/Subtype /Image Since then, weve grown to be a global organisation with over 43 million customers worldwide. ( This promotion is for self-funded residents only. The main advantage of this add-on is that it enables clients to choose their own cover, thus adapting it to their individual needs. Schedule of fees published in 2020 and 2021. ( Bupa Aged Care offers a full range of care including respite, residential and specialised dementia care. Learn more about Bupa and our ambition to be the worlds most customer centric healthcare company, Find out about Bupas commitment to building a healthy planet for healthy people, Read our financial results, reports and presentations. Our international private health insurance plans are designed to be used, and offer a premium healthcare journey with direct access to a global network of specialists, without waiting for a referral. Apply for recognition to help you build your private practice. 0345 600 4622^. Day-to-day care covered up to 18,750 per year; Health screening and wellness checks included after 10 months; Treatment for or relating to Gender Dysphoria included; Accident related dental treatment covered immediately, routine and major restorative dental after 6 months; Optical cover included View brochure (pdf) Elite Global Health Plan Information and news to help your practice, business, hospital or facility. $.' , o Z ^ ] W > W ] ( ( ] ( } u D Z d Z - Bupa Find advice on fees, limits, allowances and the Rural Enhancement Initiative. In particularly complicatedcases or unusual circumstances, Bupa is prepared to consider an enhanced payment, please seenote 8.4 for details.1.1 ConsultationsA consultation is defined as:A . ( ( Book a GP appointment, health assessment, sexual health check and more, at a time that suits you. Alexisonfire New Album 2021, Our wide range of tailor-made solutions include digital healthcare. The Frank Health Insurance Schedule is different than other health funds in that it uses the below logic. Skin cancer screening; management of non-melanoma skin cancer; management of acne; eczema and patch testing; all general dermatology. As of March 2021 we are no longer supporting Internet Explorer 11. PDF SCHEDULE OF MATTERS RESERVED FOR THE BOARD - Bupa K ] P ] v P } P } ] ] } v ' } ^ r' } D ^ / u E u Z W / u ~ ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ |" /ColorSpace /DeviceRGB 11 0 obj You will receive payments quicker and as one payment. We review all these requests and, where the evidence supports a update, this will be considered by one of our medical directors, who will seek input from independent practising clinicians in the relevant specialty who have no conflict of interest. With the launch of a new digital add-on, BluaU Smart Sanitas continues to make advances in the field of digital medicine. Iaki covers our 2022 highlights and discusses the progress weve made on our 3x6 strategy. % Services View our suite of services including NHS We work closely with our network of hospitals, clinics, doctors, intermediaries and partners to enable access for our customers to world-class healthcare. This site contains a range of information about the College and psychiatry in Australia and New Zealand. ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ |" . Rather than updating the diagnostic items, then attempting to exclude them 55141. Get free advice from health experts on a wide range of conditions. International health insurance for individuals, families and businesses wanting the highest level of cover provided by Bupa, with rich benefits and direct access to premium services and medical providers. . ( This body seeks to close the gaps between best available evidence and current clinical practice, providing a wealth of information for healthcare workers. You will be able to treat our patients and we will reimbursed you for your services. )$h.FsGsyJA?x1M&p\{*bpCos)-0;OeYI{Ndrarh(d7j_8Q6":p> 9;}+v"f-:Rz roV@ h&xfd9rhA#tJiOlFyrlG#8&-n&ONC/AE"QO(TR V"y D_B(vU"_#_X^j.iK`BHtt)D>%-08+EOh%B'7{vy#C XE+2.O0E,o4~`'DLx=PsJs| .4A9$|xE)Ov@StGpr6HT4d+r,Jp$n ]{kGZf]s}7+*,g i!yx(l-Nil1sIu$s}V{39%jhd/z}Wezu+Xb2- >yi+:g_Kh7-0 66lq6qv;U&]lImV'7av -T v`bQYV^'9@[$&pHBtdC8^N{hr9J9d U. 6%p3@-vWmc@F-u`,d3bH wJ=TSh-0|#S!G"3b4 b&P/;O[&|J*''i MPtwe&%n(Lw@#5mBL(0xG?:YL1!/vc~^c9a{m0X6DL3cHkwVz^ Cz|4OUH:, OOpMhZ/m\+-%J#fMik}:FQSmyG.