Bulk-Billing to Mixed Billing: Cashflow & Finance Plan for Clinics Changing Their Model in 2025
Cashflow and finance plan for clinics moving from bulk billing to mixed billing – Switchboard Finance
Bulk-billing to mixed billing: cashflow & finance plan for clinics changing their model in 2025
Before you announce a fee change, line up a simple cash bridge and staged upgrade plan so the transition is calm, not chaotic for doctors, nurses and reception.
Model change in three simple steps
Clinics that map this change properly often pair it with the Whitecoat Clinic Cashflow Safety Net strategy instead of hoping the numbers “just work”.
What actually changes when you move off full bulk-billing
The moment you introduce gap fees, your patient mix, average consult value and daily cashflow all move at once. You’ll see fewer quick visits, longer consults and more conversations about fees at reception.
A simple before/after view helps doctors and practice managers agree on what “success” looks like: fewer patients, but better revenue per session and calmer rosters instead of sprinting through 60 consults a day.
| Area | Before (bulk-billing) | After (mixed billing) | What to watch |
|---|---|---|---|
| Consult revenue | Small margin per consult, high volume needed | Higher fee per visit, lower daily consult count | Don’t panic if daily consult numbers drop – watch weekly billings instead. |
| Receipting pattern | Mostly Medicare rebates same day | Mix of rebates, gap payments and late payers | Track how quickly patients pay their portion so reception isn’t chasing debt. |
| Reception load | Fast check-ins, minimal fee conversations | More time spent explaining fees and options | Allow longer standard consult times so queues don’t spill into the hallway. |
| Doctor & nurse time | Short consults, more rushing and burnout | Longer consults, more complex care and follow-up | Balance rosters so longer consults still match your wage bill and room capacity. |
Example: A three-GP suburban clinic drops from 38 to 30 consults per doctor per day after moving to mixed billing, but weekly billings rise 18% once the new fee structure beds in and patients adjust.
Set up a simple cash bridge before you announce the change
The safest clinics lock in their finance safety net first, then change their billing model. That way wages, rent and supplier bills are covered even if the first few months feel bumpy or quieter than expected.
Think of it as a three-part bridge: a flexible LOC for bills, a short-term top-up facility, and a way to bring forward Medicare and insurer receipts if payment times blow out.
Example: A regional clinic sets up a $150k LOC plus a modest working capital loan before changing fees. When consult numbers dip for two months, salaries and rent still go out on time while the model settles.
Stage upgrades so debt and mixed billing move together
Changing your billing model and doing a full refit at the same time can stretch everyone. It’s usually safer to separate “model change” from “big equipment and fitout projects” so the clinic sees how patient behaviour stabilises first.
You can still plan the upgrade ladder now – chairs, rooms, imaging – but line it up with the Low Doc Asset Finance pathway, the Whitecoat Growth Pack and your key Whitecoat upgrade blogs.
| Stage | Main focus | Finance move |
|---|---|---|
| 3–6 months before change | Fee modelling, communications, minor room tweaks | Use targeted fit-out finance only for essentials like reception flow and patient-facing areas. |
| First 3–6 months after change | Monitor bookings, DNA rates, patient feedback | Hold off on large medical equipment spends until you have three months of clean, post-change data. |
| 6–12 months after change | Lock in new “normal” and growth plan | Refinance older loans into a cleaner low doc structure and align new equipment deals with the upgraded fee model. |
Example: A coastal clinic waits six months after moving to mixed billing before financing a new ultrasound room. By then, their numbers show stable demand, so the lender is more comfortable with the deal and repayments stay inside a safe slice of revenue.
Change the billing model with a safety net already in place
Moving from bulk-billing to mixed billing doesn’t have to be scary if you treat it like any other growth project: build a buffer, line up the right facilities and track the numbers. Use this guide together with the Whitecoat Clinic Cashflow Safety Net and Business Cashflow System blogs.
Clinics that prepare early usually combine a LOC, a small working capital facility and, where needed, invoice finance – then add upgrades through Low Doc Asset Finance once the model is proven. That way the new fees feel like a step up, not a leap off a cliff.
Bulk-billing to mixed billing FAQs for clinics
Short answers for practice owners and managers planning a model change but wanting the numbers to feel predictable, not fragile.
Most clinics build a simple 12-month cash flow forecast that compares “old model” to “new model” billings and wages.
That doesn’t need to be fancy – just clear assumptions on patient volume, fee levels and when you expect demand to stabilise after the announcement.
Sometimes. It’s worth checking contracts, sessional agreements and any written trade terms that mention pricing, bulk-billing or gap fees.
Most partners are fine with well-communicated changes, but lenders like to know you’ve checked this so no key agreement is accidentally breached.
Track your days in accounts receivable before and after the change so you can see if claims are stretching out.
If they are, backing in a LOC or invoice finance facility gives you options to smooth that timing rather than leaning on personal cash.
Gap fees change the mix of what shows up in your BAS, especially if you’ve been heavily bulk-billing up to now.
Your accountant can map this out quickly so you know how much to set aside each month and how that interacts with any finance repayments.
Expect to provide recent bank statements, a simple profit snapshot and a short explanation of your billing change.
If you already have clear fee policies and basic projections, it’s much easier for a lender to size a LOC or working capital facility that actually fits your clinic.
