Getting Paid - Gap Schemes

Please click on the following links to read about Gap Schemes:

  1. Gap Schemes
  2. Entitlements
  3. Eligibility

1. Gap Schemes:

Gap Schemes (a.k.a "No Gap" schemes) were introduced by RHBOs in an attempt to overcome some of the inherent problems with the private health system and its administration.

Historically, doctors (Standard Providers) would send an invoice directly to the patient who would either:

Whilst this method of billing is still commonly used, the RHBOs have recognised the following problems associated with it:

To counteract these problems, in the year 2000 the first RHBO "Gap Scheme" was introduced.

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2. Entitlements:

As a registered Gap Scheme provider, you are entitled to send invoices directly to the RHBOs rather than to the patient. The RHBOs will then:

Ultimately, this reduces the instances of patient gaps being charged since the RHBOs are offering comparatively higher and much faster rebates.

In return, as a Gap Scheme provider, you are legally required to obtain signed financial consent from patients prior to surgery (or as soon after surgery as is reasonably possible) for any proposed gap.

The RHBOs hope that by offering this service, doctors will be less likely to charge a gap. This strengthens their public profile as they can offer patients financial security, and the potential to have an operation without paying bills or collecting cheques.

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3. Eligibility:

If you are a currently registered Australian doctor, you are eligible for Gap Scheme benefits provided you are registered as a Gap Scheme Provider with all of the Australian RHBOs. This includes providing the RHBOs with your provider number, contact details and banking details for direct funds transfer into your nominated account. This will be done automatically for you upon registering with Surgeonline.

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