Accounts for consultations with the doctor are to be settled on the same day:
- An Initial Consultation with Medical Oncologist is $350.00 (Medicare refunds $231.35); subject to change without notice and
- A Subsequent Consultation with Medical Oncologist is $140.00 (Medicare refunds $66.25); subject to change without notice;
If insured and your health fund has a contract with the Riverina Cancer Care Centre you will be required to sign a health fund form (after each visit) which will be filled out by the chemotherapy nurses. This covers the facility fee and will be sent by the Riverina Cancer Care Centre to your health fund. The amount you will be out-of-pocket for the facility fee will depend on your excess and/or copayment with your health fund.
- All patients are charged the Medicare schedule fee;
- For uninsured patients Medicare will reimburse 85%;
- For insured patients, Medicare will reimburse 75% and your health fund will reimburse up to the remaining 25% depending on your cover; Costs associated with each chemotherapy session are displayed in the table below.
If in a Health Fund: If Self-Insured/Uninsured: Treatment Duration Schedule Fee 75% rebate Health Fund rebate (up to 25%) 85% rebate Gap (15%) Less than 1 hour $ 66.10 $ 49.60 $ 16.50 $ 56.20 $ 9.90 1-6 hours $ 99.50 $ 74.65 $ 24.85 $ 84.60 $ 14.90 More than 6 hours (1st treatment) $ 112.55 $ 84.45 $ 28.10 $ 95.70 $ 16.85 More than 6 hours (Subsequent treatment) $ 66.30 $ 49.75 $ 16.55 $ 56.40 $ 9.90
Medicare initially pays 85% of the Schedule fee for outpatients. Once you have paid approximately $470 of this 15% gap (the difference between the Medicare benefit and the Schedule fee), you are said to have reached the “Safety Net”. Any accounts submitted to Medicare after you have reached the Safety Net will attract a 100% rebate of the Schedule fee rather than the 85% rebate. The Safety Net is valid for a calendar year.
However, often you would not have reached the Safety Net prior to the submission of the final account. If this is the case, Medicare will only have rebated 85% of your account. To receive the further 15% refund, Medicare requires you to pay the balance of your accounts to us first then present your receipts to Medicare. Medicare then should refund you the amount that you have spent in excess of $470 in gap payments (the difference between the Medicare benefit and the Schedule fee).If you have not registered for the Safety Net you may not be entitled to this additional refund from Medicare. Please contact Medicare on 132 011 to determine if you are registered. A registration form is available from the Riverina Cancer Care Centre Accounts Department or from any Medicare office.
- Please settle your account at the end of each visit. We accept cash, money orders, Eftpos or credit card (we do not accept personal cheques, business cheques, Diner’s Club or American Express Credit Cards).
- For insured patients with appropriate hospital cover we are able to claim directly from your health fund and Medicare via Eclipse.
- For uninsured patients once payment is made, we are able to claim on your behalf the rebate from Medicare via Medicare Online.
Important noteIf you feel that your financial circumstances are such that you may have difficulty paying for the required treatment please feel free to discuss this with our Accounts Staff or your Medical Oncologist as they may be able to offer some form of assistance.
It is very important to have an up-to-date referral when you are seeing the Doctor.
Medicare may pay at a lower rate or refuse to pay at all if your referral has expired. A specialist referral is valid for 3 months and GP referral is valid for 12 months. So that you can obtain the maximum rebate from Medicare, if your referral is not up- to- date please see your GP and request an indefinite/ongoing referral.
To determine the status of your referral or if you have any questions relating to these procedures or about an account that you have received please do not hesitate to contact the Accounts Department on (02) 69321000.