Bulk-billing GPs accused of Medicare breach by also charging patients

[Lees75]

The bulk billing incentive scheme is only for children under 16 and patients with a Commonwealth Concession Card. It's still not compulsory, though, for these cohorts. My GP generally bulk bills students (so my 20 and 17 yrs olds) and charges me $20. 

[purplekitty]

2 hours ago, MoukMouk said:

There’s a real limit for what you can do with Telehealth. Also in covid you were only meant to do Telehealth via bulk billing. How do check a blood pressure? Swab a throat? Palpate a prostate gland or a sore tummy? Biopsy a suspicious mole? Depending on your practice yes a lot can be done but a lot can’t. And it’s procedures that make money because of how Medicare is set up. Part of why female GPs tend to earn less. They are good at the “ talking” stuff which isn’t recognised by proper remuneration.

My husband says he can observe so much just watching a patient walk from the waiting room to the consultation room. 

Telehealth is just not best practice for much of medicine despite its advocates.

For a GP to earn a reasonable income now they have to push through short consultations.

They don't want to practice medicine that way, they shouldn't have to, and I know their patients don't want that either.

[CrankyM]

Yeah bulk billing is practice dependant. GPs are paid $$$$ where I am and we still can’t get enough of them. I haven’t even bothered going to the doctor recently even though I should for a few reasons because not only is it $108 before the rebate, I’m probably going to wait 6-8 weeks for an appointment to be free. So all of that medical care that should be happening to prevent issues occurring doesn’t happen. We have an urgent care but they are often out the door with patients by 10am. (Run by the practice I go to, so actually takes away more doctors appointments). You won’t get a GP up here earning less then 250k with remote area allowance, housing subsidies and electricity subsidies. It’s a running joke. 

[BoyMum2]

1 hour ago, STBG 2 said:

incentives are paid to GP practices to bulk bill but I guess if they were worth it then more would BB children. That said all those in our area and in the area we used to live in BB under 16 even if they are not a BB clinic.

I am $45 OOP at mine, they charge $90, any GP who charges more than $135 for a standard consultation is seriously having a lend.

If they’re not going to bulk bill children, then at least share the Medicare threshold somehow. It’s not like my children earn any income and I’m constantly bringing them in for one thing or another. I’m sure it adds up to a few thousand a year between myself and them yet we never get higher rebates. 

[CrankyM]

Oh I just check my current practice. First available appointment is 7th November. I looked at another practice in town I should register with, and their first available is 12th October...

[Tinsel]

We are so fortunate where we are.  I don't know of a GP clinic in my suburb that doesn't bulk bill everyone who holds a Medicare card, and there are a lot of GP clinics here.  We haven't paid for GP appointments since we moved here almost 35 years ago.  My recent post surgery wound checks with the necessary dressing changes all bulk billed too.  They certainly deserve a much higher Medicare payment than they currently receive. 

[Prancer]

2 hours ago, BoyMum2 said:

If they’re not going to bulk bill children, then at least share the Medicare threshold somehow. It’s not like my children earn any income and I’m constantly bringing them in for one thing or another. I’m sure it adds up to a few thousand a year between myself and them yet we never get higher rebates. 

Our Medicare safety net is $2500.  And we are almost there!  But we usually get there in like the last 2 months of they year only to pay out again in January.

[Paddlepop]

2 hours ago, BoyMum2 said:

If they’re not going to bulk bill children, then at least share the Medicare threshold somehow. It’s not like my children earn any income and I’m constantly bringing them in for one thing or another. I’m sure it adds up to a few thousand a year between myself and them yet we never get higher rebates. 

What do you mean by share the threshold? Are you all on the same Medicare card and registered for Medicare Safety Net? You can check this in the Medicare app. Once you get close to the threshold they’ll ask you to confirm your family members.

I don’t think there’s any bulk billing clinics in my area. We pay $98 upfront for a level B 15min consult. It used to be $93. Only DVA Gold Card members are bulk billed. We need whooping cough vaccinations and the nurse appointment for them will be bulk billed, which is surprising but welcome. We’re so used to paying for every appointment there. $55 for the actual vaccine from the clinic or $35 from Chemist Warehouse with a script.

Yesterday the three of us all saw the GP. I paid a total of $296 + $1.35 eftpos fees for the appointments. Got a total of $274.60 back in Medicare rebates thanks to the Medicare Safety Net. 

[Paddlepop]

11 hours ago, LemonMyrtle said:

They should just say “after your third appointment we will bulk bill you for the rest of the year”. That would cover their admin fees. A membership is just a cash grab because so many people would pay it, and then only need the doctor once or twice a year. What a scam.

