy of this will be saved into their patient file in your practice software for your record and auditing purposes. If using Zedmed, you can download the PDF copy of the patient's consent directly in the HotDoc Dashboard.

 

In this article

  • How does our Bulk Billing Consent feature work?
    • When is consent requested?
  • How to enable and send bulk billing consent requests
  • How to view a list of patients that received consent requests
  • What to do when a patient's consent status is 'Requires action'
  • FAQs
    • Does it have to be a HotDoc appointment for a request to send?
    • Does this have to be a telehealth appointment for a request to send? 
    • Do you resend the request to a patient if they don't reply?
    • Does a request send if we click 'Hold' on the invoice? (Best Practice)
    • Does this send if the invoice is billed to DVA? 
    • Do we still need to fill in the DB4 / DB4e form?
    • Do I need to send the patient a copy of the completed DB4 form?
    • Can we export patient data from the Bulk Billing Consent page? 
    • Do requests sent to patients expire?

 

How does our Bulk Billing Consent feature work?

HotDoc can automatically send a notification to the patient to request their consent to bulk bill the consult once the invoice has been generated for their appointment, if you have enabled one or both of the following settings: 

  • Send notification to request patient consent for telehealth consults
  • Send notification to request patient consent for face-to-face consults

We will also resend an additional notification if they do not respond to their initial notification. 

The consent request will include the date and time of consultation, item number, benefit amount, patient name and healthcare professional name. 

Once the patient selects 'I agree' to provide their consent, if using Best Practice or Medical Director (Pracsoft) we will save this as a PDF to the patient's file in your Practice Software, and for Zedmed you can download a PDF copy manually in the HotDoc Dashboard.

The PDF will include the date and time the patient agreed to assign the of Medicare benefit to the practitioner, alongside the information mentioned above. 

 

When is consent requested?

Consent requests will be sent when the appointment meets the relevant criteria below:

For telehealth appointments (When 'Send notification to request patient consent for telehealth consults' is enabled)

  • The appointment type name contains one of the following terms: 'Telehealth' - ' Telephone' - ' Phone call' - ' Phone consult' - ' Teleconference' - 'Video' -  ' Tele health' - ' Phone - consult' OR, the appointment type has Telehealth settings enabled in HotDoc 
  • AND, the invoice is billed to Medicare with a valid MBS item 

For face-to-face appointments (When 'Send notification to request patient consent for face-to-face consults' is enabled)

  • The appointment is not telehealth (as identified above)
  • AND, the invoice is billed to Medicare with a valid MBS item 

Please view the steps below to enable this and see how it works.


 

How to enable and send bulk billing consent requests  

Select the respective tab below to see the appropriate instructions for your practice

If Best Practice is your Practice Management Software:

  1. In the HotDoc Dashboard, go to Bookings > Bulk Billing Consent, check the box next to Send notification to request patient consent and/or Send notification to request patient consent for telehealth consults > select Save
    Screenshot 2025-07-22 at 4.06.21 PM.png
     
  2. After enabling the setting, once the patient has been seen for their appointment, the practitioner will finalise the visit in Best Practice with the relevant MBS items and select Save:

    finalise visit BP.png

     
  3. Once the practitioner finalises the visit, you can click create account directly from the appointment tile in Best Practice to create the invoice:

    Screenshot 2023-10-05 at 4.20.24 pm.png

     
  4. In the invoice ensure "Bill to" is "Medicare Direct Bill" then select Store.

     

    Please note: If using HotDoc Payments and the patient added a payment method for this appointment, assigning this to Medicare Direct Bill will automatically cancel the HotDoc payment request. 


    med direct bill invoice.png

     

  5. The patient will then automatically receive one notification in the following priority order: push notification or email or SMS, asking them to approve bulk billing for their visit:  
    • Emails will be prioritised over SMS as they have the highest consent response rate and are preferred as per Services Australia's recommendations.
    • Push Notification is sent to the patients mobile and opens in HotDoc app
    • Email & SMS are sent to the details listed in their patient file in Best Practice

       

      Note: Bulk Billing Consent requests for face-to-face appointments will be sent by email and push notification only, not by SMS. Please ensure your patients have an email address in their patient file.

