DON MEDICAL CLINIC - BILLING POLICY
Terms & Conditions of Engagement of Don Medical Clinic Services.
1. Don Medical Clinic Doctors and staff offer a confidential and personal service to all our Patients. It is a condition upon becoming a patient at our clinic that you agree to abide by our Fees, Terms and conditions for engagement of our services. We are a private business providing Medical Care on a "Fee for service" basis
2. Don Medical Clinic will not tolerate abusive, aggressive or drunken behavior towards Doctors, staff or other patients of the practice. If this is found, the person/s involved will be asked to leave the premises immediately or we will call for assistance.
3. By attending your appointment at Don Medical Clinic, you agree to the fees and charges levied for the services required and agree to settle all accounts on the day. Should you be unable to pay on the day, please talk to the Practice Manager prior to seeing your Doctor to make arrangements for payment. A full list of Services and Fees are available.
4. An account keeping fee of $15 will be added to any accounts not paid on the day. Any outstanding accounts must be paid prior to any further attendance for consultations.
5. Don Medical Clinic will accept the Medicare Schedule Fee Payment for all children under 16 years of age who have a concession card for "short" and "standard" consultations. Longer (>15 mins) & more complex consultations will attract a concession fee.
6. All young people aged 17 to 25 years of age will be eligible for our concession fee. Children 16 and under will be bulk billed for general consultations.
7. All current concession card holders and aged pensioners are eligible for our concession fee for all consultations. All Concession Fees not paid on the day of consultation, will revert to our normal full fee plus the account keeping fee.
8. All consumable items such as dressings, INR testing, bandages, sutures etc will be charged to the patient as a private fee. We will always keep the use of these items to a minimum. There is no Medicare or private health contribution towards these items.
BASIC CONSULTATION SERVICE FEES (AUGUST 2023)
* EFTPOS Transaction fees do apply. You can minimise these fees by using your savings/cheque options for payment instead of Credit card option.
Children and Young People Policy:
Children and young people aged 17 to 25 will be eligible for the concession fee for standard consultations. Children 16 and under will be eligible to be bulk billed for standard consultations. Mental Health plans and GP Management plans will be bulk billed for ages 18 and under
Keep Well Clinic Program: (KWCP)
We want to ensure patients with chronic health conditions receive consistent ongoing care. Patients are eligible to join our Keep Well Program that encompasses regular health assessments, Care Plans (GP management plans), Team Care arrangements and scheduled review appointments. This includes patients of all ages. Please discuss with reception or your GP regarding eligibility for this service, especially if you are a person with a chronic condition. This may assist with access to higher Medicare rebates where applicable
Our Keep well program is to assist you to manage your chronic conditions and minimise your out of pocket expenses where we can by scheduling regular visits and any required further testing. This is to minimise your risk of complications where we can. Patients committing to our Keep Well Program for chronic disease management will be asked to attend scheduled regular appointments but may be eligible for a reduced fee structure to minimise your out of pocket expenses, dependent on number of appointments required.
Aboriginal & Torres Strait Island people
Don Medical Clinic management and staff pay respect to all Aboriginal and Torres strait islander people and have a goal to provide affordable care to the traditional owners of our land. We recommend all Aboriginal and Torres Strait Island people have an annual, Medicare subsidise Health assessment to monitor for change and allow early intervention. This Health assessment is available for all from Birth and are specifically tailored to your age group.
If any of our first nations people have eligible chronic conditions, we can register them into a Medicare program that provides our practice with extra funds to manage your care. If you are eligible, this means on an annual basis you will need to do the following.
- Annual Aboriginal & Torres strait Islander Health assessment
- Annual registration to the Practice Incentive programme with Medicare
- Have a GP Management Care plan and have at least 2 review appointments each year of this plan.
If you have an eligible chronic disease and we complete these simple steps, your consultations for the year will be at a concession rate
If you do not have Medicare eligible chronic conditions, you are still strongly encouraged to register for the Close the gap program which will reduce the cost of any prescribed medications, and also strongly recommend you have the Medicare subsidised annual Health assessment to monitor for any health changes. Your consultations for the year following your health assessment will be at our concession fee.
Don Medical Clinic provides Healthcare and support to our Defence Force Veterans.
Gold Card holders are billed to DVA with no expense to the patient for all consults but may be billed for private medical and/or insurance reports, or items not covered by DVA. Gold card patients are encouraged to enrol in the Coordinated Veterans Care (CVC) program that provides us with extra funds to assist our DVA gold card patients to manage their care
White Card Holders consults are billed to DVA if the consult pertains to their DVA white card conditions. Other standard consults not related to the patients DVA white card conditions may be Bulk Billed to Medicare where appropriate. Private fees may occur for some non-MBS items, medical reports and insurance reports.
Our practice nurses are highly trained, experienced, and valuable members of our clinical team. They will often triage your calls if requested by reception or the GP. They can provide services such as
- Wound care,
- weight management and smoking cessation,
- Blood pressure measurements,
- ear syringing etc.
