Healthcare Debt Management and Recovery

• AusHealth manages debts relating to Medicare-eligible or Medicare-ineligible patients.
• Our recovery team is experienced in engaging productively with debtors
• They are specially trained to safeguard vulnerable patients.
• AusHealth can be called upon any time after invoice generation – including at the back end of the revenue lifecycle.
• AusHealth is a charity and all proceeds from our debt management services go to support medical research.

Healthcare receivables sit at the intersection of patient vulnerability, complex payer arrangements, legal obligations and financial sustainability. Generic collection approaches can create complaints and reputational harm while still leaving legitimate revenue unrecovered.

AusHealth combines specialist healthcare knowledge with disciplined debt-management and recovery processes to recover more revenue while treating patients, residents and families with dignity.

Our debt management and recovery model

• Segmented, risk-based strategy: Profile accounts by value, complexity, payer, vulnerability and probability of recovery so effort, contact methods and review frequency reflect the circumstances of each account.
• Payer validation and routing: Confirm the party responsible for payment across private health insurance, Medicare-ineligible and overseas patients, compensable schemes, DVA, guarantors and self-funded accounts before recovery action progresses.
• Respectful multichannel engagement: Use appropriate telephone, SMS, email and digital channels, with collection paused and reviewed when a debt is disputed, consent is unclear or vulnerability is identified.
• Hardship and payment arrangements: Apply structured financial assessment and offer suitable payment plans, deferments, negotiated settlements, waivers or referrals where circumstances warrant them.
• Write-off and impairment support: Recommend write-off only after reasonable recovery options are exhausted, supported by evidence and reason codes that strengthen root-cause analysis and AASB 9 impairment assessment.
• Reconciliation and reporting: Provide secure handling of recovered funds, invoice-level remittance information, regular reconciliation and clear reporting on recovery performance, payment arrangements, disputes and write-offs.

Long stay debt management

Long-stay patients can move between funding categories as insurance benefits exhaust, classifications change and discharge pathways remain unresolved. These accounts require active management throughout the admission rather than a standard process applied at discharge.

• Early and recurring review: Review funding status, insurance entitlements and billing classification throughout the admission across clinical, social work, bed management, revenue and finance teams.
• Extended-admission accuracy: Track benefit caps, pre-approvals, accommodation changes, status reclassifications and charges across specialties so the account remains complete and correctly classified.
• Complex-payer and impairment management: Engage insurers and government payers before benefits or recovery windows close, and support individual assessment of material receivables that fall outside routine provisioning.

Aged care debt recovery

Aged care debt involves residents who may be vulnerable or cognitively impaired, representatives acting on their behalf and, at times, grieving families and deceased estates. Recovery must reflect that context while protecting legitimate fee and accommodation revenue.

• Authority and capacity: Verify capacity and the authority of attorneys, guardians, administrators, trustees or other representatives before financial engagement proceeds.
• Fees, accommodation and estates: Reconcile means-tested fees, co-contributions, RAD and DAP arrangements and other charges, and manage deceased-estate recovery sensitively with executors, administrators and solicitors.
• Vulnerability-aware recovery: Use structured vulnerability and hardship assessments, appropriate payment arrangements and clear write-off reasons while suppressing collection where consent or authority is not established.

Governance and delivery

Services can be delivered onsite or remotely. Each action is documented to support auditability and compliance with applicable privacy, consumer-credit, healthcare, aged-care and debt-collection requirements.

Bottom line: From identifying the correct payer to resolving long-stay, aged-care and complex debt, we manage the full recovery lifecycle, helping recover more revenue while protecting patients, residents and your reputation.

If your receivables are being managed through a generic collection model, a targeted ledger review can identify what remains recoverable and where the process is leaking revenue.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Aged care debt is especially complex. It sits with frail and often cognitively impaired residents, the representatives acting for them and the estates of residents who have died. Adding to the complexity, it’s often entangled with capacity, guardianship, means-testing and grief.

