16 September 2009

Health Centre bulk billing

| paperboy
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It’s now been a couple of weeks since it was announced that the Phillip Medical Centre and Ginninderra Medical and Dental centre would start charging $30 for a standard weekday consultation and $40 for a weekend visit to the doctor.

At the time, the Phillip medical centre medical director Robert Allan told the Canberra Times it was a business decision because the owner of the practices Primary Health Care was making a loss.

Bulk-billing was to continue for children under 16 and pensioners or health care card holders, but as for ordinary working people there was going to be an up-front fee.

So for those who visit the centres, how’s it going?

Has it reduced the waiting time, or caused any angst among those having to pay.

And is there a refund from Medicare of that up-front fee?

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Doctors are there to get you in and out as soon as they can. And I have to bring that cheque in? OMG. Troublesome!
I am sure they were ‘making a loss’ in sense that they realize they can charge more & they can.

I am going back to my family GP as well ^^

Clown Killer12:14 pm 30 Sep 09

I had cause to visit the centre in Phillip yesterday morning. It was my first time and I wasn’t looking forward to it given the bad wrap that it had received in the early days.

I was pleasantly surprised. I arrived just before 9.00am, got to see a doctor, have and x-ray and saw the doctor again to discuss the x-ray all in less than 45 minutes. OK so I didn’t get my GP, but I also didn’t have to haul my butt over town to get the x-ray done, and then reschedule to see the doctor again to discuss the results. All-in-all I’d have to say their business model is pretty good.

prhhcd said :

As far as I understand the DA approval was given on the basis of a bulk billing practice!

Katy Gallagher should chase this up with her good friend Andrew Barr.

Well I guess if anyone is still going to these centres the new fee is workign out quite well for them. Pity.

These centres are good in an after hours crisis, but otherwise your own GP is far better.

the person above whose parents were given the big hint to go elsewhere ‘as you can afford it’, the medical centre dr was either giving them the tip-off that they would get better care at a normal GP, or else was adhering to policy of getting rid of complex (time-consuming) on-going illness patients from medical centres. Complex cases do not make money for doctors.

the phillip centre has been pretty quiet now, but I am certain that this move will shift the non-essential cases back to TCH ED dept. and bottleneck it, making true emergency patients wait even longer.

Just as an update, I’ve received the cheque so yes, it does go to the patient to pass on to the medical centre.

low_income_earner7:04 pm 21 Sep 09

I am a childcare worker. I get paid just under $480 a week and my rent is $300 a week. Despite my low income, I still earn too much to qualify for a Health Care Card or any centrelink assistance. Most weeks I don’t have two cents to rub together, never mind trying to find $60+ to see my GP. For me, the Phillip Medical Centre was a good alternative to my GP on the weeks when I’m broke! $30 is better, but not if it’s still a walk-in service, and especially not if you have to do their mail for them!!
Really it’s the low-income earners who are the ones who are suffering with this. Yes, I may be turning up to the Emergency Department a lot more, but only because I literally can’t afford to see a doctor in a practice!!

Called into the Phillip centre yesterday to go to the chemist and the waiting room was a lot quieter than I remembered it from before, so it looks like the patient traffic has slowed (based on the 5 mins I was there).

“I have been to Ginniderra Medical Centre since it introduced the $30 fee.. My receipt states the appointment was $63.55, Payment received $30 – Outstanding $33.55 to be paid for by Medicare.”

What happens if you have reached the safety net? You would get more than $33.55 as a rebate, or do you need to go to Medicare to get the rest?

vandam said :

justbands said :

> I thought the purpose of that centre was to provide at least one bulk billing service for non health care card holders in Belco. Back to Emergency it is.

Back to Emergency???? Half the problems we have are thanks to people with a sniffle crowding up the Emergency ward! Personally, I’d say if you earn a wage…then you can afford a GP. Find one, use them (& NOT the Emergency wards!), pay. Simple really.

Hang on here. Every year We all pay an outrageous amount to Medicare. This year I paid around $1000. I did not use the public system once during that year.

If I get the sniffles or need to see a doc, why should I have to pay after already paying $1000 for nothing? They should look at capping say 5 free visits per year.

I also on top of that pay for private health insurance. It’s rediculous that people can spend up to $2000 a year on health combined, never use it or use it once and still be expected to pay $30-$40 for a simple consultation.

Ummm usually if you have private medical cover, you don’t have to pay the medicare levy. That was my assumption.

And trust me it is quite easy to spend over $2000 in one year on medical ! I know I’ve spent more than this treating an injury

Vanilla Bean12:57 pm 18 Sep 09

I don’t blame them in a way. I have been at the Ginninderra Medical Clinic and seen people go in with their entire families (4 or 5 relatives) rather than making separate appointments, just to take advantage of the “free” service. I also imagine a lot of their trade is helicopter parents who visit 2-3 times a week if their kid sneezes or has a tummy ache – because they don’t have to pay so they think they might as well. If paying $30 discourages at least some of these people, thereby reducing the waiting times for the rest of us, all good.

outdoormagoo1:03 pm 17 Sep 09

If you go to the ED and see a doctor, consider yourself lucky. Being from Sydney myself and having been to several ED of major hospitals up there with genuine emergencies, one of the first questions you are asked when ou walk in is what are you there for. If it is not an emergency, they will tell you to go home and call your GP.

