PHI Key Elements – Hospital

Medicare pays a benefit of 75% of the MBS fee for in-hospital treatment

• True

• False

Medicare pays a benefit of 85% of the MBS fee for out-of-hospital treatment (e.g., appointments with the obstetrician in their rooms before having a baby).

• True

• False

Private Hospital covers you as a..........

• Private patient in a private hospital only

• Private patient in a private hospital, and

  Private patient in a public hospital

• Private patient in a public hospital only

As an inpatient service, what percentage of the Medicare Schedule fee is paid by Peoplecare?

• 85%

• 100%

• 25%

• 75%

Select all the correct answers:

What does ambulance cover includes?

• Emergency ambulance treatment and transport via air, land & sea

• Call out fees

• Non-emergency patient transfers

• Emergency ambulance treatment without transport

Permanent Queensland residents are automatically covered for emergency pre-hospital ambulance treatment and transport Australia-wide

• True

• False

Who is responsible for facilitating arrangements between hospitals, doctors, and health service providers on behalf of Peoplecare?

• BUPA

• Medicare

• ARHG

• AHSA

Select all the correct answers:

What is Access Gap?

• Access Gap aims to reduce how much specialists charge you in out-of-pocket costs

• Specialists can choose to take part in Access Gap on a case-by-case basis

• Your gap can be no more than $500 per episode or $800 if it is an obstetrics episode

• Your gap can be no more than $400 per episode or $600 if it is an obstetrics episode

Select all the correct answers:

What are the benefits for doctors to participate in Access Gap?

• Fast turnaround of accounts

  21 days turn around for our payment

• Doctors must have a contract?

• No contracts required

  Doctors can opt-in on a case-by-case basis

• One schedule & rules for all 26 AHSA fundst

A prostheses is a surgically implanted device, such as a lens for cataract surgery, a stent for cardiac surgery, or an artificial hip or knee component during a hip/knee replacement.

• True

• False