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IMPORTANT: Changes at HCF require action by you by 29 June 2015

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IMPORTANT Changes at HCF require action by you by 29 June 2015

This bulletin contains important information about changes at HCF that will affect you from 1 July 2015. Please take a moment to read it now.

Best wishes,

 

 

IMPORTANT: Changes at HCF require action by you by 29 June 2015

Effective 1 July 2015, HCF is introducing a Known Gap claiming scheme, which will operate separately from its No Gap scheme.

The fees for the existing No Gap scheme will also change effective 1 July 2015.

Key facts

  • There will be 2 separate fee schedules with different fees payable under each:
    1. A No Gap fee schedule
    2. A Known Gap fee schedule
  • The No Gap fee schedule offers higher fees than the Known Gap fee schedule
  • No Gap fees for consultation items have been reduced under the new schemes
  • You can only participate in one scheme at a time
  • You can change your option with 30 days notice
  • The maximum Known Gap is $500 per admission
  • Informed Financial Consent must be provided where a Known Gap is charged. This is a legal requirement for all Known Gap schemes


What you need to do

  • Decide which scheme you want to participate in (we have included some claiming examples below to help you decide).
  • Read HCF’s terms and conditions here.
  • If you do nothing you will automatically be enrolled in the Known Gap scheme which pays less than the No Gap scheme.
  • If you want to participate in the No Gap scheme go to: www.hcf.com.au/HCFMedicalProviderPortal and login. It is a very quick 3 click process once you are logged in. If you are not already registered, it will take a little longer as you will need to register first.


Claiming examples under the new HCF arrangements effective 1 July 2015

Consultations:

  • MBS Item Number
  • Current MBS Schedule Fee
  • Current HCF No Gap Fee
  • New HCF No Gap Fee
  • New HCF Known Gap Fee
  • 104
  • $85.55
  • $114.25
  • $106.10
  • $104.35
  • 105
  • $43.00
  • $55.15
  • $53.30
  • $52.45
  • 110
  • $150.90
  • $193.85
  • $187.10
  • $184.10
  • 116
  • $75.50
  • $96.95
  • $93.60
  • $92.10

Procedures No Gap

  • Item No
  • Description
  • New HCF No Gap fee
    (current fee in brackets)
  • Patient Known Gap
  • 32090
  • FIBREOPTIC
    COLONOSCOPY
  • $458.05 ($445.15)
  • NOT PERMITTED


Procedures – Known Gap

  • Item No
  • Description
  • New HCF Known Gap
    (current fee in brackets)
  • Patient Known Gap Maximum Contribution
  • Maximum Total Fee Chargeable
  • 32090
  • FIBREOPTIC
    COLONOSCOPY
  • $448.00 ($445.15)
  • $500.00
  • $948.00


Anaesthetic – No Gap

  • Item No
  • Description
  • New HCF No Gap fee
    (current fee in brackets)
  • Patient Known Gap
  • 17615
  • Pre Anaesthetic Consultation
  • $142.60 ($141.80)
  • NOT PERMITTED
  • 20810
  • Initiation of Anaesthetic
  • $138.85 ($138.80)
  • 23041
  • Anaesthetic Time
  • $138.85 ($138.80)
  • TOTAL:
  • $420.30 ($419.40)


Anaesthetic – Known Gap

  • Item Number
  • Description
  • New HCF Known Gap fee (current fee in brackets)
  • Patient Known Gap Maximum Contribution*
  • Maximum Total Fee Chargeable
  • 17615
  • Pre Anaesthetic Consultation
  • $135.00 ($141.80)
  • $100.00
  • $235.00
  • 20810
  • Initiation of Anaesthetic
  • $134.50 ($138.80)
  • $200.00
  • $334.50
  • 23041
  • Anaesthetic Time
  • $134.50 ($138.80)
  • $200.00
  • $334.50
  • TOTAL:
  • $404.00 ($419.40)
  • $500.00
  • $904.00


* The patient maximum known gap amount can be divided across the MBS services in any proportions as long as the total does not exceed $500.

Please contact us on 1300 510 114 if you have any questions at all.

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