It has happened to two people I know in Queanbeyan as well. ED Nurse – ‘Got the sniffles. You’ll be right. Go home and call your doctor.’

post #10 – thats what I meant. It is farking our system. Which is why ACT health will hopefully step in. As far as I understand the DA approval was given on the basis of a bulk billing practice!

captainwhorebags7:27 am 17 Sep 09

…and if you’re sick after hours, you can ring up CALMS and get an allocated appointment time. It’ll cost you, but you won’t be waiting in ED for four hours.

I have been to Ginniderra Medical Centre since it introduced the $30 fee.. My receipt states the appointment was $63.55, Payment received $30 – Outstanding $33.55 to be paid for by Medicare.

I have no objection to this new policy, the day I arrived I was unable to get in to see a specific doctor and was told to either return at 130pm that afternoon, or I could book an appointment for 6pm the following day.

For those of you who would rather attend the ER because you have to pay $30 or wait a few hours to see the doctor.. UMM HELLO… How long are you going to have to wait at the ER ? Which is an EMERGENCY ROOM – are you attending with an emergency ? Or can it wait until you can see a doctor ?

justbands said :

> I thought the purpose of that centre was to provide at least one bulk billing service for non health care card holders in Belco. Back to Emergency it is.

Back to Emergency???? Half the problems we have are thanks to people with a sniffle crowding up the Emergency ward! Personally, I’d say if you earn a wage…then you can afford a GP. Find one, use them (& NOT the Emergency wards!), pay. Simple really.

Hang on here. Every year We all pay an outrageous amount to Medicare. This year I paid around $1000. I did not use the public system once during that year.

If I get the sniffles or need to see a doc, why should I have to pay after already paying $1000 for nothing? They should look at capping say 5 free visits per year.

I also on top of that pay for private health insurance. It’s rediculous that people can spend up to $2000 a year on health combined, never use it or use it once and still be expected to pay $30-$40 for a simple consultation.

I have been 3 times since the $30 charge and each time I have had my usual Doctor. The longest I have waited is an hour as the Doctor wasn’t due to start until 11am. I was through and had a good checkup and was in my car by 11.45am.

I have been to other Doctors surgeries with family members and watched them wait over an hour and pay $76.

Pathology is still bulk billed. I suppose XRay is as well.

I am ok with paying and it isn’t so busy anymore.

Haven’t had any mention of any cheques.

barking toad said :

And #2 – “back to emergency” is exactly the attitude that is helping to fark our health system

Agree.

Igglepiggle said :

Medicare has a system in place wherein if the cheque isn’t banked by the practice witin a certain period of time (I think its 45 days) then the money gets paid straight to the practice and the cheque cancelled…ever wonder why so many practices are pay on the day only? ( and thats all health practices, not only doctors)

I believe it is 90 days. And yes that is generally the reason why practices stop bulk billing…

…compared to some countries we seriously have a fabulous health system…those who can afford to pay should do so…people should stop expecting to get everything for free…either pay for a specific appointment time or don’t pay and expect a long waiting time…simple really and quite reasonable as far as I’m concerned.

gun street girl6:50 pm 16 Sep 09

justbands said :

Back to Emergency???? Half the problems we have are thanks to people with a sniffle crowding up the Emergency ward! Personally, I’d say if you earn a wage…then you can afford a GP. Find one, use them (& NOT the Emergency wards!), pay. Simple really.

Not really – the problem stems from access block, which is not caused by GP type patients presenting to ED. The whole “stop minor illnesses from cluttering the ED and the hospital will be okay” is a relatively inexpensive claim, used by politicians who don’t like to own up to the real (much more tricky and expensive) problem.

a stat dec can be used for sick leave and can be filled in by a pharmisist ( when yo get you medicine. If you just need a cert to get out of work, stay away from these centres to make it quicker for those who may have a real sickness.

justbands said :

Back to Emergency???? Half the problems we have are thanks to people with a sniffle crowding up the Emergency ward! Personally, I’d say if you earn a wage…then you can afford a GP. Find one, use them (& NOT the Emergency wards!), pay. Simple really.

But the problem is, just because you can afford a GP does not mean you can get in and see your GP. There’s so few of them serving an ever increasing population that you normally can’t get in to see them when you need them.

Previous place I worked required a doctors cert even if just having one day off sick. Most of the time I could not get into my GP within a minimum of 3 days! Sure, I didn’t resort to use the emergency department, but it normally meant I either stayed at work (worrying that I’d make others sick) or spend the day trying to find a doctor that had space.

It’s really not simple at all.

Inappropriate said :

I have a feeling not many people will forwarding on those cheques…

That could be true. Why would people bother? It’s not like the Centre can come back and claim you stole money seeing it’s cheque (and one would guess made out to the centre).

