How LONG does it take for MEDICARE to write a cheque?

[artforartssake]

Following routine surgery on 9 Dec last yr, I lodged a claim at Medicare for my anaesthetist’s fees. Two weeks later, I checked my online account and noticed that the claim had been processed. It’s now nearly the end of Jan and I STILL haven’t received the chq for the anaesthetist.

Contrast that with the situation of the surgeon, where I paid his fees myself UPFRONT prior to the surgery. I then lodged a claim with Medicare and in less than one week, the refund (a LAUGHABLE 20% of the total) was in my bank account.

So why does Medicare takes forever to issue a chq to the anaesthetist, but refunds PAID DIRECTLY to the patient/claimant are credited in under a week?

And how CONVOLUTED is this system? If you DON’T pay your med professional upfront but rather, wait for Medicare and your pvt health insurer to stump up first; this is the logistical nightmare you’re faced with:

1. Submit your bill to Medicare together with the form
2. Wait weeks and weeks for Medicare to send you the cheque for your med professional
3. Send that chq to your med professional
4. Wait for the revised bill from your med professional
5. Submit the new bill PLUS Medicare statement plus another form, to your pvt health insurer
6. Wait a few more weeks for your pvt health insurer to send you the chq for the med professional
7. Forward that chq together with the balance to the med professional.

How much time and money is this costing everyone?

To be honest, I detest this scam of a health system of ours!

We pay “Medicare Levy” of 2% PLUS we pay huge pvt health insurance premiums (which are skyrocketing in leaps and bounds way above the rate of inflation) but (excluding hospitals) we STILL end up paying about 75% of our own med bills. And on top of that you now have to wait weeks for chqs to arrive, all the while being HARASSED by the doctors to pay their bills, which you can’t do anyway because you don’t know what your share is going to be!

Why can’t people like me just opt out of Medicare and negotiate a deal with a private health insurer to adequately cover all med bills?

[grandmoon]

After my Op  I presented my receipts to Medicare and the money was deposited into my bank account within 3 to 4 days.

[artforartssake]

exactly, but my point is : what happens when you DON'T pay your surgeon or anaesthetist upfront and instead FIRST submit the bills to Medicare?

That's what I'm getting at here: why does THAT take so long compared to direct refunds to patient?

[siggie-reported-by-alarmists]

Phone them and ask.

You might not get a refund for that bill.

[artforartssake]

according to their website, I AM entitled to a claim of $225 out of a tot of $1,185 and the claim has already been processed - but there's no sign of a chq.

I really don't want to have to spend 2 hours on the ph to them

In any event, can you believe that they pay you LESS than 20% of the total? I mean, what's the point of Medicare anyway? Surely we'd be better off without it and to be able to do deals directly with our health insurer?

[tezza2844]

I think (but not for sure) that Medicare have to contact the surgeon or anaesthetist to confirm that the account is correct. So the delay may lay in that area. I'm sure that if Medicare just paid without confirmation you would end up with a new fraud industry

[artforartssake]

I guess that makes sense, but does it need to take 6 weeks?

[cherry*135]

Are you taking into account closures over the Christmas- New Year period for office staff? They may have very reduced staff on that period.

Was it not an option for you to have the money deposited in your bank account?? Take far less phaffing around than getting a cheque written, signed, posted and then a few days for delivery.

If you are paying 2% Medicare levy and have private health insurance, then your household earnings must be quite high, so waiting a few weeks for a few $hundred doesn't seem to much of an imposition.

[artforartssake]

Thanks for yr response, but the hols are well and truly over now

I'm assuming you are aware that, if the med professional doesn't ask for payment upfront, you have 2 choices:

1. pay it yourself in full and claim the refund from Mediscare and then claim another refund from yr pvt health insurer or

2. send the bills first to Mediscare and then to yr pvt health health insurer and then pay what's left, yourself

I spelled this all out in detail in my opening post

Since my anaesthetist DID NOT ask for payment upfront (it seems to me that anaesthetists never do) I choose option 2. HENCE it isn't me that's waiting for the money but the anaesthetist

BUT it's causing me the embarrassment of having the anaesthetist now waiting nearly 2 months for payment and this is the guy who had my life in his hands!

As far as I know every taxpayer pays a "Mediscare Levy" and unless you want to be at the mercy of the pub health system you'll have pvt health insurance too. How can you not have it? If I didn't have pvt health insurance, I would have had to wait 12 months for eye surgery by which time I would prob have lost my sight in that eye

[cherry*135]

Low income taxpayers are exempt from Medicare Levy  - up to certain amount of income p.a.

A lot of people/families don't have private health fund membership - they can't afford it.

I wouldn't be concerned about the anaesthetist  money - they know how the system works, delays etc.. why stress yourself about that?