Mixed Billing Explained

Changes to our Billing Structure:

Unfortunately, the current government funding system for bulk-billed services has become unsustainable for general practice. We, like many other Practices across Australia, have had to make the difficult decision to bill more of our patients, or risk closing our practice due to insufficient funding.

Our fees reflect the time taken and the degree of complexity of each consultation. This means you may have some out-of-pocket costs associated with your GP attendances/services. The introduction of Mixed billing means we will have both private billing and bulk billing options at our clinic.

Unfortunately, we are no longer able to sustain 100% bulk billing as the amount set by the Government does not cover the cost of providing a high-quality medical service.

We have done our very best to keep costs as low as possible so we can continue to be an accessible provider for our valued patients. The Australian Medical Association (AMA) recommended rate for a consultation of less than 20 minutes is $84.00. Under our updated billing policy, the out-of-pocket cost for a standard appointment is around $35, which is still considerably less than AMA recommendations.

Visit our Fees page for an updated list of pricing.

From April 2023, Inala Primary Care’s fees have changed. Our fees reflect the time taken and the degree of complexity of each consultation. This means you may have some out-of-pocket costs associated with your GP attendances/services. The introduction of Mixed billing means we will have both private billing and bulk billing options at our clinic for eligible patients.

Unfortunately, the current government funding system for bulk-billed services has become unsustainable for general practice. We, like many other Practices across Australia, have had to make the difficult decision to bill more of our patients, or risk closing our practice due to insufficient funding. Other contributing factors include:

  • Inflation driven increase on insurance, interest rates and rent
  • Increased costs in medical supplies due to COVID
  • Increases in award rates

Bulk Billing means that the doctor is paid directly by Medicare on behalf of the patient. This means that the amount paid for each medical service is the amount set by the Australian Government, and there is no additional payment required.

Mixed billing is a private fee set by the practice to bridge the gap between what the government subsidises and the actual costs of delivering care.

Our practice delivers a high level of patient medical care, which includes comprehensive care, longer consultations, and minimal waiting times with the doctor of your choice. Unfortunately, Medicare subsidies have not kept up with the inflation rate,  and do not cover the real cost of delivering care. This is why we, like many other General Practices across Australia, have been forced to make the difficult decision to privately bill our patients, or risk closing our doors. Therefore we have had to change the way we bill our patients.

  • Children aged 16 years and under are eligible for bulk-billed appointments.

and

  • Patients with a concession card who have any of the following care plan agreements in place:
    • General Practitioner Management Plan (GPMP)
    • Team Care Arrangement (TCA)
    • Mental Health Care Plan

We understand that chronic conditions mean frequent visits to your GP, In an effort to keep our care accessible to those who need it the most we have decided to bulk-bill patients with both concession cards and active chronic disease care plans in place.

Please note:

  •  Government-funded vaccines, Health Assessments, Diabetes Reviews & Care Plans will remain bulk-billed for all patients.
  • You must hold a valid Medicare Card at the time of your appointment to be bulk billed.
  • There may be some out-of-pocket fees for additional services/and or procedures. Please check with reception at the time of booking.

We have introduced a reduced concessional fee rate which is available to the following patient groups for standard consultations:

  • Concession Card holders (Centrelink, DVA, Pension)

This discounted rate will have an out-of-pocket fee of roughly $20.

Failure to attend your appointment without notice will result in a $30 fee, this will need to be paid before your next appointment can be booked. We require a minimum of four hours’ notice if you are unable to attend an appointment so that we may offer your appointment to another patient in need. Repeat offenders may be declined appointment opportunities in the future.

Please note: Failure to attend GP Management Plans, Team Care Arrangements, Mental Health Care appointments or any other Nurse-led appointments will result in a $50 DNA (did not attend) fee.

You may give notice by calling the practice on 07 3275 5444 or speaking directly with reception.

Telehealth Consultations are only available only to patients who have previously attended the practice in the past 12 months. These appointments are considered a convenience service and will have an out-of-pocket fee of $35.25 for all patients unless otherwise stated by your doctor.

Medicare Cards: Must be valid at the time of the appointment, otherwise you will be fully privately billed.

We are a cashless practice and do not carry any cash on the premises. You can make your payment method via Eftpos or Credit Card (excluding American Express) and for your convenience, we will process your refund on the spot. This means you will need to have the full fee amount in your bank account or credit card at the time of payment.

For example:

If you have a standard consultation you will need to have $75 in funds available at the time of processing. The Medicare rebate of $39.75 will be processed instantly, leaving you with an out-of-pocket cost of $35.25. If you do not have the full fee amount available in funds, your electronic payment will not be able to be processed and you will have to follow up with Medicare.