Estimate Example - Standard Gap

Scenario: The Doctor/Practice does not enter into an agreement with a Health Fund, nor opts into a scheme and charges their own fees. Therefore there will be an out-of-pocket expense for the patient, which will be displayed in the Gap Column of the New Estimate of Fees window.

The calculations are based on the following:

• Doctor's fees will be displayed under Fee.
• Medicare rebate of (75%) under Medicare.
• Health Fund (25% of MBS Fee) will be displayed under Health Fund.
• Gap Difference under Gap Column.
  
  
  

  Therefore if a practitioner charges above the Schedule Fee for Item 32090 please find example listed below:

  Practitioner Charges for Item 32090	$603.00
  Less Rebate Medicare ($376.90) Health Fund ($125.60)	502.50
  Gap to pay	$100.50