       

      Screenshot 2025-07-21 at 11.19.00 AM.png
      Example of email, sent for both Telehealth and face-to-face appointments

      original-A1F7A65D-DE55-4720-9D2B-1B1150308BE7.png

      Please note: It can take 5-10mins for the first sms to go through for patients
       

      Example of SMS, sent for Telehealth appointments only


       

  6. Upon opening this, for security reasons they will be required to enter their last name and date of birth then select Verify confirm it's them before providing their consent:

    Screenshot 2023-10-10 at 4.56.38 pm.png

     
  7. The patient will then be redirected to a page with all appropriate details for their consult in alignment with the approved digital assignment of medicare benefit form, where they will select "I agree" to provide their consent, or select "decline". 
     

    - Please note: If the patient declines, you will see this in the Bulk Billing Consent History in your Dashboard. We will not send another notification if they decline. Please contact the patient directly to capture payment or consent via an alternative method.


    Screenshot 2023-12-18 at 11.41.37 am.png
    Screenshot 2023-12-18 at 11.43.21 am.png
     
     

    • If the patient is 12 years or younger, there will be a field for the guardian to enter their full name:

      guardian decline button.png

       
  8. After clicking 'I agree' the patient will see a confirmation message informing them their consent to bulk billing has been recorded and they can download a copy of their consent.

    pt confirmation.png

     
  9. A PDF document of the patient's consent is then saved in patient's file in Best Practice, under Correspondence In. Click this to open the document to view their consent. 
     
    bb consent in pt file BP.png
    Screenshot 2023-12-18 at 12.01.59 pm.png
    Example of the PDF document once opened

     
  10. From here, the doctor will not need to fill in the DB4 / DB4(e) form, unless they captured consent verbally from the patient. View Services Australia's page here for more.

     
  11. If the patient does not respond to their consent request on the day of their appointment, we will resend a second and final notification the next day from 9am (all timezones) via the original send method if possible.

     

    Screenshot 2025-07-22 at 9.22.00 AM.png Screenshot 2023-11-09 at 1.31.02 pm.png



 

  •  
    •  

If Medical Director (Pracsoft) is your Practice Management Software

  1. In the HotDoc Dashboard, go to Bookings > Bulk Billing Consent, check the box next to Send notification to request patient consent and/or Send notification to request patient consent for telehealth consults > select Save

    Screenshot 2025-07-22 at 4.06.21 PM.png

  2. After enabling the setting, once the patient has been seen for their appointment, finalise the visit in Pracsoft, ensuring: 
    • Invoice to: is Bulk Bill 
    • You've added the relevant MBS items 
    • Remove from Waiting Room is ticked in Visit options 
    • Finally, click Voucher (or Claim)
      • Please note: Clicking 'Voucher'/'Claim' triggers HotDoc to sync the invoice and send a request to the patient. If your software submits a claim to Medicare upon clicking 'Claim', it may send prior to capturing consent. We recommend batch claiming to Medicare after receiving patient's consent.


         

        mbs items pracsoft - harry coldstien.png

         



         

  3. The patient will then automatically receive one notification in the following priority order: push notification or email or SMS, asking them to approve bulk billing for their visit:   
    • Emails will be prioritised over SMS as they have the highest consent response rate and are preferred as per Services Australia's recommendations.
    • Push Notification is sent to the patients mobile and opens in HotDoc app
    • Email & SMS are sent to the details listed in their patient file in Medical Director

       
    • Note: Bulk Billing Consent requests for face-to-face appointments will be sent by email and push notification only, not by SMS. Please ensure your patients have an email address in their patient file.

