Docklands Family Medical is committed to providing high quality health care. The costs of providing this care are passed onto our customers and their insurers.
Docklands Family Medical charges fees in excess of the Medicare Rebate. This is known as ‘Private Billing’. Below is an explanation of the Medicare Rebate, our Costs of Business, Out of Pocket expenses for Australian Medicare Card Holders and Exceptions to our policy.
Medicare Australia insures the Australian Permanent Resident population by providing rebates on Medical Services.
Current Rebates are structured to encourage short consultations (for example doctors are paid the same if they spend 5:01 minutes or 19:59 with a patient).
Short consultations encourage quick assessments, and quick prescribing of medications. Short consultations discourage thorough assessments, accurate diagnosis, and considered treatment involving treatment options and explanations. Short consultations can lead to overuse of expensive diagnostic tests, unnecessary specialist referrals and over prescription of medications.
Medicare Australia provides an incentive in addition to the regular rebate rate for members of the community considered as high need for Medical Services. This includes children under the age of 16, Commonwealth Pension Card Holders and some others. This incentive reduces the loss incurred to Medical Practices by attending these individuals at bulk billing rates.
Costs of Business
Medical Clinics and practitioners incur considerable Costs of Business. In addition to standard business expenses, General Practices employ Nurses and other services to assist in care of their patients. Such services do not generally generate income. Professional Indemnity Insurance and Professional Registration fees add to higher costs. Furthermore, Practicing as a General Pracitioner is only possible after 6 years of unpaid university, followed by 4-5 years of low paid Hospital and General Practice training. The community has a high expectation of the quality and reliability of the service we provide and these costs must be met from the single consultation fee.
How much Out of Pocket costs would I incur at a Private Billing Clinic?
Many Australians visit the GP less than once per year, although we would think this is well below optimal. We feel that on average a person would require medical input on 3 occasions per year. An out of pocket fee of approximately $30-40 per consult would mean that such a person is making an investment of around $100 in their health per year.
On discussion with both of our current GP’s we have agreed to provide longer consultations to encourage and promote high quality care, detailed and accurate assessments and considered treatment advice. We believe in the long run this is both safer, healthier and cheaper for our patients.
The Bulk billing model is not viable in this location with the high quality care model our GPs are committed to providing. We will be operating on a Private Billing model. We have set our rates at below the fees recommended by the Australian Medical Association (AMA). For example:
Medicare Rebate $37.05
Our Fee $75 (Out of Pocked $37.95)
Exceptions to the billing policy
There will be some situations that will be bulk billed, at the Doctors Discretion.
Dr. Maclay has committed to Bulk Billing all Chronic Disease Management consultations where such conditions are managed at our clinic through the relevant Medicare sponsored Management plans. This would enable a person with, for example, Heart disease or Diabetes to receive care from their GP on up to 4 visits per year without incurring an out of pocket expense. The reasoning for this exemption: (1) people with Chronic Disease are more likely to need regular medical care (2) Medicare provides additional funding for GPs providing such care (3) people with Chronic Disease have significant costs related to their illness in addition to General Practice care.
Dr. Maclay Bulk Bills DVA (Department of Veteran Affairs) Gold Card holders in recognition of their service to our country. In addition, we discount Children under 16 and Aged Pension Card holders.
Please Note, care provided by the Practice Nurse under the Doctor’s guidance will not incur out of pocket fees generally.
Is Bulk Billing the right option for you?
Many people look for Bulk Billing clinics as they do not incur direct costs to their patients from consultations. But what other costs are there? Most illness in our community is related to diet and lifestyle. Do short Bulk Billing consultations allow my Doctor to assess these and other risk factors? Is my doctor forced to get me in and out as soon as possible by Bulk Billing – normally with an expensive script in hand? Does Bulk Billing adequately reward those doctors and practices striving to provide excellence in health care?