Bulk Billing

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,

In essence when someone visits a Doctor, Medicare will pay 85% of the Medicare Schedule fee for services provided by the treating practitioner. Let's say that the "scheduled fee" is $38.00

If a Doctor fully bulk bills, they will not charge you, but they will get paid 85% of that $38 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 85% of the scheduled $38 fee back from the local Medicare Office ($32.30). Net cost to you = $17.70

2: The doctor collects $17.70 from you, and gets you to sign the Medicare benefit over to them, and they claim the $32.30 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.

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




Links:

• Bulk Billing Doctors on the Gold Coast - Gold Coast Bulk Billers
  
• Bulk Billing Doctors in Sydney - Sydney Bulk Billers
  
• Bulk Billing Doctors in Brisbane - Brisbane Bulk Billers
  
• Bulk Billing Doctors in Perth - Perth Bulk Billers
  
• Bulk Billing Doctors in Adelaide - Adelaide Bulk Billers
  
• Bulk Billing Doctors in Melbourne - Melbourne Bulk Billers
  
• Bulk Billing Doctors in Cairns - Cairns Bulk Billers
  
  
  
  





Bulk Billing Statistics




In 2000, over 70% of all services covered by Medicare were bulk billed with the patient not having to pay anything.

In the December quarter of 2005, 75.1 per cent of all Medicare services were bulk billed.

In the March quarter of 2008, 73.7% of all Medicare services were bulk billed. This varied in each State as follows:

84.1% New South Wales
78.7% South Australia
76.4% Victoria
76.2% Queensland
73.3% Tasmania
71.8% Western Australia
62.9% Northern Territory
52.2% Australian Capital Territory



Bulk Billing Statistics from:http://www.health.gov.au/medicarestats



Medicare Rebate is now $31.45 (Jan 2008), up from the $30.85 in 2006.

Extract from: http://www.aph.gov.au/.../05bd058.htm

For example, a standard consultation with a GP lasting 15-20 minutes (item 23 on the MBS) has a schedule fee of $30.85.
The 85 per cent Medicare rebate for this service is $26.25. The amendments to the Health Insurance Act proposed by this Bill will increase the rebate for this service by $4.60 to $30.85. This means that, for a standard GP consultation:

• where the doctor bulk bills (that is, where the doctor accepts the Medicare benefit as full payment for the service, and bills Medicare directly, thus providing the service free at the point of delivery to the patient), the doctor will receive an extra $4.60 as payment for the service, and


• where the doctor does not bulk bill, the patient will receive an additional $4.60 of Medicare benefit.
  

For example, under the current arrangements patients receive a Medicare benefit of $26.25 for a standard GP consultation.
Under the new arrangements proposed by this Bill, patients will receive a rebate of $30.85.
This means that, if a doctor charges $50 for a standard consultation, the patient’s out-of-pocket costs (the difference between the fee charged upfront and the Medicare benefit) will be reduced from around $24 to around $19.

2008 Medicare Rebate figures:

Scheduled rebates and Consultations category.

A= $37.95 - Simple diagnosis (not too much time spent in consultation)
B = $55.75 - Selective medical history required (not too much time spent in consultation)
C = $73.75- Comprehensive medical history required (or B and took over 20 mins)
D = $103.15 - Highly complex diagnosis (appointment was at least 40 mins)