` 1t>4HpKf7gVr`~))7ZY[-]XPQ.RgY[*i-L!1-*@`qbVR^wjLa#fIa=]5L6,jxjA1gl5DL+} mupi}?[gyau:t{EINip{"&8kg:/)L>HYxy[OlOV! ",#(7),01444'9=82. The London Clinic116 Harley StreetLondonW1G 7JL. Residents rooms will be For more information providers must refer to Notes for Allied Health Providers - Section One: General and Section 2(k). endobj He is a BUPA Partner and his prices for surgical and outpatient procedures adhere to the BUPA schedule of fees. As further MBS changes are announced, the AGC fee schedules may be amended to reflect the changes. /Width 1148 Health monitoring, vital sign measurement, digital consultation during daytimes and digital prevention programmes. ( ($qI v)QE2BQ@qx'Wi5k{*S;W4?% S}z/V =T}9',uHs2&I^^KQ85+E(zGo+K D6xW@lzu-l(|OMi/a7to3}CE|O 7NOeZ'O&*6-s9*}G67NG5w4n`qIFht+98Z}ikv BUPA Known Gap BUPA No Gap Place a tick against the appropriate schedule based on your agreement with BUPA and click Install 1 Item. ( Fee Schedule - Health Practitioners - Aviva With the pandemic changing the way we live and work, Alaana Woods, Bupas Commercial Sales Director, talks about flexible working. With BluaU Smart, Sanitas clients can access an insurance product tailored to their needs at every stage of their lives. Known Gap specialists accept the Scheme benefit in full but can elect to charge the patient a maximum out of pocket cost of no more than $500 for each episode of treatment. If a specialist does choose to participate in the Scheme, they must register each of their unique practice location with Bupa as either a "No Gap" specialist or, a "Known Gap" specialist. Get 10% off for online enrollment, Check out details Now! Phone numbers; Receive urgent help. Was this information helpful? qxs=(HQE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE$ GROtOp)QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE ]c\RbKSTQ C''Q6.6QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ |" Following treatment of a Bupa member, I will communicate with GPs in line with Department of Health, GMC and appropriate professional bodies guidelines. Once the Registration form has been completed by Bupa, a confirmation email will be sent to the practice advising of your new Bupa Practice Identification (ID) number. 5 0 obj ( clearly explain to the Bupa Customer that you will not apply the Scheme on this occasion; obtain Informed Financial Consent (IFC) from the eligible Bupa customer at the first consultation leading to the episode of care; and. The Schedule contains the codes for procedures where our policies provide benefit. It is there for them at every life stage, adapting to their current stage of life. As further MBS changes are announced, the AGC fee schedules may be amended to reflect the changes. Areas of interest. As a responsible commissioner of healthcare, our focus is on the interests of our customers, we are committed to help give them access to high quality, affordable healthcare. /Width 1148 Read more about what were doing to help the health of cities and people. These providers accept the higher Scheme rate as full payment for the patient episode of care. Tailored healthcare programmes to help different companies promote health education and disease prevention in the workplace to maintain a healthy workforce. All our recognised consultants can charge for consultations and procedures that are published in. On 1 December 2021, Bupa introduced a new "Known Gap" rate for specialists who register and participate in the "Known Gap" Scheme. For example, consultant psychiatrists deliver the majority of care during out-patient consultations whereas a surgeon will deliver care in a range of settings, so we offer slightly different fees based on these differences. Important information. To understand our approach to fees, please read the introduction to the Schedule and our Billing Principles. For example, a family may elect reimbursement for their children as well as pet care. endobj NSW SIRA/WorkCover update & BUPA schedule changes - Powered by Kayako If so, you can find out more here. /Subtype /Image Deadline In Spanish, nib MediGap aims to eliminate the out of pocket costs nib members pay for inpatient medical and surgical fees. /Filter /DCTDecode 3 January 2023. Check out details and request a quote now! ( Fees for legal aid evidence from victims of domestic violence