Your GP may ask you to see one of our nurses for follow up, assessment or prior to your appointment. If you are under an annual GP management care plan, up to 5 visits/year are Medicare rebatable. If you are Aboriginal or Torres strait islander and have had an annual Aboriginal Health assessment, up to 10 Nurse visits/year are Medicare rebatable. Other Nurse only visits may incur a non-Medicare rebatable fee.
Overseas visitors and visitors
All consultations and procedures will be privately billed - this includes skin checks. Patients can then submit their tax receipt to their private health fund (if applicable) to make a claim.
Commercial Drivers licences and all Pre-Employment Medicals will be privately billed.
Please note that some companies have arrangements with Don Medical Clinic to perform Commercial Driver's medicals, pre-employment medicals and skin checks. When booking consults, please advise our reception team member to confirm if the consultation is a standard or long appointment. These consultations are not subject to a Medicare rebate, but may be eligible to claim as a tax deduction for work expense.
When you start to plan your travel is when you need to plan any travel vaccinations. Some vaccinations may need more than 1 dose over a period of months. Prior to discussion with your GP you should have a clear idea of where you are travelling to and from including any stopovers as different vaccinations many be required for each country. All travel vaccinations are private fee prescriptions (No PBS subsidy). Consultations solely to discuss travel Medicine/vaccinations and to administer travel vaccines may not always be eligible for a Medicare rebate if they are for the Business travel vaccinations. Don Medical Clinic GPs are experienced in travel vaccination advice and we have accreditation to administer Yellow Fever vaccine.
Medical reports, insurance reports, NDIS and Centrelink applications/forms are also privately billed with no Medicare rebate
These are all time-based fees. Please ask your GP how long it will take to complete and refer to the service fees table. To Minimise the amount of time needed, please ensure all sections to be completed by the patient are completed prior to giving to the GP. For long reports, please confirm with the patient or company requesting the information the estimated fee BEFORE the report is completed. These reports attract GST. Reports may require a signed patient consent to release information. Payment needs to be made before the report will be released. Once payment is confirmed, the report can be sent.
Procedures and Lesion Removals.
Don Medical Clinic GPs are trained to perform skin checks and lesion removals. They will often recommend a Biopsy first to determine the pathology of the lesion. This assists to minimise your cost and out of pocket expenses. The Medicare rebate for the patient for procedures and lesion removals will vary dependent on the size, location and in particular the pathology result of the lesion. The procedure for a similar size lesion removal does Not vary dependent on the pathology. It is Don Medical Clinic policy that the private fee charged for a specific size lesion and location will be the same regardless of the pathology result. This means the patient will have a higher out of pocket gap fee if the lesion is benign than if the lesion is malignant. Please refer to the Don Medical Brochure and fees regarding lesion removals.
Wound Care Fees
Don Medical Clinic aims to achieve 100% compliance with Medicare's rules.
"If a practitioner bulk bills for a service the practitioner undertakes to accept the relevant Medicare benefit as full payment for the service. Additional charges for that service cannot be raised. This includes but is not limited to: any consumables that would be reasonably necessary to perform the service, including bandages and/or dressings..." Medicare Benefits Schedule - Note GN7.17
Why is there a charge for dressings, plasters, suture removals, etc.?
Don Medical Clinic charges fees for items such as dressings, suture removal, plasters, etc. for the purpose of shared cost recovery. These fees have been determined in consideration of the cost of the materials, nursing time, procedure room supplies, waste disposal, and other factors. Simply accepting the bulk billing amount from Medicare for appointments requiring items such as the above does not pay the practice for wound dressings etc. If you have a procedure performed (eg Lesion removal), you will be charged a procedure pack fee at that visit to cover the cost of the instruments used etc. This means your consultation cannot be bulk billed as per Medicare legislation.
If you have a wound that will need re-dressing several times over weeks, at your first wound review you will be charged for your visit and receive a Medicare rebate. You will also be charged a wound care fee of $60.00. This will be charged up front, but can be paid off at $20 each visit. This covers up to 3 wound care reviews and dressings with the Nurse. If you require more than 3 wound care visits, further accounts will be generated at $60. If at any of these reviews the GP also reviews the wound, the GP consultation will be at a Medicare rebate only fee. If any of these visits also lead to a GP consultation, there may be a Consultation fee charged for which the patient will receive a Medicare rebate.
Cryotherapy and Other consumables
Cryotherapy can often be used to remove some lesions. Currently there is not a Medicare rebate for this. A Fee will be charged for all Cryotherapy. We always endeavour to keep these costs to a minimum. As stated above, when there is a fee for Cryotherapy, we CANNOT bulk bill the consultation. There will be a Consultation fee, which will receive a Medicare Rebate.
Telehealth consultations (Video and telephone)
Some consultations may be conducted by Video or telephone and a may attract a Medicare rebate to the patient (subject to Medicare conditions). These are often time based.
All Telephone and video consultations will attract a consultation fee and Most will be eligible for a Medicare rebate, so there will be an out of pocket expense in most cases. Our reception team will contact you following the appointment to arrange payment, or may send an SMS "link" for secure online payment.