Choosing who recovers it is a governance decision as much as a commercial one. This decision must conform to the new Aged Care Act, its Statement of Rights (and the statutory duty it places on registered providers) and work under post-Royal Commission scrutiny.

The activity can be outsourced, but the obligation cannot: a collector built for utilities or telco arrears can generate complaints, findings and reputational harm – all of which remain with the aged care provider.

AusHealth combines specialist aged care knowledge with disciplined recovery processes to recover more of this revenue while treating residents and families with dignity. It is a simple fact that people treated with respect engage and pay more readily than those pursued and overwhelmed.

Our aged care debt recovery model

• Early intervention: Work with admissions and finance teams to fix the upstream causes of arrears, such as incomplete means assessments, unsigned agreements and unclear payment arrangements, before they become debt.
• Authority and capacity: Confirm who is genuinely authorised to act (attorney, Public Trustee, guardian, administrator or next of kin) and whether the resident had capacity to enter the agreement; this ensure defective consent does not become an unrecoverable debt. Distinguish registered supporters under the new Act who help residents make decisions but do not by that role alone have authority over their funds.
• Deceased-estate recovery: Engage executors, administrators and solicitors proactively and sensitively to recover outstanding fees and accommodation charges, timed around probate and without adding distress to a grieving family. Where the agreement allows, reconcile permitted deductions from the RAD refund and track statutory refund timeframes, so the refund process doesn’t itself create a compliance breach.
• Means-tested fee and accommodation reconciliation: Reconcile residential care fees, co-contributions, RAD and DAP payments and extra-service charges against Services Australia and departmental means assessments. Ensure debt from reclassification and assessment lag is corrected rather than chased.
• Vulnerability-aware, risk-based recovery: Apply structured vulnerability and hardship assessment with awareness of cognitive impairment and elder financial abuse, profile accounts by value, complexity and probability of recovery. Suppress collection where consent or authority is not established.
• Arrangements, write-off and reconciliation: Offer flexible payment plans, waivers and hardship referrals; recommend reason-coded write-off only once reasonable recovery is exhausted, supporting AASB 9 impairment; and provide secure trust-account handling, daily reconciliation and clear reporting.
• Complaints and feedback: Handle disputes and complaints in line with the provider’s own complaints process and Aged Care Quality and Safety Commission expectations Report themes back so recurring issues are fixed at the source.

Services can be delivered onsite or remotely, with every action documented to support auditability and compliance with the Aged Care Act 2024 and Aged Care Rules, the Statement of Rights, the strengthened Aged Care Quality Standards, the Aged Care Code of Conduct, the Privacy Act, and the ACCC and ASIC Debt Collection Guideline.

Bottom line: From verifying authority and capacity to reconciling means-tested fees and resolving estate accounts, we manage the full aged-care recovery lifecycle, recovering more of your legitimate fee and accommodation revenue, easing AASB 9 provisions and reducing the complaints and reputational harm generic collection creates, while treating residents and families with the dignity the Statement of Rights demands.

If your aged-care debt sits with a panel appointed on price, or your estate and means-tested ledgers have not been reviewed, a targeted ledger review can identify what remains recoverable and where the process is leaking revenue.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Some patients remain in hospital for months rather than days, long after their need for acute care has passed. This might be because an aged-care placement, NDIS plan or mental health bed has not arrived and there is nowhere else for them to go. As the system of last resort, the health service carries the financial cost every day.

This exposure is material and multi-layered: activity-based funding shortfalls, insurance benefits that exhaust mid-admission, overseas insurer resistance and AASB 9 obligations that collective provisioning was never built for.

AusHealth manages these accounts actively throughout the admission, as a cross-functional discipline rather than a billing task, protecting funding and insured revenue while treating patients with dignity.

