Media releases

June 19, 2001

Easy access to no gap doctors

Finding out which doctors might charge out-of-pockets for in-hospital procedures has been dramatically simplified.

Australia’s largest health fund, Medibank Private, announced today that the list of doctors who have been charging under the health fund’s GapCover arrangements is now available on its website - allowing members rapid access to information on possible no and known gap practitioners.

In addition to accessing this information from the health fund’s website, members can also obtain lists from Medibank Private retail centres or go down the more traditional route and ring the fund’s 132 331
hotline requesting information about specific specialist doctors.

The doctors being referred to are those involved in in-hospital or day-surgery procedures, the lion’s share being surgeons, assisting surgeons and anaesthetists.

The medical gap is the difference between the fee patients are charged by their specialists and doctors for in-hospital procedures and the total benefits they receive from Medicare and their private health fund.

These fees are separate from accommodation, other service fees and any excess or co-payment the member has agreed to pay as part of their health insurance cover.

Under Medibank Private’s GapCover schemes – the first of which was introduced in November 1999 followed by a second in September last year - doctors conducting in-hospital procedures can elect to charge either no or known gaps and can do so from procedure to procedure.

Medibank Private managing director, Mark Burrowes, says that providing members with access to a list of GapCover doctors via its website is in essence "short-circuiting" what had been an unnecessarily laborious process.

"Members accessing our website will be able to find information on a specific doctors or the full array of doctors, their addresses, and specialties.

"Members will also have a facility to search for doctors by specialty or post code."

Mr Burrowes says providing a website listing of no or known gap doctors represents another step by Medibank Private towards becoming a member advocate and assisting members navigate their way around a complex health system.

However, he stresses, while the website list is there to inform members, it does not attempt to rate or recommend doctors.

Although over 3,500 GapCover doctors are listed on the Medibank Private website, this does not include the full gamut of doctors who currently charge under the fund’s GapCover arrangements.

This figure currently stands at 4,428 nationally.

Medibank Private has not listed the names of participating doctors who have asked that their names not be published.

The list also does not include the over 11,438 specialist doctors who charge patients – generally welfare recipients and pensioners - according to the Commonwealth Schedule of Fees. Charging according to the schedule means patients do not incur out-of-pocket expenses.

Since the implementation of Medibank Private’s GapCover schemes, the level of gap payouts has soared. In the 12 months to February, the health fund paid out almost $60.5 million, well up on the $7.5 million paid out in the corresponding year prior.

Currently close on 70 per cent of in-hospital services do not incur a gap.

Those seeking further gap information can ring our Gap Hotline on 1800 030 055.

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