dedja wrote:Psyber wrote:It would be simpler for everyone if the system allowed the GP to be paid the Medicare component directly and bill the patient only for any gap, based on their ability to pay, but they have never trusted doctors to make this assessment.
Isn't that what HICAPS does?
It doesn't apply to
outpatient medical bills, and is only operative in medicine for inpatient care when the private health fund is involved.
Private health funds are currently not allowed to contribute to outpatient
medical care - that was last allowed under Malcolm Fraser.
Then, Medicare payed the basic 75% of the government's "Schedule Fee", private health fund topped up to the "Schedule Fee" level and if charged more the patient paid the rest. (In those days - the late 1970s - the "Schedule Fee" was only $5 to $10 less than the AMA recommended fee, but the "Schedule Fee" has only risen by about 60% of inflation each year over the last 40 years blowing out the gap hugely.)
https://www.yellowpages.com.au/articles ... 08n00f0126HICAPS stands for Health Industry Claims and Payments Service. It is an electronic, instant claims and payments service. HICAPS covers most private health funds in Australia and a large number of healthcare professionals such as dentists, physiotherapists, optometrists, psychologists, chiropractors, osteopaths, podiatrists, occupational therapists, speech pathologists, dietitians, remedial massage therapists, acupuncturists, naturopaths etc. You will need to be in a private health fund to be eligible to claim with HICAPS.
Difference between HICAPS and Medicare
With a Medicare card, the government pays for all or most of the fees charged by your doctor or public hospital, depending on the services provided. If you have private health insurance, then a similar system is available whereby other healthcare professionals take your private health fund card and process your claim for you there and then. This is called HICAPS.
Posted: Mon Jan 19, 2015 7:48 am