Our long-stay debt management model

• Early, cross-functional funding review: Review each patient’s funding status, insurance entitlements and billing classification at regular intervals through the admission, not at discharge, across clinical, social work, bed management, revenue and finance.
• Care type change and Nursing Home Type Patient (NHTP) or Maintenance classification: Prompt timely clinical documentation of the change from acute to maintenance care and apply NHTP status once the patient passes the continuous-stay threshold. This means the correct patient contribution and fund benefits are raised from the right date, not backdated or missed.
• Extended-admission billing accuracy: Track benefit caps, reclassifications, accommodation changes and pre-approvals as they accumulate, reconciling charges across specialties into one correctly classified account. Issue interim accounts and fund claims through the stay rather than one large bill at discharge.
• Authority to act: Confirm who can make financial decisions for the patient, whether a financial attorney, guardian, administrator or Public Trustee. Where the patient lacks capacity and no one is appointed, flag and support applications to the relevant state tribunal so that billing and placement can progress.
• Overseas and complex-payer liaison: Engage health funds, overseas insurers and government payers early, before an overseas patient whose repatriation is blocked slides from fully insured to unrecoverable within weeks.
• Individual AASB 9 impairment assessment: Individually assess and document long-stay receivables that fall outside collective provisioning, so the provision is accurate and defensible at audit.
• Compassionate, informed engagement: Handle the financial conversation with staff who understand the vulnerability of a patient who has become stuck over weeks or months.
• Discharge and estate resolution: Finalise accounts on transfer to aged care, NDIS accommodation or another setting, and engage executors and administrators sensitively where a long-stay patient passes in hospital.

Services can be delivered onsite or remotely, with every action documented for auditability and compliance with the Privacy Act (APPs), RG 96, AASB 9, the NSQHS Standards and the Australian Charter of Healthcare Rights.

Bottom line: By managing long-stay accounts actively from admission to resolution, we recover more of the funding, patient contributions and insured revenue you are entitled to before benefits exhaust, keep provisioning accurate and audit-defensible, and see your longest-staying patients treated with dignity.

If your long-stay patients are being managed within workflows built for short admissions, a targeted ledger review can show what remains recoverable and where revenue is leaking.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Customers who fall behind on hospital accounts may do so because of a number of circumstances.

Some face a short-term payment difficulty, some are in genuine financial hardship, and some are vulnerable. Their capacity to engage may be affected by illness, grief, cognitive impairment, language or isolation.

Not recognising these factors can generate complaints, fly in the face of regulatory findings and cause reputational harm, while leaving recoverable revenue uncollected.

Recent ASIC hardship actions have raised the standard of care the regulators expect from creditors. Inconsistent, ad-hoc decisions now carry direct compliance risk.

AusHealth applies a structured, documented hardship and vulnerability framework that identifies each customer’s circumstances early and matches them to the right response, protecting legitimate revenue while treating people with dignity.

Our hardship and vulnerability assessment model

• Structured, defensible assessment: Assess each account across five hardship dimensions, seven vulnerability domains, six debt-risk dimensions and five cause categories, with transparent scoring and matched courses of action that replace inconsistent, ad-hoc decisions.
• Payment difficulty, hardship or vulnerability: Distinguish a short-term payment difficulty from genuine financial hardship and from vulnerability, so each customer receives a proportionate response rather than a blanket approach. Since vulnerability may be temporary, set review points and don’t assume a status is permanent.
• Vulnerability identification and adjusted care: Identify cognitive impairment, illness, grief, literacy, language and social isolation, and domestic violence; adjust communication, timing, third-party support and referrals to meet a higher standard of care.
• Early support and alternatives to legal action: Identify difficulty early and offer payment arrangements, deferrals, waivers and referrals to financial and legal counselling before an account escalates to legal proceedings.
• Governance, training and quality assurance: Support the framework with role-based staff training, interaction-quality and prohibited-conduct standards, and customer-experience measurement, all documented for audit and continuous improvement.