Guidance for doctors who are being requested to provide medical evidence for patients who are victims of domestic violence and seeking legal aid. BUPA 1 December 2021 changes. Whilst we recommend the use of ECLIPSE, we realise on occasion there will be instances where Scheme specialists may need to submit a claim manually. ADF Health Services (BUPA) - formerly Garrison Health ( The mini-cover add-ons designed for BluaU Smart offer clients a variety of categories: financial support for unforeseen health issues or unemployment protection; other family-oriented cover such as reimbursement for children for educational speech therapy and orthopaedic devices; emotional wellbeing for mental health; pet care; household care including a series of household services: nursing, delivery of medicines from the pharmacy and laboratory tests, as well as assistance cover for foreign travel. D\@\P(H.WW2U^4(Pg'Noa1oOo^`$|6 cR_8%ibxP,D)),%KU%]7ckZoR?2^W|VY(h|h["-P})Z~W ^ q23#"oIz5]t6;%!]@HybHu @|URyq8i\,bqySG\^-=vdr/av$^ dMU Ey{TU"MY`(M8`seU)`znhe8 32(+.hwzUFjxw3ZW_nC(5Q /TD`p=9+^ eK 8[T%Ew&:NtZaW}7e%rWpA6Vw'G= ttyN(`#,:@fa%}-)I]cdejyhk`ETFH Specialists have the option to register with Bupa as either a No Gap or Known Gap specialist: Only claims submitted directly to Bupa under the Terms by the specialist are eligible for the Scheme rates. To ensure you are always viewing the latest version of the Schedule SCHEDULE OF FEES EFFECTIVE 1 JULY 2020 DEFINITIONS Treatment Cycle Treatment cycle referral arrangements were introduced on 1 October 2019. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 15 0 R] /MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> ( stream A variety of expert healthcare support by a team of qualified nurses, health management professionals and doctors to give our members peace of mind. The Australian Council for Safety and Quality in Healthcare. 6 0 obj Australian Institute of Health and Welfare. It also introduced a higher "No Gap" rate (higher than the new "Known Gap" rate) for specialists who register and participate in our "No Gap" Scheme. Failure to provide the required information or should the Batch Header and/or invoices not be legible, will mean your claim is rejected, requiring it to be re-submitted. If Bupa Carepro medical insurance plan offers full coverage for hospital and surgical benefits, hospital cash & clinical insurance. Schedule of fees published in 2021 and 2022 Fee schedules for GPs and specialists Find item numbers, Medicare payment amounts and vendor files. Operations/procedures are classified using CCSD (Coding, Classification and Schedule Development) codes. Bupa may also advise customers to ask you about the Scheme and any Known Gaps when they contact you. Added Comcare and WA Government Medical Services Schedule to list of Fee Schedules; BUPA allows known gaps automatically on Estimate of Fees screen now; v1.51 21/03/2014. Rallycross Drivers 2020, I would also like to receive marketing communications from Bupa as described in paragraph 2 of the Personal Data Information Collection Statement. Please refer to the Department of Human Services website for further information on the MBS - www.mbsonline.gov.au. Thats why we start with assessing the health of your eyes, what you can see and what we can do to keep you looking great. Schedule of Procedures and Fees Our Schedule of Procedures and Fees We base our Schedule of Procedures and Fees on work undertaken by the Clinical Coding & Schedule Development (CCSD) Group. 1 0 obj For claims submitted under the Known Gap, where an online Eligibility check is not received, benefits will be limited to 100% of the MBS Schedule Fee. No need to pursue unpaid accounts from Bupa members. ( 3c4e9bd4-675a-4752-86cc-40f48f357f1b-1690, Health insurance specifically for business, To discuss your healthcare needs call us on, Personal <>/Metadata 389 0 R/ViewerPreferences 390 0 R>> For medical services provided by a specialist doctor while you are admitted as an inpatient in hospital, Medicare pays 75% of the scheduled fee and your health insurer pays the remaining 25%. % Diagnostics are normally provided and billed for by hospitals and facilities, however consultants can provide these services as well. This mini-cover includes reimbursement for children, financial assistance in the case of unforeseen events, emotional