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?

[artforartssake]

yep, I guess you're right: why should I worry? and I've already told the secretary at the anaesthetist's practice that it's not my fault and I'm waiting on chqs from Medicare and my pvt health insurer - and I even sent them an instalment of $300 as I felt so bad

I guess also, I feel bad because this particular anaethetist was wonderful. I'm a terribly nervous patient, but he was reassuring, patient and understanding and when I awoke after the op I felt fine. In previous ops I've had very bad reactions to anaethesia such as palpatations and panic attacks

just wish i didn't have to deal with Medicare and could go my own way with a private health policy that suited my needs

[tezza2844]

artforartssake wrote:

yep, I guess you're right: why should I worry? and I've already told the secretary at the anaesthetist's practice that it's not my fault and I'm waiting on chqs from Medicare and my pvt health insurer - and I even sent them an instalment of $300 as I felt so bad

Looks like you are having just as much trouble from your private fund.

At most of doctors/specialist practises you can lodge your Medicare claim when paying the account and your rebate will appear in your bank account within a few days

[artforartssake]

no, private fund never so bad - but the procedures require you to get the first chq from Medicare. ONLY THEN can you go to yr pvt health insurer for another partial (very partial I should say) contribution

as mentioned, the account hasn't been paid yet as I don't know exactly what to pay UNTIL I've received the chqs from medicare and my pvt health insurer

It's a real pain and so convoluted: costing everybody masses of time and money

I'd like to see Medicare abolished for those who don't want or need it

[cherry*135]

Anaethetist - will be getting payments coming through all the time... and heaps of them.

I do find it strange that Govt collects 2% of total income from a taxpayer and if that taxpayer has private health fund then the Govt pays them 30% rebate on the taxpayers health fund premium (if taxpayer is eligible for that rebate).

Which could end up being around the same amount collected as the amount returned as a rebate!

[lyndal1838]

It is a few years ago now but when my father had an operation I was given a form to submit to his private health fund which allowed them to claim the Medicare refund on his behalf and forward the combined payments to the doctor.

The health fund notified us of the gap amount within 2 weeks and it was delivered to the doctor the day after they received the Medicare/fund cheque.

[cezm]

We've been using Medicare Two-way where we give the bills to either Medicare or Bupa and they sort it out with the other. I'm not sure if that works for all health funds though.

[lyndal1838]

I believe it does with most funds.  You say it works with Bupa, and i know it works with Medibank Pvt and the Government Employees Health Fund.

I have always given the bills to the private fund and they have been paid promptly...not sure how quick it would be if they were given to Medicare to start the process.

[artforartssake]

I'm with H.C.F. and they WILL NOT pay out before Medicare has paid first, that's just how it has always worked with H.C.F.

1. Claim FIRST from Medicare

2. THEN claim from H.C.F.

Why does the govt force Medicare on those who can afford pvt health insurance and would be prepared to pay more to their pvt health insurer for better coverage and a simpler system? Why have this convoluted, expensive and complicated two-tier system that no-one is happy with?

I guess that's my main gripe: I just wish we could get rid of Medicare from our lives!

[cherry*135]

A problem with that could be - at present you ( or any other Australian adult) can afford Private Health insurance.. what if circumstances changed and you could no longer afford that in your household.... if your scheme was in place, where you didn't have to pay Medicare levy.... new situation - no private health fund, haven't been paying in to Medicare levy.

Why should you ( or any other Aust. adult)  be able to hop back on the Medicare wagon when you/they haven't been paying any levies to Medicare, for example, for 5 years?

[lyndal1838]

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@artforartssake wrote:

I'm with H.C.F. and they WILL NOT pay out before Medicare has paid first, that's just how it has always worked with H.C.F.

1. Claim FIRST from Medicare

2. THEN claim from H.C.F.

Why does the govt force Medicare on those who can afford pvt health insurance and would be prepared to pay more to their pvt health insurer for better coverage and a simpler system? Why have this convoluted, expensive and complicated two-tier system that no-one is happy with?

I guess that's my main gripe: I just wish we could get rid of Medicare from our lives!

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I understand you have to start the process with Medicare, but do you get the 2 Way form that allows your fund to collect the Medicare amount and send the 2 cheques to the doctor?  It saves so much time and running around.

When we submit a Medicare claim electronically it is paid into our bank account within a few days.

I agree that the worst thing that ever happened to private health cover was when the Government got involved in setting the rules as to how much the funds could pay out.

I have always had private cover and before medicare i never paid anything for doctors, hospitals or dentists.   It was all covered by the fund.

As soon as Medicare came in I started paying much higher premiums and getting much lower payouts.  These days I am questioning whether it is really worth it to pay for private cover as you pay almost as much again in gap payments while those who rely on Medicare pay zip.