Medicare and Payment Information

[Payment Options] [HICAPS]  [Netbanking] [ATAPS] [Medicare Items] [Medicare Safety Net] [GP Mental Health Plan] [Enhanced Primary Care Plan]
[Other Health Fund Information]

Payment Options

The Gymea Lily Psychotherapy Centre accepts cash, cheque, as well as Eftpos, Visa and Mastercard. Clients are free to pay directly before or after each session, or an invoice can be sent out, if this is what they prefer.

Netbanking has also become a popular option for many of our clients. For more information, see below.

HICAPS

If you have private health insurance that covers psychological treatment, we can offer you instant rebates after your session, without having to wait in lines. Click here for more HICAPS information.

Netbanking

More and more clients are wanting to pay us electronically and we have agreed upon the following procedure to hopefully work well for all parties involved.

Should you have an appointment booked with your therapist on a regular basis it is important that the money is actually credited to the Gymea Lily account the working day before your appointment.

We suggest that you e-mail us at mail@gymealily.org with a copy of your transaction record to show that the payment has been made. We also advise just in case electronic equipment breaks down to bring with you a printed copy of the transaction record so that your therapist can issue you a receipt for the session and the money received.

The account number of the Gymea Lily Psychotherapy Centre is:

Bank: CommonwealthBank, Engadine
Account name: Gymea Lily Psychotherapy Centre
BSB number: 062 164
Account number: 1034 8694

Access to Allied Psychological Services (ATAPS)

Any person with a mild to moderate mental disorder (as diagnosed by a GP or psychiatrist) such as anxiety and depression, and who are identified as;

-            low income earners,

-            youth,

-            Indigenous,

-            from a culturally and linguistically diverse background, 

-            women who are in the perinatal period and their families

For further information please speak to your GP or see http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-boimhc-ataps

Medicare Items

The Medicare scheme allows all Australians to have access to effective psychological treatments from experienced health professionals. Below are some further details.

Who do I have to be referred by?

Clients must be referred by a GP, psychiatrist or paediatrician in order to get a Medicare rebate.

Who is eligible for the Medicare rebate?

Any person who falls into one of the categories below:

GP Mental Health Care Plan

Any person with a mental disorder (excluding dementia, delirium, tobacco use disorder and mental retardation) who is being managed by a GP under a GP Mental Health Care Plan or a psychiatrist assessment and management plan. They may also be referred directly by a psychiatrist or paediatrician from an eligible Medicare Benefits Schedule (MBS) service.

It is recommended that you speak to your referrer to ensure that you are eligible for the rebate.

What sort of services will be provided to me?

Any Focused Psychological Strategy (FPS), including: psycho education, cognitive-behavioural therapy, relaxation strategies, skills training (e.g. problem-solving, anger management) and interpersonal therapy (especially for depression).

How many sessions am I allowed?

This will depend on which of the above programs you are referred through. Most clients are eligible for at least 6, and some clients could be eligible to receive rebates for up to 10 sessions per calendar year (under ATAPS). Your GP will prepare a referral for 6 initial sessions before reviewing your progress after feedback from the therapist; the GP may then approve further sessions if it is deemed appropriate (4 more).

You are also able to claim a rebate for up to 10 Group Therapy Sessions per calendar year in addition to your individual ones.

Exceptional Circumstances

·       Defined as a significant change in the patient’s clinical condition or care circumstances which make it appropriate and necessary to increase the maximum number of services. 

·       It is up to the referring practitioner to determine whether the patient meets the requirements. 

·        If so, a new referral should be provided and invoices from psychologists should state that exceptional circumstances apply.

What is my psychologist required to do?

Psychologists must provide a written report to the referring medical practitioner following every six services and on completion of the treatment.

It is also important to note that your psychologist must have a Health Insurance Commission (HIC) provider number.

Multiple consultations on same day

·       If there is more than one consultation with the same client on the same day by the same therapist, the time of each consultation should be stated on the account/receipt. 

·       The second consultation must not be a continuation of the initial consultation. 

·       There should be a reasonable lapse of time between each consultation.

Enhanced Primary Care Plan (EPC)

Services for Patients who have a Chronic Condition and Complex Care Needs

•  A chronic medical condition is one that has been present for at least 6 months.

•  A patient is considered to have complex care needs if they require ongoing care from a multi-disciplinary team consisting of their GP and at least 2 other health care providers.

•  Patients are considered to be under an EPC plan if during the last 2 years their GP has put in place a GP Management plan and Team Care Arrangements, or has reviewed their existing EPC plan.

•  Before a Medicare Rebate can be paid for a psychological service, the patient must have already claimed a rebate for the relevant EPC planning item/s, or the GP must have lodged a direct bill (bulk billing) claim with Medicare.

Autism or other Pervasive Developmental Disorders

• Must be referred by consultant psychiatrist or paediatrician

• Children must be under 13 years of age at time of assessment

• Report to be written at conclusion of assessment sessions

• 4 assessment services, 20 treatment services

• Report to be written at completion of each course of treatment (up to 10 treatment services)

 Medicare Safety Net (EMSN)

 Any person who holds a current Medicare Card and who has reached the ‘threshold’ in medically related expenses, as determined by Medicare will be eligible to reclaim a proportion of the expenses.

For further information please see

http://www.medicareaustralia.gov.au/files/1856-241210-how-does-the-medicare-safety-net-work.pdf

For further details regarding Medicare rebates please visit

http://www.medicareaustralia.gov.au/

Other Health Fund Information

Some private health funds offer rebates for psychological services; it is strongly recommended that you check this with your provider.