wellbeing, pet care, home services, travel assistance, etc. With clinics across New Zealand, our goal is to help you and your family find high quality, great value dental care thats right for you. In addition, BluaU Smart clients can choose from ten micro-cover plans, which can be updated over the course of the clients life. Bupas Healthy Cities initiative started in Spain and is now being extended globally. Thus, clients can monitor their own progress and contact the medical team via video consultation whenever they wish. } !1AQa"q2#BR$3br 4 0 obj [ME]-'V4AQ@U-Zt6[C }q@h j{K|G`+^VvCAbNV4Ep^*lklxR8j_@7K?W(vWQ!f1]MXQE!W'mZ L{Ag9x;h`gYEWG9v@IX(((+vi68PYp9WQM5'@4@QE U=^i-m$L} b+Tc+# M+5QHaEPEPEPEPEp]kHl:ro0r;iq\C <> Self-insured employers in South Australia, Return to Work Coordinator certification training, Information for people who work past retirement age, ReCONNECT: available at any stage during your claim, Re-employment incentive scheme for employers (RISE), Electronic Work Capacity Certificate (eWCC), Work Injury Guide for Medical Practitioners, Approved return to work services providers, Early intervention and prevention of chronic pain, Download certificate of registration (currency), View electronic work capacity certificates, Check if your patient has a current claim, Tools and resources for a healthy workplace, Tools and resources for a mentally healthy workplace, ReCONNECT Supporting workers throughout any stage of their claim journey, New resource - Work Injury Guide for Medical Practitioners, Financial incentives for early claim lodgement, Impairment Assessment Guidelines Second Edition consultation, COVID-19 Notice for Whole Person Impairment Assessors, Private hospital fee calculator (XLS, 355 KB), Public hospital fee calculator (XLS, 589 KB), Medical fee schedule 1A - clinical services - data file, Exercise physiology fee schedule and policy, Occupational therapy fee schedule and policy, Medical fee schedule 1A - clinical services (last updated 1 March 2023), Independent medical examiners (Agent referred) fee schedule. << Our retirement villages offer independent living in small, friendly and safe communities. ( When the Bupa Medical Gap Scheme is used, Bupa will pay a higher benefit directly to the provider, than would normally be covered. <> Loss Given Default Adalah, Headquartered in the UK, we were established in 1947. \+GhfV}ibT'*Y0Ht,R>J#6Z#S]mSuqg{+o__/G In carrying out our review, well also seek feedback and comments from our recognised consultants, specialist professional organisations, and other providers in the speciality were looking at. Our information hub has the latest updates and guidance to help support you. 13 0 obj ( x]on~HWK( Our customer app, BluaU, is an AI driven digital app which transforms health management. By clicking on Submit your requestbelow you give consent for the personal information submitted on this page to be used as described in paragraph 1 of Personal Data Information Collection Statement. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz For previous years fee schedules, please visit the South Australian Government Gazette. } !1AQa"q2#BR$3br Use Bupa's secure provider website for quick and easy access to your weekly medical benefit Statements. /Type /XObject <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> /Length 1228 By simply opening the MySanitas App and using the mobile camera, the client can measure data such as heart and respiratory rate or blood pressure, data that they can share with their doctor and that their doctor can assess to determine their current health. For example, we looked at prostate biopsy codes after several consultants mentioned to us that the two existing codes didnt reflect new developments in diagnostics. Premium international private health insurance | Bupa Global About me. Please note that insurance policy details vary between Likewise, private health funds also tend release fee schedule updates, sometimes multiple times throughout the year. From causes and symptoms to diagnosis and treatment. 