Bulk billing, help?

[hubbert0403]

Hi guys

since arriving in December I have visited the Dr 4 times, first time due to existing problem other 3 follow ups after tests. Each time I have paid $65 and then received so much back again in same transaction. Yesterday I was informed by a friend (who has been here 10 years) that i should not be paying anything if Dr is bulk billing, which they are.

Also had to go as morning outpatient for another test, called our health care provider who agreed that this bill could be paid by them, all well and good so we thought until today. Received a call from consultant secretary stating that the consultant agreed tests to go under bulk billing but she could not put it through as we are on prociricle medicare card??? she explained that she was sending an invoice and a claim form for medicare.

a) still have no clue exactly what bulk billing is

b) should we be paying

c) what on earth is the secretary on about, do we have to pay for treatment nd claim back although insurance were paying for it?

:mask:

Any help would be beneficial

[Guest guest73691]

Bulk Billing is when a provider (e.g. a doctor) bills Medicare directly for any medical services that the patient receives. The patient doesn't need to pay anything. I see a doctor who bulk bills and I don't pay them anything despite only being on a reciprocal (rather than a full) Medicare card - I think this is what the secretary may have meant?. I think I just had to sign/fill in a form when I registered with the GP surgery. This link will give you some more information about builk billing: http://www.medicareaustralia.gov.au/provider/medicare/bulk-billing.jsp.

[Alaska]

I know someone who had a similar problem on a Reciprocal card and the GP had to put on the forms that it was an "acute medical condition". They didn't get billed again.

[paisleylass]

I *think* at a bulk-billing practice you pay something (around half +\- $5) if you are on a 457 visa, so classed as a visitor, from a reciprocal country, as opposed to a PR who would pay nothing. At least that's how the receptionist at my GPs explained it. Something to do with the colour of the card??

 

That said, I have been to see my GP 4 times and been sent to pathology, but only ever got charged the first time?! Confused!

[Alaska]

We are on a 457 visa and don't pay anything at a bulk-billing practice Paisleylass. We have visited 3 different ones between us and never paid a cent.

[paisleylass]

Thanks Alaska, I'm not sure what's going on with my GP, I think they actually stopped bulk billing anyway 'cos I was warned when I made my last appt that there'd be something to pay (while waiting, I heard them say that to everyone), but didn't get charged on the day?! I may change GP before they realise I've been seen 3 times for gratis :oD

[Quoll]

Medicare is a co-pay system so most Aussies expect to pay something - I've never seen such a focus on getting bulk billed as there is from the UK expat community. Bulk billing was instituted for those who couldn't afford to pay the co-payment. It seems that doctors choose to be bulk billing practices where there is more competition for their services - where there is a dearth of GPs you are less likely to find bulk billers. The corporate medical centres are more likely to bulk bill than individual general practice surgeries.

[NicF]

Check with the receptionists as it might be that, if there are several drs at the practice not all of them bulk bill. Where we go children are bulk billed all the time, people on a health care card are bulk billed during the week only and some drs only bulk bill for appointments before a certain time.

[blossom]

We were in reciprocal Medicare cards for nearly five years. The only time I ever had to pay was when I was waiting for a new Medicare card ( they went through a stage of sending then out lasting two months at a time, and we kept having to reapply). I paid on the day, took the receipt into Medicare and got most of it back. And got to by pass the queue as I was counted as a private pacient rather than a bulk billing one.

Hubbie did have to pay for an X-ray (which I told him he didn't need, and he was told he had to pay as it wasn't needed. Doh.

 

Something sounds a bit strange here.

[Johndoe]

Medicare is a co-pay system so most Aussies expect to pay something - I've never seen such a focus on getting bulk billed as there is from the UK expat community. Bulk billing was instituted for those who couldn't afford to pay the co-payment. It seems that doctors choose to be bulk billing practices where there is more competition for their services - where there is a dearth of GPs you are less likely to find bulk billers. The corporate medical centres are more likely to bulk bill than individual general practice surgeries.

 

I have also found that those who bulk bill seem to be "more in touch with the common man" and the problems that they may have meeting medical bills.

[tonyman]

ive joined a new pratice last year that only bulk bills and is two mins away from our place ! i get in straight away and waiting time is minimal, never paid a cent eather .....twin cut his head open last monday that was a Public Holiday , phoned my GP , come straight away they said , saw the doc , then nurse , doc cleaned his head ,put stitches in ect and said come back next week to remove them , with nothing to pay .......

 

i was 5 yrs with another local practice , waiting time was a joke ,always at least 45 mins and got sick of paying out , when you have 5 kids like us you dont want to be hanging around doctors when they are sick ,they just get irritable ...some people treat the docs like a community centre but i better not get to involved in that subject!

[tonyman]

A quick definition of Bulk Billing is where the Doctor charges the Government for your medical care, and you pay nothing.

You will find some locations where most doctors will Bulk Bill, and other areas where few doctors will bulk bill.

In the cheaper areas of Western Sydney, almost all doctors bulk billed, but in the more expensive areas of Sydney, very few doctors would consider it.

Due to recent legislation, we are now finding that more doctors are bulk billing for Children and Pensioners, due to financial incentives from the government for the Doctors to do this,

Medicare will normally cover the following:

 

 

• 100% of the Schedule fee for GP services
  
• 85% of the Schedule fee for other out-of-hospital services
  
• 75% of the Schedule fee for in-hospital services
  
• The Schedule fee is a fee for service set by the Australian Government and not what your doctor charges you.
  

