Medibank launches Find a Provider – giving customers access to specialists’ out-of-pocket costs

Medibank customers can now have the guess work taken out of choosing a specialist with a new Find a Provider tool helping customers and their GP find out how much, and how often, a specialist charges out-of-pocket costs.

Accessible via Medibank’s website, customers can see out-of-pocket information for more than 14,000 specialists.

Specialists can charge no out-of-pocket costs, an out-of-pocket of up to $500 or an out-of-pocket of more than $500 for a hospital admission. Over the past year, Medibank data for 14,000 specialists listed on Find a Provider showed that for hospital admissions - 83% of claims did not have an out-of-pocket for Medibank customers, 13% of claims had an out-of-pocket of less than $500, and 4% had an out-of-pocket of more than $500.

However, this data does not include out-of-pocket costs that may be charged by doctors for out-of-hospital care, including in their rooms, or those fees charged by other doctors involved in the hospital admission.

Medibank Chief Medical Officer Dr Linda Swan said customers are concerned when they’re admitted to hospital about how much it will cost. This new portal now enables them to have a conversation with their GP about what their specialist may charge.

“We’re making more information available to customers and their GPs to help them have better conversations about out-of-pocket costs before they select a surgeon,” said Dr Swan.

“We know having surgery can be a difficult time for our customers and their families. We want to make sure when they’re home recovering that they don’t receive an unexpected bill.

“We want the best experience for our customers and to help them make informed choices – that’s why we’ve been working to provide customers with more information,” said Dr Swan.

If you’re visiting your GP or specialist, Dr Swan recommends planning ahead with a list of questions before a consultation.

“You’re not second-guessing your doctor or questioning their expertise. It’s about making well-informed decisions about your own health.”

“Just because a particular specialist’s name is on the GP’s referral letter, this doesn’t mean you can’t take the referral to a different doctor. You may find different specialists charge very different fees for the same treatment or procedure. Paying more doesn’t mean you’ll get better quality of care.”

Customers will also need to ask about the fees that each health professional involved in their admission will charge, such as the anaesthetist, assistant surgeon or diagnostician.

Doctors are able to decide whether or not to use Medibank’s GapCover on a claim by claim basis, regardless of whether the hospital is contracted with Medibank. Medibank encourages all doctors to participate in our GapCover scheme to eliminate or reduce out-of-pocket medical costs for our customers.