Absolutely. That way the amount paid would go towards the patients’ Medicare Safety Net. A “membership” fee obviously doesn’t and is just costly bullshit.

[BoyMum2]

1 hour ago, Paddlepop said:

What do you mean by share the threshold? Are you all on the same Medicare card and registered for Medicare Safety Net? You can check this in the Medicare app. Once you get close to the threshold they’ll ask you to confirm your family members.

I don’t think there’s any bulk billing clinics in my area. We pay $98 upfront for a level B 15min consult. It used to be $93. Only DVA Gold Card members are bulk billed. We need whooping cough vaccinations and the nurse appointment for them will be bulk billed, which is surprising but welcome. We’re so used to paying for every appointment there. $55 for the actual vaccine from the clinic or $35 from Chemist Warehouse with a script.

Yesterday the three of us all saw the GP. I paid a total of $296 + $1.35 eftpos fees for the appointments. Got a total of $274.60 back in Medicare rebates thanks to the Medicare Safety Net. 

I don’t really know how it works tbh but assumed each person has their own safety net?

The only time I reached it was doing IVF and I ended up having cheaper OB appts for the last two months of the year. 
 

This year has been fairly expensive for us. I’ve had a few surgeries with specialists plus developmental paed appts for my son. On top of the seemingly endless GP appts for flu, infections, eczema, mental health, etc etc. 

[Paddlepop]

@BoyMum2 Here’s a link that explains it. You need to register your family for it. It’s definitely a shared safety net for adult(s) and their dependents under 16.

[Mrs Zee]

It is very hard to get a dr here that stays long term. Thankfully in about 10 years DH has only had two GPs including his current one. I've been to 3 different practices and now use DH's dr. My last one was wonderful despite a very high turn over. However i left when they told me they could no longer guarantee all their drs would bulk bill over 12 year olds. They couldn't even tell me at the time of booking an appointment, they said it would be determined on the day and I couldn't afford that risk. 

Anyway, another bulk billing practice here sent letters to some patients whose dr has suddenly left the practice, saying they could no longer provide care for them, please find a new practice. some of these people have attended the practice since it opened over 10 years ago. I understand they don't have the capacity given the critical shortage of Drs but gosh it's pretty shitty. 

[Grumbles]

We followed our GP to a super clinic and it is now over $100 an appointment with lots of extra fees for add ons. Some of the doctors are good but some of them are not great. The receptionists are poor, have booked me into doctors that don’t do what I made the appointment for and there are certain things you can’t do online but the wait to speak to a real person on the phone can be an hour.

 I had a block on my account because my husband forgot to pay for a Telehealth for DS and I was the parent on his file. Instead of sending a bill they made my account require prepayment when you book an appointment and the system actually automatically cancelled an appointment made over the phone as the receptionist didn’t realise I was a bad debtor. They are very tiresome to deal with.

[purpleduck]

1 hour ago, Grumbles said:

We followed our GP to a super clinic and it is now over $100 an appointment with lots of extra fees for add ons. Some of the doctors are good but some of them are not great. The receptionists are poor, have booked me into doctors that don’t do what I made the appointment for and there are certain things you can’t do online but the wait to speak to a real person on the phone can be an hour.

 I had a block on my account because my husband forgot to pay for a Telehealth for DS and I was the parent on his file. Instead of sending a bill they made my account require prepayment when you book an appointment and the system actually automatically cancelled an appointment made over the phone as the receptionist didn’t realise I was a bad debtor. They are very tiresome to deal with.

That sounds totally shyte  Are you not able to book in with the same GP for your appointments? Or are they booked out too far for your needs?

[Grumbles]

Our GP is only a general doctor 2 days a week, the rest of the week she works as a “specialist” doctor charging way more (the field she works in is quite lucrative in our location). Increasingly many of the GPs are specialising in a specific field and not available for general appointments. So they might only do vasectomies, skin, menopause, travel medicine.

[Prancer]

@Grumbles it’s just shite isn’t it!  I have a lovely doctor, though he disappeared for a few years.  We have a big clinic too and it’s rubbish.  30 minute wait on phone to speak to someone.  There is an app, but my doctor is not on it.  I also got stuck in a loop of my password not working but not being able to reset it.  Asked reception for help and they told me the app was crap and they could not help.