       

      Screenshot 2025-07-21 at 11.19.00 AM.png
      Example of email, sent for both Telehealth and face-to-face appointments

      original-A1F7A65D-DE55-4720-9D2B-1B1150308BE7.png

      Please note: It can take 5-10mins for the first sms to go through for patients
       

      Example of SMS, sent for Telehealth appointments only
  4. Upon opening this, for security reasons they will be required to enter their last name and date of birth then select Verify confirm it's them before providing their consent:

    Screenshot 2023-10-10 at 4.56.38 pm.png

     
  5. The patient will then be redirected to a page with all appropriate details for their consult in alignment with the approved digital assignment of medicare benefit form, where they will select "I agree" to provide their consent, or select "decline". 

     

    - Please note: If the patient declines, you will see this in the Bulk Billing Consent History in your Dashboard. We will not send another notification if they decline. Please contact the patient directly to capture payment or consent via an alternative method.



    Screenshot 2023-12-18 at 11.41.37 am.png
    Screenshot 2023-12-18 at 11.43.21 am.png

     

    • If the patient is 12 years or younger, there will be a field for the guardian to enter their full name:

      guardian decline button.png

       
  6. After clicking 'I agree' they will see a confirmation message informing them their consent to bulk billing has been recorded and they can also download a copy of their consent.

    pt confirmation.png

     
  7. A PDF document of the patient's consent is then saved in patient's file in Medical Director under Documents. Click this to open the document to view their consent. 

    BB MD documents.png
    Screenshot 2023-12-18 at 12.01.59 pm.png
    Example of PDF consent


  8. From here, the doctor will not need to fill in the DB4 / DB4(e) form, unless they captured consent verbally from the patient.

     
  9. If the patient does not respond to their consent request on the day of their appointment, we will resend a second and final notification the next day from 9am (all timezones) via the original send method if possible.

     

    Screenshot 2025-07-22 at 9.22.00 AM.png Screenshot 2023-11-09 at 1.31.02 pm.png




 

If Zedmed is your practice software

  1. In the HotDoc Dashboard, go to Bookings > Bulk Billing Consent, check the box next to Send notification to request patient consent and/or Send notification to request patient consent for telehealth consults > select Save

    Screenshot 2025-07-22 at 4.09.21 PM.png

     
  2. After enabling the setting and once the patient has been seen for their appointment, bill the patient in Zedmed by creating a new invoice, ensuring:
     
    • Payer: Medicare 
       
    • You've added the relevant MBS items
    • Finally, click Supress

      zedmed invoice.png

       
  3. The patient will then automatically receive one notification in the following priority order: push notification or email or SMS, asking them to approve bulk billing for their visit:   
    • Emails will be prioritised over SMS as they have the highest consent response rate and are preferred as per Services Australia's recommendations.
    • Push Notification is sent to the patients mobile and opens in HotDoc app
    • Email & SMS are sent to the details listed in their patient file in Medical Director
       
Note: Bulk Billing Consent requests for face-to-face appointments will be sent by email and push notification only, not by SMS. Please ensure your patients have an email address in their patient file.

 

  • Screenshot 2025-07-21 at 11.19.00 AM.png
    Example of email, sent for both Telehealth and face-to-face appointments

    original-A1F7A65D-DE55-4720-9D2B-1B1150308BE7.png

    Please note: It can take 5-10mins for the first sms to go through for patients
     

    Example of SMS, sent for Telehealth appointments only
  1. Upon opening this, for security reasons they will be required to enter their last name and date of birth then select Verify confirm it's them before providing their consent:

    Screenshot 2023-11-13 at 6.02.54 pm.png

     
  2. The patient will then be redirected to a page with all appropriate details for their consult in alignment with the approved digital assignment of medicare benefit form, where they will select "I agree" to provide their consent, or select "decline". 
     

    - Please note: If the patient declines, you will see this in the Bulk Billing Consent History in your Dashboard. We will not send another notification if they decline. Please contact the patient directly to capture payment or consent via an alternative method.


