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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 $39*, 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.
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 a copper IUD), 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 a copper IUD). 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 are able to transmit an electronic claim to Medicare after processing your payment. Medicare will then pay your rebate directly in to 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: $39 per visit will be the non concession Gap Fee to be paid in addition to the relevant Medicare Benefit Schedule (MBS) fee associated with the doctor consultation. For instance, you attend SHV for a general doctor consultation lasting 30 minutes, an MBS Level C/Item number 36 currently equivalent to $79.70 is charged plus the Gap Fee of $39. The total fee we will charge you is $118.70. We will process the rebate to your Medicare registered bank account of the doctors consultation fee of $79.70 and you will only be left out of pocket by $39.
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 and 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: People such as international visitors (including students, temporary residents or tourists) who do not have a Medicare card will be billed the appropriate MBS rate and Gap Fee for medical consultations. Procedural services will be billed per SHVs fee estimate schedule. All fees due on the day must be paid on the day. Holders of international health insurance such as ‘OSHC’ may be eligible to claim a rebate from the insurer. SHV can provide copies of receipts to assist you in this process when requested. SHV does not process health insurance claims.
Q: I am just 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 $39 (no cost if concession card holders or people aged 21 and under). For general consultations with either a nurse or a doctor the total out of pocket cost after any applicable Medicare rebates* will only be the appropriate Gap Fee amount.
*For those eligible to receive Medicare benefits and where a consultation with a doctor has taken place and an MBS item number has been billed by the doctor.
If you have any further enquiries regarding the changes to our fees please speak to our reception staff.