Media releases

August 8, 2001

Thousand specialists added to no gap listing

The number of medical specialists listed on the Medibank Private GapCover website has increased by over 1,000 in just six weeks.

Since Australia's largest private health fund first announced in mid June that it was listing the names of the doctors in its "no" and "known" gap arrangements, the number of doctors published on the fund's website has increased from 3,500 to 4,686 specialists.

The most significant increases have occurred in NSW and Vic where the number of doctors now listed total 1,597 and 986 respectively.

In SA the number has risen to 801 doctors, Queensland to 672 and WA (442), Tas (131), ACT (37) and NT (20).

The services provided by these doctors are in-hospital or day-surgery procedures, with the most listed doctors being obstetricians, anaesthetists, assisting surgeons, and immunologists.

The medical gap is the difference between the fee patients are charged by their specialist doctors for in-hospital medical 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 members have agreed to pay as part of their health insurance.

Under Medibank Private's GapCover schemes, doctors conducting in-hospital procedures can elect to either charge 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 doctors who have participated in the fund's GapCover arrangements via its website is in essence a short-cut to what had been a more time consuming process.

"Members accessing our website will be able to find information on a specific doctor or a range of doctors, including their addresses and specialties.

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

In addition to accessing this information from the Medibank Private website, members can also obtain lists from the fund's retail centres or go down the more traditional route by ringing the 132 331 hotline.

Although over 4,600 doctors are listed on the Medibank Private website, this does not include all doctors who have charged under the fund's GapCover arrangements.

This figure currently stands at 6,433.

The list also does not include the over 11,000 specialist doctors who eliminate the gap by charging patients up to the Commonwealth Medicare Benefit Schedule of fees. Charging 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 June, the health fund paid out just under $60 million.

Says Mr Burrowes: "This is Medibank Private's investment in closing the gap."

Currently, approximately 70 per cent of in-hospital services do not incur a gap.

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