 

 

 

• www.medicare.gov.au/
  

 

 

If a Doctor fully bulk bills, they will not charge you, but they will get paid all of the scheduled fee direct from the Medicare.

Some Doctors wish to charge, say $50.00 or more, so one of two things happens:

 

 

1. The doctor will charge you say $50, and YOU claim 100% of the scheduled $33.55 fee back from the local Medicare Office. Net cost to you = $16.45
   
2. The doctor collects $16.45 from you, and gets you to sign the Medicare benefit over to them, and they claim the $33.55 direct from Medicare. Net cost is the same.
   

 

This difference is called “A Gap”

More very recent legislation is putting a limit on the maximum “Gap” that you have to pay each year. ie: Once you have paid a certain figure, Medicare will step in again, and repay more of the doctors bill to you. I don’t have full details to hand.

When someone visits a Specialist, Medicare will pay 85% of the Medicare Schedule fee for services provided by the treating practitioner. Let’s say that the specialist performs a Category “C” Consultation for which the “scheduled fee” is $73.75, but charges you $150. You end up paying the difference between the $150 and the Medicare rebate of $73.75 ie: $76.25

Public Hospitals don’t charge anything for Medicare patients, and sometimes even give you free medicine !!

[h=5]Bulk Billing Doctors House Calls[/h]Family Care Medical Services

Family Care Medical Services provides after hours doctors house calls in South East Queensland as well as in North and West Sydney.

Doctors after hours house calls start from 6 pm from Monday to Friday and cease at 8 am the following day.

Saturday services commence at noon.

House calls are available all day and night on Sundays and gazetted public holidays.

www.familycare.com.au

There is a fee for the consultation if the patient does not attend to General Practices which subscribe to the service.

The minimum fee for a standard consultation after 6 pm is $165 and after 11 pm is $185. (as at Dec 2010)

Medicare will refund $120.30 before 11 pm and $141.75 after 11 pm. (Subject to annual changes)

Patients of subscribing General Practices that are concession card holders (i.e. pension, health care card, DVA gold card), a child under 16 years or a Family Care Friendly Society member or a nursing home resident will be bulk billed.

Family Care Friendly Society

www.familycarefriendlysociety.com.au/

Family membership $42.50 per year

Covers the member and spouse, children under 18 years, full-time dependant students 18 years to 25 years, parents over 75 years and permanently disabled children of age living in the member’s household.

[h=5]Links:[/h]

[Eera]

Mine advertises as a bulk billing practise, but only bulk bills certain patients like pensioners and children. If I need a prescription renewed I generally wait until a child needs something looked at and get it done at the same time; I resent paying for a doctor to scribble on a piece of paper.

[ali]

Our practise only bulk bills children, Elderly and health care card holders. Some blood tests aren't bulk billed for example by path labs.

[Guest littlesarah]

Personally, I don't have a problem with the idea of contributing directly to the costs of my health care. My recent miscarriage led me to incur about $150 of co-payment fees for scans, but bloods and everything else was covered in full by medicare. I'm just pleased that I was treated promptly and well, and with compassion by every health worker I came into contact with. The outcome isn't one I can say I'm happy with (obviously), but at least I'm still here and safe - a few decades ago I may not even be here now, and in some countries in this day and age women still die from complications of foetal demise. I'd have paid a lot more than $150 to know that my health would be preserved.

 

As for a prescription being just a 'scribble on a bit of paper' - I think that rather underestimates the ethical and legal aspects of prescribing. Given that all drugs carry potential risks as well as benefits, I place considerable value on safe and appropriate prescribing. It's remarks like those that make me glad I'm no longer involved full-time in delivering patient care, when a person considers years of training and ongoing education to be of little or no worth. If your GP is willing to prescribe for you when you're not even attending as the patient, you're fortunate. Still, I'm sure every person who makes those sort of remarks quite happily works for nothing just because others think their knowledge and skills have no value :err:...

[blossom]

I have been to get the pill, told the dr what one I take and not even had my blood pressure taken. All I have received is a scribble on a piece of paper.

 

I don't agree with a system which will stop some people getting treatment because they don't have the spare money for the fee. I know a few people like this. They work so can't claim anything but just don't have the spare money so go, so problems get worse and worse.

[Guest littlesarah]

I have been to get the pill, told the dr what one I take and not even had my blood pressure taken. All I have received is a scribble on a piece of paper.

 

I don't agree with a system which will stop some people getting treatment because they don't have the spare money for the fee. I know a few people like this. They work so can't claim anything but just don't have the spare money so go, so problems get worse and worse.

 

Given that a prescriber has a degree of liability for adverse outcomes that result from their prescribing, I would always have concerns about one who doesn't follow best practice guidelines in minimising risks associated with the drug they're writing up.

 

There surely cannot be many people who cannot afford to see a doctor, and not be eligible for some assistance. We're not exactly loaded, but always make sure we have a small sum put by to cover unforeseen events including the need for medical attention. Maintaining that 'emergency fund' hasn't always been easy, but for us it's a priority - even $1 a week can add up to one GP visit. Not all GPs do have a co-payment, though I understand that within one geographical location just getting registered with a GP can be really difficult (some areas have walk-in centres and similar to try to address the shortage of medical services for low-income households).