bulk billing

A crash course in GP clinic lingo – Lizzie at reception

During my time as a medical receptionist, it’s become clear that clinic terminology we use each day can sometimes sound like GP jargon.

So, to help clarify some of the terms you may hear when visiting Doctors of South Melbourne, we’ve created GP Terminology 101 – a crash course in GP clinic terms and concepts.

Appointment length

When booking an appointment, reception will usually ask if you’d like to book a single or a double appointment with your GP, to which patients often respond, “I’m not sure!!”

Single appointments run for 15 minutes. These are usually recommended if there’s only a single issue for which you want to see your GP.

Double appointments run for 30 minutes and are recommended if you want to discuss multiple issues with your GP or have more involved needs. This includes patients requiring cervical screening tests, multiple travel vaccinations or mental health discussions.

We may also ask what you need to see the doctor for. We’re not being nosy, just trying to make sure you get the appointment length that’s right for you.

Medicare

Medicare is the government scheme that gives residents access to certain healthcare services at a lower cost, including GP appointments. It may also extend to dentistry, optometry and other allied health services. Billing for medical services varies from clinic to clinic, but may include:

  • Bulk billing
    Bulk billing is when your GP bills Medicare directly for a health service that you receive. If you’re bulk-billed, you incur no out-of-pocket fees.
  • Private billing
    Private billing occurs when your GP bills you directly. Medicare card holders receive a rebate when they pay their private account, meaning they only have to pay the out-of-pocket portion. Doctors of South Melbourne is a private billing clinic.
  • Medicare rebates
    These are benefits you can claim when you pay a private account for your appointment. Claiming your Medicare rebate is easy – the benefit can either be processed as a refund onto any EFTPOS card or credited to a bank account you’ve registered with Medicare.
  • Out-of-pocket fees
    This is the remaining portion of your private bill that is not covered by Medicare. Private billing clinics can set their own out-of-pocket fees, so you might find that this varies.

Private health insurance

Lots of patients present us with their private health insurance cards when they come out of an appointment. However, I’m afraid there’s no private health insurance rebate for GP appointments.

“But what do I get for all those fees I pay?”, I hear you ask. Well, it all depends on your level of cover. Hospital cover helps cover costs for in-hospital treatment and accommodation while general treatment cover (often referred to as ‘extras’) is for services such as dental, physio and optical.

This government website is an excellent resource for all things private health – it answered many of my own questions!

Concession cards

Concession cards may make you eligible for discounted prescriptions and health services from some providers. There are different types of concession cards, including:

  • Health Care Card
    You may qualify for a Health Care Card if you receive certain payments from the government, have a low income, have reached the age pension age or are caring for a foster child.
  • Pensioner Concession Card
    You may qualify for this concession card if you receive certain payments from the government such as the Age Pension, a carer payment or a Disability Support Pension.
  • Department of Veterans Affairs (DVA) Card
    Veterans, their war widow(er)s and dependents are issued DVA cards. DVA Gold Card holders are entitled to DVA funding for all medical expenses. DVA White Card holders are only entitled to funding for specified conditions.

GP health plans

There are several different health plans your GP may recommend for you.

Chronic Disease Management Plans

Chronic medical conditions are those that have been or are likely to be present for at least six months. They include a wide range of conditions and illnesses.

There are two types of plans your GP may arrange for you if you are experiencing a chronic or terminal condition:

  • GP Management Plan (GPMP)
    These plans provide an organised approach to chronic disease management by outlining your health needs, what services your GP will provide and how you can help to manage your condition.
  • Team Care Arrangement (TCA)
    If your condition requires care from multiple health providers, your GP may additionally coordinate a TCA. This type of plan includes a referral to at least two other health providers for ongoing treatment directly related to your chronic condition.

Having a GPMP and TCA may entitle you to Medicare rebates from allied health providers that your GP has referred you to.

Mental Health Care Plan

If you’re experiencing a mental health disorder, your GP may arrange a Mental Health Care Plan (MHCP) for you. The purpose of this plan is to provide you with better access to mental health care services with a Medicare rebate.

Having an MHCP entitles you to a Medicare rebate for up to 10 appointments with an allied mental health service (such as a psychologist) in a 12-month period. After your first six appointments, you need to see your GP again to review your plan.

For more information about arranging an MHCP and accessing mental health services, visit beyondblue.org.au.

Scripts

Scripts, formally know as prescriptions, can seem like a secret method of communication between your GP and pharmacist, but we’re here to crack that code for you!

Repeats

Scripts with repeats mean that you can get the medicine prescribed by your doctor multiple times from a pharmacy.

For example, a script for 30 tablets of a particular medication with two repeats means the medication can be dispensed three times for a total of 90 tablets. It’s important to remember that scripts generally expire after 12 months, so any repeats remaining on the script after this time will no longer be valid.

PBS scripts

PBS scripts are medications which are subsidised by the Australian Government on the Pharmaceutical Benefits Scheme. In general, patients pay a maximum of $39.50 for scripts on the PBS (less for concession card holders) with the remaining cost covered by the government.

Referrals

A referral is a letter or request form written by your GP that allows you to access additional health services. Referrals can be for pathology tests, radiology scans, allied health, hospital or specialist appointments.

Like scripts, referrals expire after 12 months so remember to book an appointment with your GP to get an updated referral – especially if you’re planning on visiting a specialist that you haven’t seen in a while.

My Health Record

You may have heard a bit about the My Health Record in the media lately. For those who don’t know, My Health Record is an online summary of your key health information. Your information is accessible to you through MyGov, and also to health providers that you choose to share it with.

By the end of 2018, a My Health Record will be created for every Australian unless you ‘opt-out’ by 15 November 2018. Visit the My Health Record website or call 1800 723 471 for more information.

So, that’s all for today’s lesson. Please leave a comment below if there are any other confusing GP clinic terms I can demystify for you.

Lizzie is part of the incredible reception team at Doctors of South Melbourne.