Pretty much every doctor in my area will not bulk bill anyone as standard.  Even kids now.  So you can’t go elsewhere.  Doctors are not taking new patients.  So if your doctor is booked out or on holiday, you might not be able to see anyone else.  Sometimes there are a few doctors taking new patients, but they tend to be either locums or ones that are not good.  And you drop off the books after 2 years, so I went to the doctor the other day for no reason other than to stay on the books.  The whole thing is a bit ridiculous.  And when I had a health problem a few years ago, it took 3 appointments to sort as I kept getting the dodgy doctor that just was not listening.  This is frustrating enough, let alone the pain I was in, but I am paying $95 for each wasted visit!

[purpleduck]

For those who have difficulty getting in to see drs, are you urban/regional etc? Do you think the socioeconomics of the suburb impacts on the availability? I'm just curious as I can understand shortages in regional areas, but in the city, I would think there would be more options? Although they might be more expensive options...

[CrankyM]

@purpleduck I’m regional/remote. However up until about 18 months-2 years ago there wasn’t really any issues getting appointments. While we are regional/remote we also have a thriving med student program that has them come through and do their registrar years here as GPs as well as a rural clinical school which is when 4th years come and study/work in an area for the entire year. (And soon there will be a med school that does the whole program). However, my previous GP retired and the practice owner sold it and moved. So we basically went down a thriving practice. Someone took it over but rather than 5-6 GPs there is only 1 or 2. I don’t know what happened to my current practice but they also seem to be down GOs and running on half the usual number. So 3, with closed books. 2 of which don’t even put appointments on hotdoc. (But they also have a midwife, sports physiologist, mental health nurse and nurse practitioner). It’s always been 1-2 weeks wait previously but not like it is now where you are waiting 6-8 weeks.
We also have a bulk billing service in town but it’s only for aboriginal people. It’s in the name that it is an Aboriginal Medical Service. I’m not sure how they are going for staff though my friend got in within a week. But they keep appointments set aside for walk ins, sick kids and urgent needs. (I have zero issues with this. This service does a lot of good work and I believe they are actually run by the state health dept not as a private clinic. The only time I’m frustrated is when I have a sick kid and have to go wait 5 hours at urgent care). 

[Bornagirl]

There is often a week or two wait for our preferred GP at our local clinic, but on the rare occasions we've needed to see someone on the day (or it's go to emergency) they've never hesitated to fit us in (with whoever's available) with just the information over the phone.

I do love being able to check on Hot Doc if there's a cancellation, which happens more often than not.

[STBG 2]

I admit to being spoilt. I can get an appointment at either a BB clinic or my usual private one within a day or so. If my doctor is not there I can see another one. My DH goes to a different clinic, a BB one and he rings and gets an appointment within 24-48 hours, sometimes same day on a cancellation. 

In our area there are 11 BB clinics within 7 kms, I just checked and they all have some availability today.

It is horrifying to hear the stories here. It seems there are GP's charging long consult fees for standard consults.

[Mantis]

Ah yes the old GP's crying poor. 

The average GP salary in Australia is $196,213 per year or $101 per hour. Entry-level positions start at $100,000 per year, while most experienced workers make up to $296,400 per year.

[Crombek]

The earliest appointment I can get on the app for my local clinic is 24 Sept. And this is a city of 77,300 people. One GP has an appointment in 6 days but not taking new patients.

I can get an appointment with a random gp at the superclinic earlier. The fee is $103 (60.15 oop) and they bulk bill u11 children only. Students over 11 are $40 oop.

[Princess Peach]

1 hour ago, purpleduck said:

For those who have difficulty getting in to see drs, are you urban/regional etc? Do you think the socioeconomics of the suburb impacts on the availability? I'm just curious as I can understand shortages in regional areas, but in the city, I would think there would be more options? Although they might be more expensive options...

Very, very urban here. We had to resort to the 13 sick telehealth appointment for DH the other week for an ear infection as the soonest appointment was 4 days time (we tried 6 clinics),  by 4pm the after hours clinic which closes at 10pm had stopped taking more patients for the day & I lost count of the number of GP clinic's we called between our office & home that have closed their books to new patients

[VeritasVinumArte]

@BoyMum2 you can register as a family and the family threshold is around $2.5k. I have my DH, Uni Student DS19, DS17 and DD15 registered as a family. We are across 2-3 cards but registered as a family. I have to reconfirm th family registration each year as we get close to the threshold. This year we hit the threshold before the end if the first quarter. I am telling the family that this is the year to see specialists if needed and not to put it off until next year. So DS19s late trip to GP (ear infection) was $107 on card but $94.85 back from medicare.

[RynandStompy]

Urban here. We do have a local clinic that still bulk bills but it's a 1-2 week wait for GP appointments.

We usually book for Saturdays if a dr is available, which is a not bulk bill day. We've already hit threshold this year so get most back anyway.