GP clinic wants to know if we have private health insurance.

We've just moved into a new area and the GP clinic here, on the new patient registration form my wife needs to fill out and return tomorrow has a question:

"Do you have Private Health Insurance? If yes, please see reception for payment process"

I'm curious why the question considering no Private Health Insurance her covers GP fees?

This clinic Bulk Bills.

Of course we're going to tell them what we have (basic hospital and extras cover with Bupa) but still leaves me curious what difference it would make to the clinic.

Thanks in advance


  • +16

    Ask them.

    • +1

      Some vaccines aren't on the PBS and can be claimed via PHI, maybe they process the claims for you (?)

    • -4

      Another punter who doesn't know the way here. First step find your self in a situation (real or imagined)
      Go off half cocked and post here
      Disappear without providing a meaningful update. You can't expect ppl to pick up the phone and ask a simple question of the ppl at the other end of said situation.
      Hands must be held, and lives outsourced to the random many

      • +2

        What the heck are you going on about? "half cocked" "real or imagined" "hands must be held" ?

        r u k ?

        • -1

          ru>o< k?

        • Ha guaranteed OP does exactly as described.

      • +5

        another self appointed gate keeper

        • -2

          Nope. Not even close. I'm an observer. What I wrote is what happens.If you read some of the current most popular threads and miss that, then you need a comprehension upgrade

          • +4

            @Protractor: You must be the life of every party you attend.

            • -2

              @The Buyer: I'm paid to attend. They even tip me in BTC.
              Have you studied the trend you are part of here yet?

    • +1

      My wife did ask the receptionist but she didn't know and suggested we ask the GP on our first consultation.

      I'm not gonna ask because it doesn't bother me either way, I'm just curious if anybody here who works in the area knows definitively.

      • +9

        Please ask because us Ozbargainers want to know the answer

      • +1

        I am guessing it's a generic form. Some patients aren't covered by medicare but by their private health insurance, e.g. students will have OSHC that covers GP visit. And temporary residents might have private insurance that include GP visits.

        • +1

          Generic forms don't have a 'see the receptionist about milking the value out of you' clause

  • -6

    So GP can milk both the Gov't and your private health insurer.

    • The wife is a little more cynical than I so thats what she suggested.

      But I countered that GP fees aren't covered by any PHI policies in Australia (by law apparently).

    • PHI doesn't cover anything eligible for medicare

  • +2

    Why does everyone think businesses are out to get them? The other day there was a post about someone asking about payment method confirmation, plumbers gouging people, etc etc

    • +15

      Because it happens?

    • -1

      Business are out to get you.

      Get a scan at a medical hospital.

      Mention you work at the same hosptial. Boom discount.

      • +1

        I find you can often get a discount just by asking nicely.

  • +1

    Isn’t it for procedures that aren’t covered/subsidised under Medicare

    • PHI will only cover procedures in a hospital not at a clinic (I may be wrong. Again)

      • Not sure. Just I know my private health will pay a percent of my eczema creams if I submit a pharmacy invoice. So thought it might be something similar in this case

        • +1

          That might be part of extras cover, not hospital (I may be wrong. Again)

          • @Muzeeb: You know what yes haha my bad yes extras .

            • @Jimothy Wongingtons: That doesn't have anything to do with your GP tho - even if they prescribe it.

          • +1

            @Muzeeb: Yes that's claiming against the extras. :) Blood pressure monitors are another thing the GP can write a letter for and PHI will cover :)

        • +1

          Or the specialist they refer you too.

      • +1

        No, you are right.…

        "Private health insurers can’t cover out-of-hospital Medicare services. However, they might cover some of the services Medicare doesn’t, like physiotherapy and other allied health services not on the MBS."

        • I bet they have a physiotherapist or similar renting a room and giving referral kickbacks.

  • Mine did as well and it seems to be a data gathering exercise.

    • I thought that too at first but then the follow up to the question is "If yes, please see reception for payment process"

      • +4

        hmmm … I was told that it is a pro-forma questionnaire that some medical centres don't amend for their circumstances. It is meant to cover those practices that offer additional modalities, ie. podiatry, physio, etc which can be claimed via private health insurance.

        • That makes sense

        • Mmm yes that makes sense. Thank you.

    • Agree. My dentist's form asks about for details of where and what I do for work.

      • I'm a dentist, I have data like this on my form but it's just so I can give myself some talking points at our first appointment and give me a rudimentary idea about your values, education etc. For example, if someone tells me they're a doctor, I'm going to use higher level scientific concepts than if they tell me they're a Lawyer. I also offer discounts to specific professions.

        The data I collect isn't sold, or used for anything other than your appointments (and contact details are used to send reminders) its simply stored as per legal requirements.

        • +5

          Which occupation do I say I'm in to get discount (asking for a friend)?

          • +2

            @larndis: Other registered healthcare workers (not Chiropractors or Osteopaths)

        • How does knowing what someone does for work give you an insight in to their values?

          • @Eeples: Well, it's just a rudimentary idea right, for example somemone who is a local business owner booking first appointment of the day may be more time sensitive and want me to be more direct than someone like a public servant booking in at 10am.

  • +1

    Private Health Insurance her covers GP fees?

    Ours paid for some vaccines.

  • +1

    Your GP can provide referrals(public vs private) based on your private health insurance status. It can sometimes include services like scans, physio etc i think.

    • Referrals are independent of whether you hold PHI or not.

      They can write a health care plan including physio but that still comes from medicare, PHI not involved with that.

  • +1

    Specialist Referrals.
    Some Specialists only work in Private Hospitals, so normally your GP wouldn't refer a 'no PHI' patient to them.

    • A patient could always pay out of pocket when visiting such a specialist, though.

      • +1

        My GP clinic has specialists in the building and they use the same receptionist.

  • +2

    If you tick yes, you get charged more of a gap ;) It's a gotcha question!

    Plead poor and tick No and you have a chance at being bulk billed :P

    (source: aunty was a receptionist for years and she used to say "if you are ever asked, deny having private health" as her practice would charge private health patients a fee and bulk bill everybody else)

    • Kind of weird, people have health insurance for many reasons.

      • Yeah, but some GPs obviously assume if you have PHI you are happy to pay, no matter the reason you have it!

        She worked at multiple clinics (for the same company) around VIC and that was the policy across all clinic (some 20+ years ago now though) :/

  • What was the question before that?
    Was it do you have a Medicare card?

    No Medicare card but overseas visitor health cover, means GP consultations might be covered or partially covered but you have to pay upfront or a gap.

    • Yes.

      Medicare number: ——— etc

      Then lists all the various concessions like Pension, Health Care Card etc with tick boxes.

      • It could also aid GP consider treatment options if/when medical issues arise that may require for e.g. hopitalisation or specialist treatment (private vs. medicare options).

  • +1

    It's a standard question from every clinic I've visited… I think it's for both data gathering as well cover for certain things that medicare does not. (such as physio, specialists etc..) It basically makes the process & recommendations easier.

    • +1

      It also makes a difference to referrals.

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