Fees and Fee Changes from 1st July, 2023...

Following the Doctors' Committee meeting last week, the following changes will be made regarding fees in the lead up to the 1st July (our annual date for fee increases):

• The previously-indicated 'pensioner fee' (also known as the '$15 gap' fee) will be shelved, following the Federal Government's announcement that the rebate for eligible pension card holders would triple to $20.65 from the current $6.60. ALL patients should still expect to pay a gap fee for services, with bulk-billing (as always) being at the discretion of the treating GP. This boost in rebate comes into effect from 1st November, and applies to attendance items ONLY (NOT care plans).
• The Service Provider has indicated that from 1st July, MHCP services (2712, 2715 and equivalents) will be billed 'on the spot', rather than after the admin team has run an eligibility check, in order to reduce the number of outstanding accounts from patients. GPs are able to check a patient's eligibility for Mental Health Care Plans by either checking the patient's MHR, or by using the GP's PRODA account to verify eligibility (please read on for more information about the intricacies of how and when MHCP items can be billed).
• For hybrid billings (i.e. billings with both private and bulk-billed items), it is recommended that the higher priority item (generally an MHCP or equivalent) is PRIVATE billed, with the lesser priority item (3, 23, 36 44 or telehealth equivalent) being bulk-billed. This leads to fewer problems (and complaints) from patients when items under their MHCP are rejected due to delayed processing or medicare co-claiming rules and notations.
• The Inside-Out Eating Disorder Management Plan is now available from the Best Practice templates under CSMP - Eating Disorders Plan.

The general fee changes are listed in the table below:

Workers' Compensation accounts will continue to be taken by the service provider and distributed once settled by insurers - this will NOT change from 1st July!

Introducing Rose Stünzner and Akshana (Ash) Bishwakarma!

We'd also like to give you a break from all the info to welcome our new staff! Akshana (Ash - L)) joins our nursing staff, while Rose (R) is joining the admin team! Ash is with us on Wednesdays and Fridays, and Rose on Mon-Wed and Fridays! Pleas make them all feel a welcome part of the CSMP family!

Mental Health Care plans (how better access is MEANT to work)...

Earlier in the year, you'll remember I gave some information on how Mental Health Care Plans (2715/2717 and telehealth equivalents) are meant to operate. Hopefully this can give some further clarity, especially given that a number of patients will now have passed their sixth session:

• MHCPs do NOT expire: if a patient has had a 2715 at ANY point, a new one is only 'needed' if you feel that their clinical or psychological circumstances have changed, in which case - a new plan is warranted. In these cases, a new plan can be done 12 months from the previous one.
• On the 1st January, a patient's sessions 'reset', meaning they are able to access 6 sessions for that calendar year. All that is required at this visit after 1st Jan is a new referral letter for '6 sessions for this calendar year under Better Access Mental Health'.
• Once those 6 sessions have been 'used', patients should return to their GP to request another referral letter, this time for a further 4 sessions. Please note that a 2712 does NOT need to be billed at this time for these sessions to become accessible, but given the work required to properly review a plan, the remuneration is higher for a 2712 than it would be for a 23.
• In total, a patient is able to access 10 sessions within a calendar year.

When accessing PRODA to verify a patient's eligibility for mental health items, you'll need to choose each one separately (i.e. don't search for 2712/2715 together). PRODA assumes you are asking if you are able to bill all items at the one attendance; you need to check eligibility for a 2712 or 2715 one at a time!

For more information, please feel free to check the Services Australia website!

The Change - 1st July, 2023...

Having now completed the majority of the financial changes that will form our response to the increasing threat and encroachment of payroll tax for tenanted GPs, it's time to lay out the timeline for the transition for payments:

• From 1st July, the TYRO merchant switch will be 'flipped', meaning that all payments made from 1st July onwards will be directed into your nominated bank accounts for private payments.
• From 25th June, admin staff will hold processing of bulk-billed payments until 1st July to allow time (generally 72 hours) for Medicare to acknowledge the change in payment information. I will manage this using the PRODA delegations you've accepted, and via emailed correspondence for those still without PRODA access. This will mean that payments for the EoFY may be lighter, obviously being processed after 1st July.
• From 1st to 15th July, all GPs will be issued with a form to complete to authorise direct debit for the payment of fees to CSMP. The sooner this form is completed and submitted, the better. This should mean that for the vast majority of the transition, it will be largely indistinct from our current systems and practices!

I want to thank everyone for their patience through all of this - again, it's my priority to ensure that this all does not increase your workloads in areas that detract from an already significant clinical load. Should you have any questions, please let me know!

Coming Events...

• Practice Lunch! - 14th June, 1-2:30pm - Bring a plate! This may also be an opportunity for you to meet new staff, too. This year we've moved some of the days around to Thursdays and Fridays to allow folks that wouldn't get the opportunity to participate (and make food) to do so!