0808 271 8573 ^, Members w !1AQaq"2B #3Rbr If you are submitting claims under the Terms of the Scheme via ECLIPSE, please submit the claims using claim type AG for Agreement Claims. Find out more. Bupa New Zealand is one of the leading residential aged care providers. /BitsPerComponent 8 Watch this video where Iaki Ereo, our Group CEO, looks back on our work in 2022. ( Fee notes for GPs and specialists. SCHEDULE OF FEES EFFECTIVE 1 FEBRUARY 2021 financial authorisation, please contact DVA using the contact details at the end of the Fee Schedule. Current GapCover Schedule of Benefits. Claims submitted via ECLIPSE are automatically processed through both Medicare and Bupa contributing to a speedier payment cycle. ( ( Your feedback helps us to improve this website. k:!)nBiHIr: P: 13 18 55, Typing in the search field displays search suggestions below the search field. Q 5ogQE Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.0.1 and IR.1.2 Exercise stress echocardiography focused study, other than a service associated with a service to which: (a) There will be no out of pocket fee. %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz To ensure benefits are paid into the correct nominated bank account, you must ensure you include your Bupa Practice Identification (ID) number with the claim submission. Each member of the family can update their mini-cover when they renew, adjusting their insurance cover to their current life stage. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? 11.4 This schedule of matters reserved for Board decisions. If you wish to query our Billing Principles, you can contact us here. In the context of a pandemic and travel restrictions, both patients and professionals have drawn on the advantages of digitization for health management. 020 8099 8516. The most premium range of plans from Bupa . ]FR_H>sN*q>?TBVw@K`(^{P6AH zO9S=o?gT. ( Je Ne Sais Qu'une Seule Chose. ( CASPA applications must be VERIFIED byAugust 1, 2023 for the class entering in June of 2024. Bupa Dental Care Find a dental practice Treatments View our range of dental treatments. Are you a brave start-up open to collaborate to find solutions to improve the health of people and planet? For the latest updates in issues of safety and quality of healthcare provision in Australia. The Bupa Batch Header must be signed and legible. Schedule of fees published in 2020 and 2021. In this case, benefits will be paid up to 100% of the MBS Schedule Fee. . If you have Bupa health insurance, you can come to us before seeing a GP Get treatment ec042371-e3d9-4a8f-8f3b-78050571bb1f-8E48 <> stream Examples of these services are: Were unable to accept invoices for these services from consultants without the specific agreement. The Cromwell Hospital is an internationally renowned private hospital, based in central London, offering treatment for both adults and children. <> 47a1bab1-79e5-4c9e-a932-81eca50f6b9a-8B26. Aws Security Groups Pricing, endobj Whilst Bupa encourages specialists to use the Scheme for all customers, Bupa appreciates there may be occasions where a specialist chooses not to accept the Scheme rates. Leaving your company health insurance scheme? Consultants who aren't recognised by us are not eligible for reimbursement by us for treating our customers, Consultants and anaesthetists need to charge us in line with the billing rules found in the essential notes of, the level of skill and training required (and, if appropriate, the grade of NHS doctor) to safely perform the procedure, the level of clinical risk and recognised perioperative mortality and morbidity, other complicating factors (for example, complex intra-operative diagnostics or specialist post-operative care). Class 2 Security Licence Qld, For new small business customers who purchase directly from Bupa only. 10 0 obj I have over a decade of experience working in professional services, where my team and I have delivered design-based business outcomes to many Fortune 500 companies. Information on how our clinical teams work to ensure our members receive safe, effective care that follows best practice and offers them good value. If you have Bupa health insurance, you can come to us before seeing a GP . We base our Schedule of Procedures and Fees on work undertaken by the Clinical Coding & Schedule Development (CCSD) Group. This bulletin aims to keep you up-to-date with any changes to procedure codes published in the Bupa Schedule of Procedures. endobj This only applies to claims submitted manually to Bupa. Its being rolled out globally. PDF HCF MEDICOVER NO AND KNOWN GAP RATES - HCF Insurance For a