Services can be delivered onsite or remotely, with every assessment and decision documented to support auditability and compliance with the Privacy Act (APPs), the National Credit Code, the ACCC and ASIC debt-collection guideline (RG 96) and ASIC’s hardship expectations.

Bottom line: By identifying hardship and vulnerability early and matching each customer to a consistent, documented response, we help you recover more of what is genuinely recoverable, reduce complaints and regulatory exposure, and treat people in difficulty with the dignity a rising standard of care now demands.

If hardship and vulnerability are being handled case by case without a consistent framework, a focused review can identify where current decisions expose the organisation and where earlier, better-matched support would improve both recovery and compliance.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Not every unpaid account justifies the same recovery effort, and not every debtor is equally likely to pay. Pursuing low-prospect accounts can waste collection costs, while writing accounts off too early surrenders revenue that could have been recovered.

AusHealth scores each account through two lenses – propensity to pay and write-off risk – with the evidence behind every score preserved. The result is an objective, auditable view of recoverability that directs effort where it will pay off, confirms the correct payer, and supports defensible write-off and provisioning.

Our propensity-to-pay and write-off risk model

• Two assessment lenses: Score propensity to pay (the debtor’s likelihood of voluntary payment) and write-off risk (the account’s likelihood of proving uncollectable) on a common five-point scale, so most accounts carry both a recovery and a provisioning signal.
• Evidence-based, defensible scoring: Capture the evidential basis of every indicator through designation codes, so each assessment is transparent, auditable and able to withstand review, dispute or write-off scrutiny.
• Correct-payer identification: Confirm the party actually liable, whether Medicare, private health insurance, a compensable scheme, an overseas insurer, a government sponsor or the patient, using country-of-origin, visa-subclass and payer reference data.
• Proportionate, hardship-gated recovery: Match collection intensity and cost to the realistic prospect of recovery and the balance, always within the ceiling that hardship and vulnerability sets, so protections only ever reduce intensity.
• Defensible write-off and AASB 9 provisioning: Base write-off, waiver and settlement decisions on documented evidence and appropriate authority; in addition, feed a current view of recoverability into expected-credit-loss provisioning under AASB 9.

Services can be delivered onsite or remotely, with every assessment, score and decision documented for auditability and compliance with the ACCC and ASIC Debt Collection Guideline (RG 96), the Privacy Act 1988 (Cth) and the Australian Consumer Law.

Bottom line: By scoring each account for both propensity to pay and write-off risk, we help you concentrate effort where it will pay off, recover more at lower cost, and make write-off and provisioning decisions that are evidence-based and defensible under AASB 9.

If accounts are triaged and written off case by case, a focused review can show where effort is wasted on low-prospect accounts and where recoverable revenue is written off too early.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Most healthcare accounts resolve through early, respectful engagement, but some do not. When standard collection has been exhausted and an account remains unpaid, stronger and legally grounded action is needed to recover money owed, without exposing the health service to complaints or compliance risk.

AusHealth provides an extensive range of advanced recovery services, from letters of demand and skip tracing through to legal action, enforcement and, where appropriate, regulatory referral. Each step is escalated only when it is warranted and proportionate, and only with the health service’s approval. This means  recovery is pursued firmly but disputed, vulnerable or hardship accounts continue to be handled with care.

