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Doctors do not have to stick to the schedule fee but can choose to bill the Medicare administration directly, rather than the patient.
Transmitting the video conference from the hotel adds another $60 an hour to the bill, plus a $50 scheduling fee.
Patients need to pay the balance of the fees above the 85% of schedule fee level, until the safety nets cut in.
Where practitioners "bulk bill" patients, they agree with Medicare to accept 85% of the schedule fee in full payment for their services.
The service provider receives only 85% of the scheduled fee but avoids the costs and risks of billing and debt collection.
The health service provider, usually a Doctor is paid 85% of the scheduled fee directly by the government by billing the patient via their Medicare card.
Patients are reimbursed for 85% of the schedule fee for each item of general practitioner service and for specialist consultations outside hospitals.
For hospital services the Medicare benefit is only 75% of the schedule fee, but patients can insure privately to cover the gap between benefit and fee.
People who choose to be private patients in public hospitals have 75% of the schedule fee reimbursed by Medicare and pay any additional fees through private insurance, if they have it.
The standard Medicare rebate is 85% of the Medicare-determined schedule fee, called the Medicare Benefits Schedule (MBS).
Under the original Medicare safety net, once an annual threshold in gap costs has been reached, the Medicare rebate for out-of-hospital services is increased to 100% of the schedule fee (up from 85%).
Gap costs refer to the difference between the standard Medicare rebate (85% of the schedule fee) and the actual fee paid, but limited to 100% of the schedule fee.
Where the government pays the large subsidy, the patient pays the remainder out of pocket, unless the provider of the service chooses to use bulk billing, charging only the scheduled fee, leaving the patient with no extra costs.
In order to claim the Medicare rebate, the patient then has to visit a Medicare office, fill out a claim form (for unpaid claims and claims where cash is not being refunded) and claim 75% of the scheduled fee from the government (100% for general practitioner services).