Optometrists are embracing changes to Medicare that they say have encouraged them to begin charging patients an appropriate fee for service.
Total Eyecare optometrist and former national president of Optometrists Association Australia (now Optometry Australia) Micheal Knipe AM, said the transition from universal bulk billing to charging the majority of patients a private fee for service has been “smooth”.
The changes to Medicare came into effect on 1 January 2015.
Mr. Knipe said his practice continues to bulk bill pensioners, health care card holders, full time students and children.
Everyone else is now charged a private fee that leaves them with a gap after they have claimed from Medicare
“Everyone else is now charged a private fee that leaves them with a gap after they have claimed from Medicare. The gap payment is between $10 and $49 depending on the service type and circumstance.”
Implementing the change, he said, had taken time. “We have had to spend time with staff explaining the reasons for the change and training everyone in the new procedures. We have produced a pamphlet that outlines the changes to our patients.”
At the time of going to print, Mr. Knipe was upbeat: “It’s a bit early to do an evaluation but so far the transition has been smooth and the new arrangements appear to be accepted by our patients and our staff seem to have had little difficulty with new procedures.”
Thao Hannaford, principal optometrist at Hannaford optometry in Bowral NSW, said the change to private billing had been timely and had little impact on her appointment book.
“I had been considering moving away from bulk billing general eye examinations for some time and new Medicare changes presented an opportunity to make the move.”
As was Mr. Knipe’s experience, the transition necessitated a commitment to staff training and patient education via a flyer and the recall system.
“Surprisingly there has been little movement to our appointment book. With two optometrists, the practice is still booked out a week in advance. Most patients have been quite understanding of the changes and often compare the Medicare gap costs to a cup of coffee or a nice restaurant meal. Lifting the gap has also meant we can charge appropriately for our services and in particular for those patients who prefer to have a comprehensive eye test more frequently due to family history of eye disease or for their own peace of mind.
“After a month now our systems are down pat and it has been a great decision. I had underestimated the loyalty of our patients and their appreciation of the quality of eye care and services we offer. My only regret is not making the move away from bulk billing sooner.”
Hannaford Optometry continues to bulk bill pensioners, low-income health care cardholders, full time students and children. This is something Margaret Lam from the eyecare practice in Sydney feels very strongly about. “Although we know it is important to ensure our practices remain financially viable, we… believe a patient’s care should not be compromised by their ability to pay… so we can charge less for those with lower socio economic means to ensure our services remain financially accessible, or give compassionate discount rates for unable to usually afford our services.
“Studies from the US and elsewhere show that when there are financial barriers to health care, it is not only mild cases that do not seek medical care, but an equal proportion of severe cases as well. This results in health conditions reaching severe forms before intervention occurs with appropriate diagnosis and management, all of which is far more difficult and costly that treating early stage disease.”
Gary Rodney at Eyes In Design in Sydney has welcomed the removal of a fee cap, however he said new procedures for payment were complicated for some patients to understand. “I think the removal of the scheduled fee is wonderful,” he told mivision.
“Patients did benefit by only having to pay the gap at the point of service. Now they need to pay the entire fee upfront. Even though the money can be claimed back on the spot, and deposited straight into their bank account, it does appear on the surface that they are being charged more.”
Mr. Rodney said he preferred a system that enables optometrists to bulk bill the Medicare rebate and charge patients an appropriate gap. “This would be much easier to explain and, in my opinion, would make patients feel better about the payment,” he said.
