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Billing at Sexual Health Victoria
Ours is a Gap Fee billing system.
For each general consultation with a Doctor or Nurse Practitioner, there will be a consultation fee (MBS scheduled fee) plus a Gap Fee of $43*, payable at the end of your visit. Sexual Health Nurse consultations will attract the Gap Fee only.
Healthcare Card / Pension Card holders will be bulk billed for all general consultations, as will people aged 21 and under.
Reception staff can assist with submitting Medicare claims and updating details with Medicare if required.
Please discuss any questions or concerns with our reception team.
*The rate of the Gap Fee is subject to review from time to time. Please note that for some procedural services the total out of pocket cost may vary.
Frequently Asked Questions
Q: Do I have to pay on the day of my appointment?
A: Yes, we do require payment on the day of your visit. Please return to reception following your appointment to settle your account, and our reception staff can assist with submitting your Medicare claim at that time.
Sexual Health Victoria will be transitioning to HotDoc Payments to simplify the payment process for our clients.
Clients may be required to provide a payment method to their HotDoc account when booking an appointment. However, you will not be charged until your appointment is complete or if you cancel less than 2 hours before your appointment or do not attend.
For more information about how Hot Docs manages payments, click here.
Q: I have a Centrelink (healthcare/pension) concession card – do I receive a concession rate?
A: Yes. Centrelink concession card holders will be bulk-billed for consultations. Some services or items may attract a fee (such as IUD insertions), however, general consultations will be at no cost.
Q: I am under 21 years of age and concerned about costs – how will this affect me?
A: If you are aged 21 years or under, you will be bulk billed for general doctor consultations and not charged a Gap Fee for general nurse consultations. Some services or items may attract a fee (such as IUD insertions). You will be able to receive bulk-billed services up until you reach 21 years of age. Our staff are able to confidentially obtain your Medicare card number if necessary; parental permission and notification are not required.
Q: How do I claim my Medicare rebate?
A: We can transmit an electronic claim to Medicare after processing your payment. Medicare will then pay your rebate directly into your nominated bank account, usually within 48 hours. If you have not registered your banking details with Medicare our reception staff can assist with registration forms (including forms to apply for your own Medicare card if required) and help you to submit them. Alternatively, we can provide a printed receipt so that you can claim from Medicare directly at a later time.
Q: I do not have any concessions – what will the Gap Fee be for me?
A: $43 per visit will be the non-concession Gap Fee to be paid in addition to the relevant Medicare Benefits Schedule (MBS) fee associated with the doctor consultation. For instance, if you attend SHV for a general doctor consultation lasting 30 minutes, an MBS Level C/Item number 36, equivalent to $82.90, is charged plus the Gap Fee of $43. The total fee we will charge you is $125.90. We will process the rebate to your Medicare-registered bank account of the doctor's consultation fee of $82.90, and you will only be left out of pocket by $43.
Q: I have been coming to SHV for many years – do I have to pay the up-front/Gap Fees?
A: We appreciate our loyal patients' ongoing support of SHV. We have updated our fees in line with similar service providers to assist us in being able to maintain and expand our services to you and to the community. All patients will be required to pay on the day of their appointment unless exempt under one of the exclusion criteria as noted above.
Q: I do not have a Medicare card – how am I billed?
A: International visitors (including students, temporary residents or tourists) who do not have a Medicare card will be billed the full fee for medical consultations. Private pathology companies charge a fee for genital swabs and blood and urine tests. If you have pathology collected at SHV, you will be sent an invoice for the tests. Procedural services will be billed per SHV's fee estimate schedule. All fees due on the day must be paid on the same day. Holders of international health insurance such as OSHC may be eligible to claim a rebate from the insurer. SHV can provide copies of your receipts of your consult to assist you in this process when requested. SHV does not process health insurance claims.
Q: If I am seeing a nurse, not a doctor, will I need to pay anything?
A: Yes. Nurse consultations will be charged at the appropriate Gap Fee of $43 (no cost if concession card holders or people aged 21 and under).
If you have any further enquiries regarding the changes to our fees, please speak to our reception staff.