Our advanced debt collection services

• Demand and debtor location: Issue letters of demand and final demand, and locate debtors and their assets through data washing, skip tracing, investigation and a full range of company, business, individual and title searches.
• Pre-legal checks: Before any account moves to legal action, confirm the debt is valid and correctly billed, the right payer has been pursued, there is no open dispute or complaint, the account is within the limitation period, and hardship and vulnerability have been rechecked. Legal action proceeds only where the likely recovery justifies the cost and the health service has approved it.
• Legal recovery action: Pursue minor civil action with legal advice, service of documents, examination summonses and court attendance, and enforce outcomes through garnishee orders, mortgagee letters and instalment orders.
• Negotiated resolution: Resolve accounts through payment arrangements, deferments, extensions, waivers, exemptions and negotiated settlements, and manage disputed debts to a documented outcome.
• Defensible write-off: Recommend bad-debt write-off where further enforcement is not warranted, supported by the evidence and reason codes that make the decision defensible and strengthen AASB 9 provisioning.
• Regulatory referral and reporting: Handle eligible Department of Home Affairs (DHA) reporting and refer suspected immigration, citizenship or Medicare-card fraud to the appropriate authorities, alongside other mercantile-agent services where required.

Services can be delivered onsite or remotely, with each action documented for auditability and compliance with the ACCC and ASIC Debt Collection Guideline (RG 96), applicable state and Commonwealth privacy and health records legislation, the Privacy Act 1988 (Cth), the Australian Consumer Law and the relevant court and enforcement rules.

Bottom line: When standard collection has run its course, we escalate recovery firmly and proportionately, from demand and tracing through to enforcement and write-off, helping health services recover more of what they are genuinely owed while staying compliant and protecting their reputation.

If accounts are being written off simply because standard collection has stalled, a focused review can identify which debts remain recoverable through advanced action and where enforcement would be proportionate.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

When accounts have accumulated and a backlog of unpaid debt has built up, a health service needs a concentrated, time-bound effort to clear it rather than business-as-usual collection. AusHealth’s Debt Clean-up service applies that intensive effort, working through an aged ledger methodically to recover what is collectable and resolve what is not. We also actively work on younger buckets so the backlog does not rebuild.

Clearing a backlog at pace still demands care. Many patients in an aged ledger may not have heard from the health service in months, so first contact needs to explain the account clearly and expect questions or disputes.

AusHealth balances a disciplined, risk-based collections process against the sensitivity each account requires, particularly for vulnerable patients, drawing on the same capabilities as our patient-admissions and advanced-debt-collection services to recover more while protecting patients and your reputation.

Our debt clean-up service

• Scoping and baseline: Agree the scope, timeframe and exit criteria up front, and reconcile the ledger extract to the general ledger so there is a clear starting position against which results are measured.
• Risk-based triage and analysis: Profile the aged ledger through risk-based credit management, credit-loss-rate analysis and skip tracing, so effort is concentrated on the accounts most likely to be recovered.
• Third-party funder and guarantor clearing: Identify and clear amounts owed by third-party funders and guarantors, such as health funds, compensable insurers, DVA and overseas insurers; this means debt sitting with the wrong party is routed correctly rather than pursued from the patient or written off.
• Hardship-sensitive engagement: Apply structured hardship and vulnerability assessment so vulnerable patients are identified early and collection is paused, adjusted or referred rather than pressed inappropriately.
• Payment and resolution: Negotiate and take payments, and resolve accounts through payment plans, settlements and guarantor arrangements to a documented outcome.
• Complaints readiness: Work with the health service’s patient liaison or complaints team in disputes and complaints handling, since contact volumes rise sharply during a clean-up.
• Write-off and reporting: Recommend evidence-based bad-debt write-off where recovery is not warranted, in line with the health service’s delegations, and handle DHA reporting, so the cleared ledger is accurate and defensible.
• Root-cause findings and handover: Report on why the backlog built up (for example gaps in admissions, billing or follow-up), and hand remaining accounts back into business-as-usual processes with clear recommendations.

Services can be delivered onsite or remotely, with each action documented for auditability and compliance with the ACCC and ASIC Debt Collection Guideline (RG 96), applicable state and Commonwealth privacy and health records legislation, the Privacy Act 1988 (Cth) and applicable confidentiality and consumer requirements.