This story gets better all the time. So it seems that basically you’re paying $30 for an ideally faster response (5 minutes mentioned above) emergency dept. that requires you to do work for them – as in, posting mail for them.

So I guess if you need to see a doctor quick, and have the money, you go there. If you can wait (because there are so few) and you like the continuity of seeing the same doctor you go to a GP. hmmmm… not sure if that appeals to me…

Wish I could just always go to my GP, but sometimes you ring up and can’t get an appointment because they’re booked out for a few days. So if you’re only sick for a couple of days and need a doctors cert. for work I guess you have no choice but to go to the Super Clinics. Then you just hope you don’t spend the day sitting around waiting (and thereby not resting so that you body can recover) – although maybe that’s not as long a wait as I thought.

Medicare has a system in place wherein if the cheque isn’t banked by the practice witin a certain period of time (I think its 45 days) then the money gets paid straight to the practice and the cheque cancelled. People in general are notoriously bad at paying for a service after it has been received- ever wonder why so many practices are pay on the day only? ( and thats all health practices, not only doctors)

> I thought the purpose of that centre was to provide at least one bulk billing service for non health care card holders in Belco. Back to Emergency it is.

Back to Emergency???? Half the problems we have are thanks to people with a sniffle crowding up the Emergency ward! Personally, I’d say if you earn a wage…then you can afford a GP. Find one, use them (& NOT the Emergency wards!), pay. Simple really.

Inappropriate1:54 pm 16 Sep 09

I have a feeling not many people will forwarding on those cheques…

barking toad said :

The $30/$40 is the payment balance after medicare rebate on the full fee.

This would mean that are not charging a set fee. I’m on the safety net and get a lot more back from a GP visit than the standard amount and would not be happy signing over all my rebate and then paying $30 on top

barking toad1:16 pm 16 Sep 09

And #2 – “back to emergency” is exactly the attitude that is helping to fark our health system

My GF went the other week and was charged the $30 on arrival. She was told that its not refundable by Medicare. She was also advised that a check from Medicare would be sent to her address, but its actually for the Medical Center so he had to bring it in. Anyone know what thats about?

I went on first day of the new system, had to wait 5 mins to see a doc.

They explained the payment system to me and it seems a bit convoluted. I pay a $30 ‘gap’ and Medicare pays the doc the rest, so no rebate for me. The odd bit is that Medicare is supposed to send me the cheque for the rest of the money and then I have to forward that to the health centre?! Personally I am happy to do this but seems to me that a lot of people wouldn’t bother.

That said it has been weeks since I went and haven’t received the cheque yet so maybe that bit of info was wrong?

Around when this happened I was in need of a doctor. I thought seeing Phillip were now charging they would also offer the additional service of taking appointments – rather than just sitting and waiting. So I rang up to check, but only to find I was mistaken.

Instead I went in search of a local doctor near my new address. I eventually found one that was still taking new patients.

When I was there for my appointment, I overheard the secretary say that since Phillip started charging that they were getting calls from ~20 people a day. By fluke (as I was not looking for it) it turns out that my new doctor bulk bills, and potentially that was part cause of the influx. But they would only take me on after checking which suburb I lived in.

But it bugs me that somewhere like Phillip now expects you to pay, but you still can’t make an appointment. So those who are working are expected to pay, but are also expected to be able to sit around for indeterminate amounts of time and wait. ???

“At the time, the Phillip medical centre medical director Robert Allan told the Canberra Times it was a business decision because the owner of the practices Primary Health Care was making a loss.”

Making a loss?

More likely, not making as huge a profit as they were hoping to!

Primary’s interpretation of “making a loss” is a little confusing. According to it’s annual report:

(http://www.primaryhealthcare.com.au/IRM/Company/ShowPage.aspx?CPID=1650 PageName=Annual%20Report%202009),

reveues and profits from its health centre operations grew by 33%last year.

I’d love to suffer ‘losses’ of that order.

barking toad10:21 am 16 Sep 09

The $30/$40 is the payment balance after medicare rebate on the full fee.

I took it as a sign to go back to my family GP. Sure, he’s more expensive, but he actually treats me like a person and seems to genuinely care about my well-being.

My friend went yesterday and I was actually going to start a post today. She was there at 7.30 (opening time) and waited… 3 hrs to see a doc. Then got asked to pay $30. I thought the purpose of that centre was to provide at least one bulk billing service for non health care card holders in Belco. Back to Emergency it is.
Hope the ACT health dept steps in and does something.

If they are charging for a standard consultation, then it is refundable by Medicare. What is interesting is that $30 is less than the rebate for a standard consultation. So this is either an interesting business practice or its an admin charge which, I assume, isn’t refundable and they are double dipping by bulk billing medicare. I’m not sure how they can charge an up front fee under Medicare. Isn’t the fee supposed to reflect the length and complexity of the consultation?

I do attend the Phillip clinic but haven’t been since this started. Would also be interested in hearing people’s experiences.

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