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About Choice Network providers

The CBHS Choice Network is a group of over 3,000 dental and optical providers who are committed to providing exceptional treatment to CBHS members while reducing or removing the gap for Extras services on optical frames, lenses, contact lenses and preventative dental treatments. When searching below, enter ‘Dentist’ or ‘Optometrist’ in the ‘I am looking for a …' field below and select a location. Look for the search results with a ‘Choice Network’ logo, which will appear at the top of your search results.

You can also use the search function to find a wide variety of medical specialists and other health practitioners beyond dentists and optometrists, but please check your policy or call Member Care on 1300 654 123 to confirm if your policy provides any cover for these providers.

Disclaimer: Choice Network benefits are subject to overall and available limits at time of service.

 

About HICAPS

HICAPS is an acronym for Health Industry Claims and Payments System.

HICAPS is an electronic, real time; claim and payment system that offers members of participating health funds the convenience of automatic claims processing on the spot using their fund membership card for general services. This service is available to CBHS members 24/7.

Find a specialist who participates in Access Gap Cover

What is a ‘gap’?

A medical ‘gap’ is the difference between what a doctor charges for treatment, and what your health fund and Medicare pay for that treatment.

The Australian Government has a set range of fees for many medical treatments. These are listed on the Medicare Benefits Schedule (MBS). Medicare pays 75% of the MBS fee and your heath fund pays the remaining 25%.

However, doctors are free to set their own charges, and some charge above the MBS fee. When that happens, there’s a ‘gap’ and the patient is responsible for paying that gap.

(Medical services are charged separately from hospital accommodation/theatre fee charges.)

What is Access Gap Cover?

Access Gap Cover (AGC) is designed to reduce or eliminate the medical ‘gap’. The aim is for you to end up with less or, in some cases, no out-of-pocket medical expenses when you receive treatment at a private hospital as an inpatient.

If a doctor treats you under the AGC scheme, they will usually process the claim on your behalf, and take care of the applicable Medicare benefits. You can also ask for an estimate of the medical fees BEFORE receiving any treatment.

Always ask for a written estimate before you go into hospital for treatment.

General information

This search facility identifies doctors who are participating in or intend to participate in AGC, and those who agree to alternative no gap arrangements. Be guided by the referral process initiated by your own doctor. If you have been referred to a doctor, and their name doesn’t appear in the search, ask if they would be willing to use AGC for you.

The inclusion or exclusion of doctors in this search facility is not based on their skill or experience or lack of these.

The autonomous relationship between you and your doctor will not be affected in any way. CBHS does not recommend or endorse any doctors.

Doctors' details contained in this search facility are intended to help you make 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.

Please note

  • Doctors can choose whether they will participate in AGC 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 AGC in relation to your treatment.
  • Some doctors have arrangements at particular hospitals. Ask your doctor whether they will use AGC 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 not have used AGC before, so they won’t appear in this search facility. However, they may be willing to use it for you. Ask your doctor if they will participate in AGC in relation to your treatment.
  • 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:

  • Will you treat me under my fund's AGC arrangements?
  • Will there be any personal out-of-pocket expenses for my treatment and if so, can you give me a written estimate of how much?
  • 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?