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Anaesthetics Network

This first of its kind network is designed to provide anaesthetists with more certainty in billing through a single, uniformed unit value, and the ability to charge a known gap for those more complex procedures. Importantly, it will give your patients greater certainty when it comes to claiming and out-of-pocket expenses.

This network is currently available to eligible nib members via nib's GapSure Anaesthetics network.

nib GapSure Anaesthetics network

Benefits of joining the network.

  • Single RVG unit value

The nib GapSure Anaesthetics network applies a single uniformed value of $41 per unit on all MBS Item numbers with ASA RVG unitisation.

  • Known gap

A discretionary $500 known gap is permissible. The application of this known gap is only applicable to procedures with 5 and above RVG base units.

To find out more about how your personal billing profile would look under the new network, complete the expression of interest form.

  • Certainty

The nib GapSure Anaesthetics network is not discretionary. Once registered, the application of the network schedule is applicable to all your nib patients, rather than the current case by case opt-in opt-out nature of current schemes.

  • Consistency

The network covers all locations you work from.

Application process

  1. Complete the expression of interest form with your AHPRA ID, Medicare provider numbers, and contact information so we can ensure we show you your individual estimated earnings under the new schedule.
  2. You will receive an email within 3 business days that contains your estimated earnings.
  3. Once you have viewed your estimated earnings you can decide whether or not to proceed with your registration.
  4. If you wish to proceed, you will receive an online electronic agreement to review and sign.
  5. You will receive an email confirmation once participating funds have registered your payment details in their claims system.
  6. You can commence claiming under the nib GapSure Anaesthetics network schedule.
  7. You can review the terms and conditions HERE.

Frequently Asked Questions

nib partnered with Honeysuckle Health to launch its first of a kind anaesthetics network designed to provide members with greater certainty when it comes to claiming and out-of-pocket expenses. In addition, it helps to provide anaesthetists with greater flexibility when billing members, while meeting earning expectations.

The network has initially been developed for anaesthetists because they are commonly involved in surgical procedures across most disciplines. In addition, out of pocket expenses for anaesthetics has been one of the biggest pain points experienced by nib members.

In addition, Honeysuckle Health took onboard feedback from anaesthetists that the nib MediGap scheme did not best reflect their billing structure.

By providing anaesthetists with the option to choose between a no gap or known gap fee, we believe it will help to reduce common pain points for specialists when charging members for more complex procedures.

A no gap fee means nib members will not be charged any out-of-pocket costs for medical treatment. This only applies to less complex procedures.

A known gap fee means nib members can only be charged a maximum out-of-pocket expense of $500 for medical treatment. Charging a known gap fee is at the discretion of the anaesthetist, however, will only be applied for more complex procedures (5 and above base units).

The main difference between the two networks is that unlike nib’s MediGap scheme once an anaesthetist decides to “opt-in” to the GapSure Anaesthetics network they cannot opt-out on a case-by-case basis.

This provides greater certainty around costs for members when going to hospital as they will know that once an anaesthetist opts into the network, they can only be offered a known gap or no gap option.

It also helps to avoid sometimes difficult conversations for members and their surgeon or anaesthetist around fees providing a better member experience.

In addition, it's nib’s only program that provides the option for specialists to charge a known gap fee.

Yes. On behalf of nib, Honeysuckle Health has been engaging with anaesthetists, the Australian Medical Association (AMA) and billing agents to gain their important feedback regarding the new network.

We have an agreed understanding that:

  • High volume, low complexity procedures with already low to no out-of-pocket (OOP) shouldn’t be over invested in or expose nib members to increased OOP.
  • Procedure weighting for some high complexity procedures isn’t aligned with reality in its current state.

We have seen positive responses to:

  • Meeting provider earning expectations, which includes patient OOP.
  • A model that recognises the time and complexity of the procedure.

We have adapted our thinking along the way:

  • Incorporating a known gap component on high complexity procedures.
  • Applying consistent RVG pricing.

Anaesthetists across Australia are invited to join nib's GapSure Anaesthetics network. There are no restrictions on joining the network, including location or care delivery. As always, your clinical autonomy will be preserved.

To find out how your personal billing profile would look under the new network or to sign up to the network, complete our expression of interest form and follow the steps.

For any further questions, please contact Honeysuckle Health at providers@honeysucklehealth.com.au or call 1800 411 633 (Mon-Fri: 9:00 am – 5:00 pm AEST/AEDT).

You can read the terms and conditions here

The expression of interest process will include some identity verification questions to ensure we are protecting your financially sensitive billing profile. Once complete we will provide an overview of:

  • Estimated earnings from the previous 12 months based on nib claims data, including any out-of-pockets experienced by nib members.
  • A comparison of what your earnings would have been with the new network schedule of fees applied, including nib member known gap out-of-pocket expenses (for procedures with 5 or more base units).
  • The percentage variation between the above two scenarios.

Yes. A known gap fee means nib members can only be charged a maximum out-of-pocket expense of $500 for medical treatment. Charging a known gap fee is at the discretion of the anaesthetist, however, will only be applied for more complex procedures (5 or more RVG base units).

Following consultation with anaesthetists and billing agents, we understood that procedure weighting for high complexity procedures isn’t always aligned with reality.

Feedback received also detailed that high volume, low complexity procedures with already low to no out-of-pocket costs shouldn’t need further investment beyond the increased RVG unit value.

To help address these pain points, we introduced both the known gap and no gap option in our new network. This provides anaesthetists with the option to either charge no gap or a known gap up to a maximum of $500 for more complex procedures, with 5 or more RVG base units.

Importantly, it will reduce uncertainty around out-of-pocket costs and help improve the overall member experience.

Yes. Where the MBS item number has an ASA allocated unit, nib will pay $41 per unit. This $41 is applicable across all RVG categories.

No. Once you’ve registered for nib’s GapSure Anaesthetics network, you cannot opt-out and the application of billing to nib members must be consistent.

Alternatively, nib’s MediGap scheme is still available to anaesthetists and medical specialists which provides specialists with the option to charge a no gap fee to nib members on a case-by-case basis.

No. You do not have to join the new GapSure Anaesthetics network. nib MediGap scheme is still available to anaesthetists and medical specialists which provides specialists with the option to charge a no gap fee to nib members on a case-by-case basis.

Alternatively, you can continue to charge your existing private fees if you do not wish to participate in nib MediGap or the new network.

Like all health funds, nib is required by legislation to pay 25% of the MBS on a procedure, or in addition to the 25%, an amount up to the schedule fee under MediGap when you elect to use the scheme

To join, please complete the expression of interest form. The expression of interest form allows us to verify who you are before sharing any financially sensitive data. Once complete, follow the steps within the form to apply.

We’re here to help

If you have any questions, please do not hesitate to contact the team at Honeysuckle Health, who manages the GapSure Anaesthetics network on behalf of nib.

Phone: 1800 411 633 (Mon - Fri: 9am – 5pm AEST/AEDT) 
Email: providers@honeysucklehealth.com.au

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