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Private Hospital Benefits at Healthscope Group Hospitals

18 May, 2020
Private Hospital Benefits at Healthscope Group Hospitals

 

To our valued members,

CBHS is committed to providing you with private hospital cover options which offer affordable and high-quality healthcare. To meet this commitment, CBHS has agreements with over 500 private hospitals across Australia including the Healthscope Group of Hospitals (Healthscope).

Unfortunately, the Australian Health Services Alliance (AHSA) which negotiates hospital agreements on behalf of CBHS and 27 other not-for-profit or member-owned health funds has been unable to reach a resolution on a new agreement with Healthscope.

Healthscope’s proposed terms meant charges for hospital admissions would be much higher than we consider acceptable and in the best interests of our members. Agreeing to these charges would also put significant pressure on keeping your premiums as low as possible. 

As we did not agree to these terms, Healthscope made the decision to terminate our agreement effective from 17 June 2020.

What this means for you

From 17 June 2020, Healthscope hospitals will no longer be considered CBHS agreement hospitals. This means that if we are unable to resolve this issue and you attend a Healthscope hospital for a procedure or treatment, you are likely to experience out-of-pocket costs. See below for a full list of Healthscope hospitals.

As with all hospital admissions, we recommend you contact the hospital to confirm what your out-of-pocket costs will be. This is known as informed financial consent. If you know what procedure or treatment you are having, please call our Member Care team who can advise how much CBHS will cover before you go into a Healthscope hospital. You can also choose to be treated at an agreement hospital to avoid significant out-of-pocket costs.

What if I have surgery or a procedure planned?

There is no change to CBHS members whose hospital admissions are:

  • before 17 June 2020.
  • pre-booked before 17 June 2020 for admission before 17 December 2020 (excluding pregnancy and birth services).
  • pre-booked before 17 June 2020 for admission before 17 March 2021 (pregnancy and birth services).
  • part of an ongoing course of treatment, such as, chemotherapy, dialysis, psychiatric treatment or rehabilitation until completion of the course of treatment or up to and including 17 December 2020.
  • an emergency admission up to and including 17 September 2020.

Next steps

Both the AHSA and Healthscope will be participating in a mediation with the Private Health Insurance Ombudsman this week so we will update you if we are able to resolve the matter successfully.

If you would like details of options to reduce your out-of-pocket costs or if you have any questions, please see our FAQs below or contact our Member Care team Monday to Friday 7am – 7pm AEST on 1300 654 123 or email help@cbhs.com.au

As a not-for-profit member-owned fund, the health and wellbeing of our members always comes first, and that includes ensuring that hospitals and providers offer our members high quality and affordable healthcare. 


Yours sincerely,

Andrew Smith
Group Chief Executive Officer and Executive Director

 

Healthscope Hospitals

  • Ashford Community Hospital
  • Bellbird Private Hospital
  • Brisbane Private Hospital
  • Campbelltown Private Hospital
  • Darwin Private Hospital
  • Dorset Rehabilitation Centre
  • Flinders Private Hospital
  • Frankston Private Hospital
  • Gold Coast Private Hospital
  • Griffith Rehabilitation Hospital
  • Holmesglen Private Hospital
  • Hunter Valley Private Hospital
  • John Fawkner - Moreland Private Hospital
  • Knox Private Hospital
  • La Trobe Private Hospital
  • Lady Davidson Private Hospital
  • Melbourne Private Hospital
  • Memorial Hospital
  • Mount Private Hospital (Perth)
  • National Capital Private Hospital
  • Nepean Private Hospital
  • Newcastle Private Hospital
  • North Eastern Rehabilitation Centre
  • Northern Beaches Hospital
  • Northpark Private Hospital
  • Norwest Private Hospital
  • Pacific Private Day Hospital
  • Parkwynd Private Hospital
  • Peninsula Private Hospital (QLD)
  • Pine Rivers Private Hospital
  • Prince of Wales Private Hospital
  • Ringwood Private Hospital
  • St Helens and Hobart Private Hospital
  • Sunnybank Private Hospital
  • Sydney Southwest Private Hospital
  • The Geelong Clinic
  • The Hills Private Hospital
  • The Melbourne Clinic
  • The Sydney Clinic
  • The Victoria Clinic
  • Tweed Day Surgery
  • Victorian Rehabilitation Centre – Eastern

 

FAQS

Why is the contract with Healthscope being terminated?

Regrettably, we have been unable to reach a mutually acceptable resolution on the terms and conditions of a new agreement with Healthscope. We have had contracts in place with Healthscope for over 25 years and are very disappointed Healthscope has elected to terminate our agreement.