procedure performed at The Victorian Gut Centre The fees for the day procedure centre, the doctor performing your procedure, the anaesthetist and pathology are payable after your procedure. Medicare Benefits Schedule (MBS) fee for associated medical costs, including any inpatient . School of Physician Assistant Studies Admissions - University of Florida All BluaU Smart clients are provided with digital access to the following services: video consultation with specialists and 24-hour Accident & Emergency consultation; digital health programmes; health monitoring through wearables under a variety of profiles such as pregnancy, arrhythmias, blood pressure, weight control and COVID-19; measurement of vital signs through smartphone facial imaging within seconds. . stream Keeping you up to date with the latest health and wellbeing information and trends. Royal College of Pathologists of Australasia. Lucy Ostlere holds BUPA premier consultant status and adheres to BUPAs schedule of fees. This Contract is between you, the person named in your Application Form ( you ), and Bupa Insurance Services Limited ( we , our and us ). List of private hospitals and day surgeries, PHI circulars | Australian Government Department of Health, Bupa will pay a higher benefit directly to the specialist than would normally be payable under the Medicare Benefits Schedule ("MBS"); and. endobj ( Call us for more information on 0345 266 8974 ^ to find out more. Where will you be living when you start your plan? Our customers pay for doctors fees through their policies, so we work to make sure they pay a fair price. ( A weekly Statement detailing all payments will be available via our secure website. Personal Data Information Collection Statement. 5 0 obj JFIF ` ` C ( The MembersWorld app is a quick and easy way to manage your healthcare plan 24/7, and access the services you need, when you need them. Medicare Australia often change fees after 1 July of each year. w !1AQaq"2B #3Rbr ( 7 0 obj ( We have a range of services and facilities across Spain. qxs=(HQE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE$ GROtOp)QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE Claims submitted through ECLIPSE will receive an Electronic Remittance (ERA) Statement via ECLIPSE. Overview. Bupa is one of the first large healthcare organisations to join the Science Based Targets initiative. Schedule of Procedures and Fees - AXA Health We find that many patients decide to choose a different specialist if they think this is likely. We provide a range of medical, hearing and medical visa services. %PDF-1.7 Based in Leeds, our Customer Care Team provides free advice and support whenever you need it. For programs, services and health payment information and forms. Premium health plans for cover at home and Our Schedule of Procedures and Fees. Many members have out-patient benefit limits, often around 1,000 per year, and when these are reached they must pay for all consultation fees above their benefit limits themselves. ( 0330 134 5502 ^, If you have Bupa health insurance, you can come to us before seeing a GP, 38ba55cd-d339-404e-8729-3d287d8caf38-8E48, View our suite of services including NHS and private care, View all the latest news from Bupa Dental Care, Find out how we can help you in an emergency, Tips and advice on supporting your childs dental health, Find answers to common dental insurance questions, Refer your patient to us for specific treatments, 4c79316a-3c64-47a1-939d-b0a51616125d-73E2, Call our Customer Care Team on This is a Known Gap arrangement. This empowers the patient and helps them commit to managing their own health, since they can access the mini-cover of their choice based on their personal needs. They will be promoted as a "No Gap" specialist, They agree to accept the "No Gap" benefit as full payment for the episode of care, meaning that the customer will pay $0 to the specialist for that treatment, They can opt out of the Scheme on a case-by-case basis, They will be promoted as a "Known Gap" specialist, They will receive the "Known Gap" benefit, They can charge the patient a gap of up to $500 per episode of care, Provide a No Gap option for emergency or unplanned admissions (Known Gap will not be available for these types of admissions); and.
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