CHANGES TO THE FEES AT NORTHSIDE CLINIC FROM DECEMBER 2018

WE’VE MADE SOME NECESSARY CHANGES AND HERE’S WHY

As of 1st December 2018, our fees at Northside will be increasing slightly.

We’d like to provide some explanation of why this is happening.

Explaining bulk billing and private billing

The Medicare Benefits Scheme (MBS) lists the services the Government will fund, a recommended (‘schedule”) fee for each service and a rebate amount. The rebate is the amount that is paid to you by Medicare when you access eligible health services. In most cases, Medicare rebates do not cover the full cost of medical services and are typically paid as a percentage of the schedule fee.

The MBS schedule fee is a guide only and doctors are free to set their own fees for services. Private-billing patients pay for their treatment and receive a rebate from Medicare. There is a gap between what patients pay for services and the amount Medicare reimburses. This gap is known as an out-of-pocket expense.

Bulk Billing is where the Doctor agrees to accept only the rebate amount as a fee and bills Medicare directly for the medical service. There is no gap for the patient to pay. This means that you do not have any out-of-pocket expenses. It also means the doctor is receiving a lower fee for that service than if it is privately billed.

 Northside Clinic is a mixed billing clinic aiming to offer the same standard of healthcare to all, regardless of their financial status

  • We bulk bill: patients who hold a pension or health care card; children/teenagers under the age of 16; full-time students under the age of 26.
  • We privately bill: everyone else.
  • Bulk Billing is also available to any patient, at the discretion of the individual doctor.

How we set our fees

Most clinics follow the Australian Medical Association’s (AMA) list of suggested fees. These fees are higher than the Medicare schedule fees. At Northside Clinic, we generally set our fees lower than the AMA recommends. However, there is an ever-widening gap between the Medicare benefits doctors can recoup and the costs of running a practice.

Our main source of income to run the practice is consultation fees. It is not possible to run a quality general practice if all patients are bulk billed, as the business expenses cannot be covered. When you are charged a fee for a medical service, regardless of whether you pay privately or are bulk billed, the clinic must pay out of that fee all of the operational and business expenses of running the practice. This includes staff wages, insurance, utilities, consumables e.g. dressings, bandages etc. Even the magazines in the waiting room.

The “Freeze”

Governments have failed to regularly increase patient rebates over the years. In addition, between 2013 and July 2017, there was a Medicare rebate indexation “freeze”. This means Medicare rebates have not kept pace with the cost of living and have never covered the true cost of delivering quality medical care. This puts more financial pressure on privately owned clinics such as Northside Clinic, which is the same as not receiving a pay rise in 4 years. Yet, we are all aware how much the cost of living has gone up.

GPs working in private practice are not salaried. Under the rules of Medicare, we can only attract Medicare rebates when we are physically seeing patients face to face and billing Medicare. This explains why we may request that you make an appointment for certain types of referrals, receiving results and general follow-up. We may charge an administration fee for time spent if you do not attend.

Chronic Disease Management Plans

Some patients seen at the clinic are eligible for a Chronic Disease Management Plan (CDMP). This enables a GP to plan and coordinate the health care of patients with a chronic condition e.g. HIV, Diabetes, Cardiac Failure, Asthma, Cancer etc. If you have an eligible chronic condition, your GP is able to bulk bill you up to 4 times per year (at least 3 months apart) when you are seen for your chronic condition. However, for other visits unrelated to your chronic condition, or for frequent visits even if it is related to your chronic condition, you may be charged if you are a private billing patient.

High quality medical care

Many clinics that completely bulk bill their patients do so by offering brief, 5 – 10 minute appointments. This often leaves patients feeling like they have been rushed and not received quality care. Here at Northside Clinic we pride ourselves on excellent, quality medical care that is not rushed. We aim to make health care as affordable as we can to our patients, however we hope that you appreciate that there are costs involved in running a business. We hope to keep on top of those costs to continue to maintain the high standards of care and ambience that the clinic provides.

Questions

If you have any questions about our billing rates, please contact our Practice Manager, Felicia Miles, on 9485 7700.