Podcast
Questions and Answers
What determines the maximum out-of-pocket cost for neonatal care?
What determines the maximum out-of-pocket cost for neonatal care?
- Length of hospital stay
- Standard maximum gap (correct)
- Number of paediatrician attendances
- Individual health fund rebates
What is the maximum out-of-pocket cost for twins receiving neonatal care?
What is the maximum out-of-pocket cost for twins receiving neonatal care?
- $1000
- $850 (correct)
- $600
- $750
Which item is most commonly billed for the newborn check?
Which item is most commonly billed for the newborn check?
- Item 110
- Item 119
- Item 122 (correct)
- Item 128
How do the care needs of a newborn impact the invoice amount?
How do the care needs of a newborn impact the invoice amount?
What feature of the gap is specified for neonatal care?
What feature of the gap is specified for neonatal care?
Which items are used by paediatricians for brief checks?
Which items are used by paediatricians for brief checks?
What is the role of the paediatrician during a newborn's hospital stay?
What is the role of the paediatrician during a newborn's hospital stay?
What additional support is mentioned for paediatricians if they cannot attend to a baby themselves?
What additional support is mentioned for paediatricians if they cannot attend to a baby themselves?
When will you receive your paediatrician’s invoice after discharge?
When will you receive your paediatrician’s invoice after discharge?
What is the due date for payment if your baby is six weeks of age?
What is the due date for payment if your baby is six weeks of age?
What happens if families do not have Medicare?
What happens if families do not have Medicare?
What can be done to manage the account more effectively?
What can be done to manage the account more effectively?
How are Medicare rebates typically processed?
How are Medicare rebates typically processed?
What is the primary justification for setting the fees at this practice?
What is the primary justification for setting the fees at this practice?
What should you do once receipted and after obtaining your baby’s Medicare details?
What should you do once receipted and after obtaining your baby’s Medicare details?
What is the impact of the Provider’s Fee Payment Policy?
What is the impact of the Provider’s Fee Payment Policy?
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Study Notes
Neonatal Care Invoice Amount
- Depends on standard maximum gap, newborn's care needs, and services billed.
- Standard maximum gap: $600 ($850 for twins). Covers out-of-hours C-sections and unplanned urgent care. Most families pay less.
- Gap mostly applied to the first billed item (item 122 or 110).
- Many families eligible for Medicare Safety Net rebates.
Care Needs and Billing
- Invoice reflects hospital stay duration and number of paediatrician attendances.
- Paediatrician visits most days, more frequently if needed.
- Billing uses items 131/119 (brief checks) and 128/116 (discharge/involved checks).
- Gap capped regardless of care needed or stay length.
- Services billed include paediatrician's attendances (checks).
- Paediatrician responsible 24/7; locum care billed separately, but gap remains capped.
Invoice and Payment
- Invoice emailed ~2 weeks after discharge.
- Due date: 6 weeks after baby's birth.
- Admitted care invoices submitted to health fund; gap may remain.
- Self-insured families can claim Medicare rebates after full payment.
- Payment plans available for those needing assistance.
Fees and Payment Policy
- Fees ensure sustainable, high-quality care.
- Aim is to keep accounts manageable for families.
- Payment policy minimizes administrative costs and stress.
- Full invoice payment required.
- Medicare rebate claim lodged after receiving baby's Medicare details.
- Provider's fee payment policy details payment methods, terms, late fees, and debt recovery.
Medicare Rebates
- For non-admitted care, rebates paid within ~4 business hours of claim lodgement.
- Paid to nominated bank account.
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