    Screenshot 2023-12-18 at 11.41.37 am.png
    Screenshot 2023-12-18 at 11.43.21 am.png

     

    • If the patient is 12 years or younger, there will be a field for the guardian to enter their full name:

      guardian decline button.png

       
  3. After clicking 'I agree' they will see a confirmation message informing them their consent to bulk billing has been recorded and they can also download a copy of their consent.

    pt confirmation.png


     
  4. Ensure you have a copy of the patient's consent, you can Download each PDF in the HotDoc Dashboard, by going to Bulk billing consent > Download PDF
    • Please note! Consents will be removed after 30 days of sending the request to the patient. Please ensure you download these forms before then.
    • You will need to download each form individually.
    • Consents will download as [initials]_bulk_billing_consent_dd_mm_yy

      Screenshot 2025-07-18 at 1.53.46 PM.png
       

      Screenshot 2023-11-15 at 3.29.40 pm.png
      Example of PDF once downloaded


       

  5. From here, the doctor will not need to fill in the DB4 / DB4(e) form, unless they captured consent verbally from the patient. View Services Australias page here for more.
  6. If the patient does not respond to their consent request on the day of their appointment, we will resend a second and final notification the next day from 9am (all timezones) via the original send method if possible.

     

    Screenshot 2025-07-22 at 9.22.00 AM.png Screenshot 2023-11-09 at 1.31.02 pm.png


     

 


How to view patients that received consent requests 

You can view a list of patients that received a consent request in the HotDoc Dashboard under Bookings > Bulk Billing Consent. This allows you to view the:

  • Appointment date and time

  • The Patients' and Practitioners' names

  • The status of the consent request (Request Sent, Requires Action, Declined, Completed)

  • Details about how and when we sent a request (time and send method)
  • Recorded of consent PDF to the patient file (Best Practice & Pracsoft only)

  • A Download PDF button to download a copy of patients consent (Zedmed only)
  1. In the HotDoc Dashboard go to Bookings > Bulk Billing Consent where you will see a list of patient requests.

    Screenshot 2025-07-22 at 4.12.41 PM.png
     
  2. You can filter by Patient Consent Status, Practitioner, Appointment Date or search by Patient name to view specific requests: 
    • If Status = Request sent - Patient has been sent a first or second request
    • If Status = Requires action - Patient has not responded to their second and final request. You will be required follow up with the patient manually.
    • If Status = Completed - Patient has agreed and provided their consent (Completed - Via HotDoc), or you have selected Mark as Complete (Completed - Manually Actioned)
    • If Status = Declined - Patient has declined consent request, please contact them to arrange payment or consent via an alternative method

      Screenshot 2023-12-18 at 1.38.37 pm.png

       
  3. Click on any patient to view the date, time and how we sent to the request to the patient (Eg. via Push Notification, Email or SMS)

    Screenshot 2023-11-02 at 10.40.46 am.png

     
  4. For Best Practice and Medical Director clinics:
    The Recorded in patient file column indicates if we have saved a PDF copy of the patient's written consent to their patient file. For Best Practice, this is saved to Correspondance In and for Medical Director, this is saved in the Documents tab (view steps above). 
    • If Status = Completed - PDF of patient consent saved in patient file 
    • If Status = Processing - PDF processing and will soon be saved in patient file 
    • If Status = Waiting for consent - Waiting for patient to approve consent in request
    • If Status = Manually actioned - You have selected Mark as Complete in the Dashboard
    • If Status = Will not attempt - Patient declined consent request, no PDF will be recorded.

      Screenshot 2025-07-22 at 4.13.54 PM.png
       
  5. For Zedmed clinics:
    Ensure you have a copy of the patient's consent, you can Download each PDF in the HotDoc Dashboard, by going to Bulk Billing Consent > Download PDF
    • Please note! Consents will be removed after 30 days of sending the request to the patient. Please ensure you download these forms before then.
    • You will need to download each form individually.
      Screenshot 2025-07-18 at 1.53.46 PM.png
       

What to do when a patient's consent status is 'Requires action'

We will attempt to send the patient two notifications to capture their consent.

If they do not respond to their final notification, or if the patient declines the consent request, this will move into a 'Requires action' status so that you can contact the patient directly to capture their consent and Mark them as complete.

