Docs doing dirty deals
Patients cough up for secret charges
ADMINISTRATION fees worth thousands of dollars, booking fees and split bills are the secret charges greedy doctors are using to outsmart health funds and heap huge costs on patients.
Doctors would be banned by law from charging privately insured patients these types of surprise bills under a plan to end one of the main gripes of health insurance members.
Health fund lobby group Private Healthcare Australia, which is calling for the change, revealed three ways doctors slug their patients.
• Split the bill three ways and charge part to Medicare, part to the insurer and then charge the patient a gap of thousands of dollars.
● Charge an administration or booking fee that can amount to thousands of dollars.
● Charge a “deposit” to lock in the surgery on a certain date.
The group says doctors who charge more than twice the Medicare fee for operations are using the tactics to hide the full extent of their charges from health funds.
Doctors say they do it to maximise the Medicare rebate available to patients. However, it is not approved of by the Australian Medical Association which said it did “not support exorbitant charges”.
“Our position statement on this subject makes it clear that if a medical practitioner has signed a contract with a private health insurer, the billing requirements must be adhered to. Circumventing contractual arrangements by issuing a second, separate bill for a single course of treatment is inappropriate,” AMA president Steve Robson said.
The fees are not covered by Medicare or a patient’s health fund and have to be paid out of the individual’s pocket.
“We completely disapprove of charges that are being used specifically to try and get around the system and to maximise revenue from the system,”
PHA chief Rachel David said.
“You shouldn’t be able to access Medicare or gap cover fees if you’re charging patients all sorts of extra charges for the same thing.”
The latest government data shows gap fees charged by doctors surged 9.1 per cent in the year to September 2022, well above the inflation rate of 7.8 per cent.
And consumers are demanding more transparency about doctors’ fees so they can shop around and find more affordable surgery.
A recent Consumers Health Forum survey of 1200 patients found a quarter of cancer patients incurred gap fees of more than $10,000.
CHF CEO Elizabeth Deveny said: “Consumers with private health insurance should always get written financial consent from their specialists before any treatment begins so they are aware of what out-ofpocket costs they will face and also talk to their insurer so they are clear on what they are covered for.”