Bottom line: An intensive, sensitively run clean-up clears an aged backlog while protecting patients, recovering on average 40% of outstanding balances and as much as 55%, improving cash returns by more than 30%, materially reducing aged debt and doubtful-debt provisions, and holding regulatory risk below a 5% probability of an adverse event. It also leaves the health service with a clean ledger and a clear view of what caused the backlog.

If an aged-debt backlog is tying up cash and inflating your provisions, a focused ledger review can show how much is realistically recoverable through a concentrated clean-up and where to begin.

HOW CAN WE HELP?

Schedule an in-person or a virtual meeting

Call: 1-800 724 457

Email: info@aushealth.com.au

Outsourced revenue recovery rests on trust — the accuracy of the work, the legality of every patient contact and the security of the clinical and financial data moving through it.
AusHealth manages that foundation with independently certified systems, a credentialled compliance function and a modern, standards-aligned security environment, so the health services we work with can evidence quality, meet their obligations and protect their data without carrying the governance overhead.

AusHealth is independently certified to ISO 9001 (Quality) and ISO 45001 (Safety) and aligns its information-security controls to ISO/IEC 27001 and the ASD Essential Eight — the position our SOCI-classified clients rely on.

Our quality, compliance and data security framework includes

• Certified quality management: An Integrated Quality Management System certified to ISO 9001:2015 and ISO 45001:2018 (TQCSI), with clinical coders assigning accurate diagnostic and procedure codes to ICD-10-AM/ACHI/ACS, state coding authorities and IHACPA conventions.
• Quality assurance: Calls are recorded and a sample is reviewed each month against conduct, accuracy and hardship standards, with results fed into coaching to improve quality and compliance.
• Australian data hosting: Client data, including data held in our Collect system, is stored and processed in Australia, and our key technology suppliers are assessed for security and privacy risk before and during engagement.
• Staff screening and training: Staff undergo pre-employment screening, including National Police Checks, and are bound by annual confidentiality agreements and training.
• Regulatory compliance: A documented Legislative Compliance Procedure and Register aligning AusHealth to the ACCC/ASIC Debt Collection Guidelines, Australian Consumer Law, and privacy, credit and anti-discrimination law – with no finding of non-compliance under any law relevant to debt collection.
• Governed compliance and risk: A Compliance and Performance Policy consistent with AS 3806 and ISO 37301, enacted by a credentialled Quality and Compliance Manager with internal audit, and a risk system aligned to AS/NZS ISO 31000 with a Risk and Quality Plan for each implementation.
• Layered information security: Controls aligned to the ASD Essential Eight – application hardening, timely patching and application control, least-privilege access, multi-factor authentication across every access point, and secure, immutable daily backups. Controls are tested through regular vulnerability scanning and independent penetration testing.
• ISO/IEC 27001 controls and encryption: AusHealth is pursuing ISO/IEC 27001 accreditation under the Australian Government PSPF and ISM, with access-controlled sites, encryption at rest and in transit, endpoint protection and automated monitoring with full audit trails.
• Secure transfer, payments and privacy: A modern SFTP architecture using each client’s own identity provider, conditional access for cloud resources and annually reviewed PCI-DSS attestations; data is handled under the Privacy Act, its Privacy Principles and ISO/IEC 29100, with staff bound by annual confidentiality agreements and training.  Client data is never entered into public AI tools.
• Records, complaints and responsible business: Records managed to AS ISO 15489 and complaints to AS ISO 10002 and the NSQHS Clinical Governance Standard; full insurance cover; alignment to the Modern Slavery Act 2018; and, as a registered charity, profit returned to medical research – over $60 million since 1985.

Bottom line: every check and control is documented, mapped to a recognised standard and independently audited where applicable — so you can outsource revenue recovery knowing your patients’ data and your organisation’s obligations are protected, and compliance can be evidenced rather than asserted.

If quality, compliance and data security are currently assured through separate policies or ad-hoc controls, a focused review can confirm where obligations are met and where independent, standards-based assurance would strengthen your position.