Access Gap Search with Healthshare

You can find specialists participating in Access Gap Cover with CBHS through Healthshare. Find more on Access Gap Cover here.

General Information

This search facility is designed to inform you of doctors who have previously participated or have indicated their intention to participate in Access Gap Cover, as well as those who have agreed to alternative no gap arrangements. Patients are advised to be guided by the referral process initiated by their own doctor. Where you have been referred to a doctor and that doctor's name does not appear on this search facility, you should check with your doctor as to whether they would use Access Gap Cover for you. 

The inclusion or exclusion of doctors within this search facility bears no relationship to their skill or experience. The autonomous relationship between you and your doctor will not be affected in any way. Australian Health Service Alliance does not recommend or endorse any doctors. 
Doctors' details contained in this search facility are supplied to assist you in making an informed decision when being referred to, or receiving treatment from a doctor as an in-patient in an approved hospital or day hospital facility. Information is current as at Tuesday, 17 October 2017.

What is Access Gap Cover?

Medical services provided to private hospital in-patients are charged separately from hospital accommodation/theatre fee charges. Medicare pays 75% of the Medicare Schedule Fee, while your health fund pays the remaining 25%.

Some doctors charge an amount above the Medicare Schedule Fee. These costs are referred to as ‘out-of-pocket expenses’. Now through the Access Gap Cover payment and billing scheme, out-of-pocket expenses can be reduced and, in some cases, wiped out entirely.

When a doctor treats a patient under the AGC scheme, they will generally process the claim on the member’s behalf. This includes taking care of the applicable Medicare benefits. As a member, you will be able to receive an estimate of the medical fees BEFORE receiving any treatment. You should always ask for a written estimate.

Read on - Access Gap Cover: What You Need To Know

Please Note

  • Doctors are free to choose whether they will participate in Access Gap Cover on a patient by patient basis. This decision remains solely with the doctor.
  • If the doctor appears on this search facility, it does not automatically guarantee that the doctor will participate in Access Gap Cover in relation to your treatment.
  • Some doctors have arrangements at particular hospitals. Ask your doctor whether they will use Access Gap Cover in the hospital of your choice.
  • Out-of-pocket expenses may vary from patient to patient. Please ask your doctor if you will have anything to pay.
  • Your doctor may have never used Access Gap Cover in the past but may be willing to use it for you, therefore they will not currently appear in this search facility. Ask your doctor if they will participate in Access Gap Cover in relation to your treatment.
  • Australian Health Service Alliance reserves the right to refuse Access Gap Cover benefits to providers who do not adhere to the Business Guidelines.
  • Some doctors who may not appear in this search facility may also offer services with no gap. Please check with your doctor.

Ask your doctor the following questions:

  • Would you treat me under my fund's Access Gap Cover arrangements?
  • Will I incur any personal out of pocket expenses for my treatment and if so, can you give me a written estimate of how much?
  • Will any assisting doctors also use Access Gap Cover?
  • Are you prepared to send the bill to my fund directly, so that they can claim my Medicare benefit on my behalf and send the payment back to you?

Do you need more information?

CBHS’s claims support service is just one of the areas in which we deliver exceptional member care. If you have any questions about online claiming or submitting claims, contact us directly on 1300 654 123 or email help@cbhs.com.au