  • The first notification will send on the day of the appointment after you create and process the patient's invoice.
  • If no response, the next day we will resend a second and final notification from 9am.
  • If no response to the final request, the following day we will move this into a 'Requires action' status.

Please view the instructions below to see how to view these and mark them as complete:

  1. In the HotDoc Dashboard go to Bookings > Bulk Billing Consent where you will see a list of patient requests:

    Screenshot 2025-07-22 at 4.17.19 PM.png

     
  2. In the 'Patient Consent' status, select 'Requires action' to view patients you need to contact:

    Screenshot 2023-11-02 at 11.48.02 am.png

     
  3. Click on any row to view when and how the patient received their two notifications. When contacting the patient, you can use this information to inform them how they can provide their consent or capture their consent a different way such as verbally.

    Screenshot 2023-11-02 at 11.45.54 am.png

     
  4. Once you have contacted the patient and captured their consent, select 'Mark as Complete' and this will move to a 'Completed - Manually actioned' status. 
    Screenshot 2023-11-02 at 11.45.54 am.png

    Screenshot 2023-11-02 at 11.44.59 am.png
     

     

    Please Note: If you would like the patient to provide consent for one of the requests that has already been sent you can do this until 30 days.

    If you look at the Sent: Email or SMS this will look like the below and you can direct your patient to complete this.

Screenshot 2023-11-09 at 1.15.01 pm.png original-A1F7A65D-DE55-4720-9D2B-1B1150308BE7.png
Email SMS

 


 

Frequently asked questions

Does it have to be a HotDoc appointment for a request to send?

No - If you have the Bulk Billing Consent request feature turned on, a request will send for any appointments booked at your practice that meet the criteria for sending. They will send for both online-booked and practice-booked appointments.

 

What does HotDoc consider to be a telehealth appointment? 

If you have the 'Send notification to request patient consent for telehealth consults' setting enabled, a request will send for any telehealth appointment type with the following words or phrases in the name  'Telehealth' - ' Telephone' - ' Phone call' - ' Phone consult' - ' Teleconference' - 'Video' -  ' Tele health' - ' Phone - consult'  

 

Do you resend the request to a patient if they don't reply?

Yes - If the patient does not reply on the day of their appointment, we will send a second and final notification the next day from 9am. If the patient does not reply again, the next day it will move into a Requires Action status and you will need to follow up with the patient directly. You can then select 'Mark as Complete' once you've done this. 

 

Does a request send if we click 'Hold' on the invoice? (Best Practice) 

No. At the moment, we can only send a request if you click 'Store' on the invoice.   

 

Does this send if the invoice is billed to DVA? 

No. We will only send a request if bill to is Medicare Direct Bill. 

 

Do we still need to fill in the DB4 / DB4e form?

We have updated our consent request form to be compliant with the new assignment of Medicare benefit form approved by Services Australia. When patients provide their consent via our feature, you will no longer need to fill in the DB4 / DB4e form!

For Telehealth services, if patients provide verbal agreement during a consultation, the provider needs to document this agreement in an approved form (DB4E or DB020) by typing in ‘patient verbally agreed’ in the patient signature field and sending a completed copy of the approved form to the patient - Please view this on their website: verbal consent.

 

Do I need to send the patient a copy of the completed DB4 form?

When the patient completes their form online, they have the option to download a copy of the completed form themselves.

 

Can we export patient data from the Bulk Billing Consent page? 

No, there currently isn't a way to export patient data from the Bookings > Bulk Billing Consent page. You can sort through the history in this page by using the filters such as patient response, consent status, appointment date, and practitioner to get more refined results, or you can search for a patient using their name as well. Optionally, you would like to print the page you can do this by right clicking on the page and selecting print. 

 

Do requests sent to patients expire?

Yes, Bulk Billing Consents will be removed from our system 30 days after they were created. If the patient attempts to click on a URL link to open a request after it has expired, they will see the below message and be directed to contact the clinic:

 

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