GPs can make the decision to privately bill their patients instead of accessing Medicare Benefits. This means they can work in any area without having to abide by the restrictions of 19AA and/or 19AB. There are some important aspects to be aware of before you start privately billing that we have discussed below.
How does Private Billing work?
Private billing means that patients pay for medical services at their own expense and do not receive Medicare rebates.
Will Private Healthcare cover the cost of consultation?
Private health insurance does not cover medical services that are provided out of hospital and that are covered by Medicare.
Private health insurance only covers:
- hospital cover for things like accommodation and theatre fees
- general treatment cover for services like dental and physio
This means that GP consultations will not be covered by a patient’s private healthcare fund.
Do I need to inform patients?
Patients will need to be informed prior to the consultation that the GP privately bills as they will be paying out of pocket.
Will I be able to access Medicare in the future?
If you are able to meet your restrictions or become unrestricted, you will be able to access Medicare Benefits again.
How do I refer patients and request diagnostic tests?
To refer patients to a Specialist or order diagnostic tests, you will need to apply for a ‘Refer and Request’ Provider Number. You will not need to meet your restrictions to receive this Provider Number.
To apply, you will fill out the normal HW019 form and under Questions 22 tick the ‘Refer and request only’ option.
Read more about Refer and Request Medicare Provider Numbers here.
Note: The information presented above has been gathered from the Private Healthcare Australia and Services Australia websites and has been updated as of 2023-11-14.
We Can Help You
Here at People Medical Consulting, we have a passion for guiding medical practitioners through their career pathways to Australia. We have extensive experience in assisting medical facilities in recruiting doctors from local and overseas who will best suit their requirements.
We provide Document Assistance for those requiring support for their PESCI with IME, ACRRM or RACGP, registration and all other mandatory AHPRA requirements, fellowship program related forms and letters, application for Medicare provider and prescriber numbers, application for 19AB or 19AA exemptions and preparation of employment documents.
If you’re looking for assistance, contact us at firstname.lastname@example.org and we would be glad to help you.
Information from this blog has been taken directly from: