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    The 'gap' closes


    The push to reduce out-of-pocket expenses for in-hospital and day-surgery procedures by Australia's largest health insurer, Medibank Private, is fast gaining ground.

    Medibank Private announced its Gap figures today to coincide with the broader private health insurance December quarterly data released by the Federal industry regulator for the private health industry, PHIAC.

    A record 70 per cent of medical services covered by the fund during the December quarter did not incur gap fees compared to the industry result of 65%.

    However, Medibank Private's figures since December show the "no gap" trend continuing, with a record 75 per cent of all services covered by the insurer not attracting out-of-pocket expenses during January.

    Medibank Private managing director, Mark Burrowes, attributes the fund's significant strides on the gap front to a multiplicity of factors.

    "Coupled with having a choice of two Medibank Private gap products (the first of which was introduced in November 1999 with a further version, last September) doctors have also welcomed the fact that they have the option of being able to hand their invoices direct to patients or forward them on to us.

    "What has also further bolstered our position on the gap front is that we have gone to enormous lengths to consult with both practitioners and practitioner groups and have been speaking with these groups for over 12 months now.

    "On top of this, gap participation rates have also been influenced by our recent almost six per cent increase in the benefits we pay practitioners."

    Mr Burrowes was quick to praise doctors who have done much to further the push to eliminating gaps.

    "We see their participation rate as a thumbs-up for our gap schemes. Clearly they not only see the benefits for themselves in terms of a more simplified billing system but they also recognise the big positives for their patients," he says.

    While Medibank Private retains its position as the fund with the largest market share nationally, its share for the October-December quarter is down slightly on that of the previous quarter.

    Commenting on the drop, Mr Burrowes, says it is largely attributable to a "spring clean" of the fund's membership database that saw several thousand non paid-up members being deleted from the fund's database between October and December.