The Australian Health Service Alliance (AHSA) represents 28 small to medium sized health funds and negotiates with Healthscope on our behalf. We note that both the AHSA and Healthscope have agreed to participate in mediation with the Private Health Insurance Ombudsman.

In the meantime, we are doing everything we can to resolve this issue for the benefit of our members and will update you as soon as the situation changes.

Which hospitals are part of Healthscope?

  • Ashford Community Hospital
  • Bellbird Private Hospital
  • Brisbane Private Hospital
  • Campbelltown Private Hospital
  • Darwin Private Hospital
  • Dorset Rehabilitation Centre
  • Flinders Private Hospital
  • Frankston Private Hospital
  • Gold Coast Private Hospital
  • Griffith Rehabilitation Hospital
  • Holmesglen Private Hospital
  • Hunter Valley Private Hospital
  • John Fawkner - Moreland Private Hospital
  • Knox Private Hospital
  • La Trobe Private Hospital
  • Lady Davidson Private Hospital
  • Melbourne Private Hospital
  • Memorial Hospital
  • Mount Private Hospital (Perth)
  • National Capital Private Hospital
  • Nepean Private Hospital
  • Newcastle Private Hospital
  • North Eastern Rehabilitation Centre
  • Northern Beaches Hospital
  • Northpark Private Hospital
  • Norwest Private Hospital
  • Pacific Private Day Hospital
  • Parkwynd Private Hospital
  • Peninsula Private Hospital (QLD)
  • Pine Rivers Private Hospital
  • Prince of Wales Private Hospital
  • Ringwood Private Hospital
  • St Helens and Hobart Private Hospital
  • Sunnybank Private Hospital
  • Sydney Southwest Private Hospital
  • The Geelong Clinic
  • The Hills Private Hospital
  • The Melbourne Clinic
  • The Sydney Clinic
  • The Victoria Clinic
  • Tweed Day Surgery
  • Victorian Rehabilitation Centre – Eastern

When does the termination take effect?

The existing Healthscope agreement ends at midnight on 17 June 2020.

I’m due to go to hospital and my doctor practices at Healthscope

Changes only affect future bookings. There’s no change for CBHS members if:

  • Your treatment commenced before 17 June 2020.
  • You have pre-booked a procedure before 17 June 2020 for admission before 17 December 2020.
  • You are pregnant and are pre-booked before 17 June 2020 for delivery; admission before 17 March 2021.
  • You are undergoing an ongoing course of treatment, such as, chemotherapy, dialysis, psychiatric treatment or rehabilitation until completion of your course of treatment or up until 17 December 2020. 
  • You require an emergency admission up until 17 September 2020.

Please contact us and let us know what treatment or procedure you are booked in for and we can confirm what cover you have and whether any out-of-pocket costs apply.

For in-patient procedures which aren’t already pre-booked, and which take place after 17 June 2020, you may want to speak with your doctor to see if they have admitting rights at another agreement hospital.

If you continue with procedures at a Healthscope hospital, please contact the hospital and ask for written confirmation of your out-of-pocket costs and make sure you are aware of and agree to the costs involved. This is called informed financial consent.

Healthscope is my nearest hospital

Whilst you can still claim towards a Healthscope hospital bill, you may have higher out of pockets costs than you would have at an agreement hospital. We realise that you may face further travel to reach an agreement hospital, and we appreciate this is not an ideal situation. We would like to stress that it was Healthscope that decided to terminate the agreement, while negotiations were still underway.

If you do decide to go to a Healthscope hospital, please ensure you contact the hospital and ask for written confirmation of your out-of-pocket costs and make sure you are aware of and agree to the costs involved. This is called informed financial consent.

Where else can I go?

We have agreements with over 500 other hospitals across Australia. Please call us on 1300 654 123 if you’d like details of your nearest alternative hospital where we have an agreement in place.

What if my doctor won’t use another hospital?

Most doctors have admitting rights at other hospitals. However, if your doctor cannot perform your treatment at another hospital, it’s important that you obtain Informed Financial Consent before you are admitted so you are aware of any out of pocket expenses.

How much more will it cost me?

Healthscope hasn’t yet told us what rates they will be charging, so we can’t give you an estimate of your out-of-pocket costs. We recommend you contact the hospital and ask for Informed Financial Consent advising your out of pocket expenses before your admission to hospital.

Will my doctor’s fees increase?

No, this only affects hospital benefits. Medical gap benefits will be paid as normal.

Are other health funds affected?

Agreements between health funds and hospitals are confidential. However, we are currently aware of several other funds that are affected by this termination.

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