IMPORTANT CHANGES TO BILLING POLICY
Dear Valued Patients,
It is with regret that we wish to inform you that current Medicare rebates no longer cover the increasing costs associated with providing you with high quality medical care and as a result we have had to review our billing policy.
The reality is that Medicare rebates have never fully covered the cost of providing you with a safe and high quality service you know and love and that private billing is necessary to help cover our practice costs. These costs include employing and retaining skilled receptionists and practice nurses, and the other costs associated with meeting our operating expenses such as rent, medical equipment and consumables, electricity, computers and insurances. This is because the rate at which successive governments have indexed the Medicare Schedule fees has been substantially lower than increases in the Consumer Price Index (CPI) and increasing average weekly costs of running the practice.
These changes will come into effect from MONDAY 2nd AUGUST 2021.
Please continue reading to understand the changes and how they may affect you.
What is mixed-billing?
Mixed-billing means that some patients pay a ‘gap payment’ for appointments. A gap payment is an out-of-pocket cost that is the difference between the practice’s private fee and your Medicare rebate. For our practice, some patients who are eligible for a Medicare rebate will incur an out-of-pocket cost of $20-40 depending on our their individual circumstances.
Current DVA, aged-pensioners and children under 16yo will still be routinely bulk billed to DVA and Medicare, where applicable, and discretionary bulk billing is still available for those experiencing hardship – please speak to your GP or the Practice Manager if you have concerns.
Consistent with our past billing policy, we reserve the right charge a non-rebatable fee of $20 for any “Did Not Attend” (DNA) appointments. These are appointments where a patient has failed attend without providing an acceptable reason.
Again, some patients will continue to be bulk-billed or will be eligible for the lesser concession holder fee.
When will bulk-billing still apply?
Access to healthcare is very important to us. Therefore, certain patients will continue to be bulk-billed or receive a concession fee.
Patients who will continue to be bulk-billed are:
- Children 16 years or younger,
- Aged and Disability Pension card holders, and
- Defence Veterans.
Patients who will be eligible for concession fees are:
- Full-time students with a valid student card,
- Health card card holders,
- Other government-approved concession cards.
Patients seeking bulk-billing or concession entitlements will need to present their valid concession cards at their appointment.
How will the fee be processed?
You will be charged the full private fee to your debit or credit card at the end of your appointment.
We can then electronically process your Medicare rebate on your behalf to a valid debit card. The rebate should appear in your bank account within 1-2 business days. We recommend that you ensure your bank details are up-to-date on my.gov.au or to visit your local Medicare branch to avoid any delays in receiving your rebate. We are unable to process Medicare rebates back to a credit card. Please ensure you bring a valid debit card with you even if you are paying on a credit card.
Patients who are not bulk-billed or concession card holders should expect an out-of-pocket (OOP) fee as outlined in the new fee structure below:
- A standard consultation (20 mins or less):
- HCC/CC holders: $59.10 ($20.00 OOP)
- Non-CC holders: $79.10 ($40.00 OOP)
- A long consultation (40 mins or less):
- HCC/CC holder: $95.75 ($20.00 OOP)
- Non-CC holders: $115.75 ($40.00 OOP).
- An extended consultation (over 40 mins):
- HCC/CC holders: $131.50 ($20.00 OOP)
- Non-CC holders: $151.50 ($40.00 OOP)
These fees will also apply to telehealth appointments in which case an invoice will be generated and posted to the patient. All accounts are to be settled before another appointment will be made.
If you are under financial strain at any time, please contact the Practice Manager to discuss options for payment plans.
*Please note that whilst we do accept cash as payment, exact payment is required as we do not keep any cash on the premises to be able to provide change.
How will I know the cost of my appointment before I come in?
Our reception staff will always try to give you the most accurate advice possible about the costs of your appointment ahead of time. However, please keep in mind that the reception staff will only be able to offer you advice based on the information you provide and that your type of consultation may vary in your appointment.
Key indicators that will change the cost of your appointment include the length (time) of your appointment, how many issues you discuss with the doctor, and whether there is a procedure involved in your appointment. We have purposely kept the gap payment consistent all affected appointment types so that patients do not experience too much variation.
Reasons for the change in policy
We introduce this new billing policy with mixed emotions after many years of consideration and hesitation. As a practice, we strongly believe that everyone deserves to have access to high-quality healthcare regardless of their financial situation. We have remained a primarily bulk-billing practice for so long because we believe it is an effective way to keep people engaged with their healthcare when they may otherwise not.
To our dismay, the reality of our healthcare system remains that this ideal is far too big and bold for one small practice to carry. We have held out in hope of reforms to Medicare that have never come. The returns we receive from Medicare simply do not cover our costs of operating as a practice, let alone as a practice that prides itself on providing the highest quality of primary healthcare possible.
This increase to our common services will allow us to continue to bulk bill for the many other services we currently provide, such as Care Plans, skin excisions, spirometry, etc. and as is our current practice, any follow-up appointments will continue to be billed at the discretion of the GP.
We are committed to maintaining and improving the quality of healthcare we provide and have had to take this step in order to protect the sustainability of our practice.
We cannot thank you enough for your ongoing support of our practice – in the past and into the future – as we make this transition.
Please don’t hesitate to reach out if you are in need of assistance.