photo Hyngry Head Beach, Urunga

Clarity

 
 

Shelley Jackson
Psychologist MAPS - Reiki Master/Teacher

Ballina - Northern NSW Australia
 
 
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PSYCHOLOGY SERVICES & MEDICARE - INFORMATION FOR CLIENTS
     
How can a psychologist help me?
What will it cost me?
What are Focused Psychological Strategies (FPS).
What if I have private health insurance?

Who is eligible for these benefits?

How do I pay?
What is meant by a mental health condition?
The Medicare Safety Net
For further information about this program

What is the Better Access to Mental Health Care Program?

Psychologists often receive referrals from doctors to assist their patients. However, Medicare benefits can now be paid for psychological services provided to you by a psychologist registered with Medicare Australia. The Australian Government has introduced a number of new programs in recent years, which enable Medicare benefits to be paid for psychological services: the MedicarePlus Chronic Disease Management initiative, which is part of the Enhanced Primary Care program (EPC); the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative, and the Non-Directive Pregnancy Support Counselling initiative.

On 1st November 2006, the Better Access to Psychiatrists, Psychologists, and General Practitioners through the Medicare Benefits Scheme initiative was introduced to enable people with diagnosed mental health conditions to access services from a range of mental health service providers, including psychologists. This initiative provides considerable assistance to people with mental health conditions and to their families, allowing them greater access to psychologists and providing more affordable mental healthcare. These Medicare services promote a team approach to mental health care, with general practitioners, psychiatrists and paediatricians encouraged to work with psychologists, and other allied mental health professionals as well as mental health nurses, to increase the availability of care.

Shelley Jackson is a registered provider with Medicare Australia

Shelley Jackson is a registered Psychologist and a registered provider with Medicare Australia. Under the Medicare Better Access to Mental Health Care initiative, as a registered psychologist, Shelley is able to provide consultations using Focused Psychological Strategies (FPS).

Focused Psychological Strategies (FPS) includes provision of psycho-education, cognitive-behavioural therapy, relaxation strategies, skills training (including problem-solving, anger management, social skills, communication skills, stress management, parent management), and interpersonal therapy.

How many sessions am I entitled to?

Eligible patients can generally receive:

Up to 12 individual services in a calendar year. Your referring doctor will review your progress after the first 6 sessions and decide if further treatment is needed, before approving a further 6 sessions.
Provisions also exist for the referring doctor to approve an additional 6 services, where exceptional circumstances arise.
Up to 12 group therapy services in a calendar year where such services are available and seen as appropriate by the psychologist.
Who is eligible for these benefits?
You must be referred to a psychologist by your GP, your psychiatrist or paediatrician. Patients who have been identified by their referring doctor as having a mental health condition can be referred to a psychologist for additional assistance. The referring doctor may decide that a particular patient would benefit from services beyond what the practitioner can offer, for example psychological services. Back to the top
What is meant by a mental health condition?

Mental health conditions include a range of clinically diagnosable conditions that significantly impact on a person's emotions, thoughts, decision-making, and social skills. This includes mental health conditions arising from:

Adjustment disorder
Attention deficit disorder
Anxiety disorder
Bipolar disorder
Bereavement disorders
Depression
Conduct disorder
Eating disorders
Drug use disorders
Obsessive compulsive disorder
Mixed anxiety and depression
Phobic disorders
Panic disorder
Psychotic disorders
Post-traumatic stress disorder
Schizophrenia
Sexual disorders
Sleep problems
Unexplained somatic complaints ß Alcohol use disorders
Mental disorder, not otherwise specified
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How does referral work?
The referring doctor should provide a referral letter, and when the patient is referred by a GP who is managing the patient under a GP Mental Health Care Plan, a copy of the plan may also be provided (with the patient's permission). For Medicare benefits to be paid, your first consultation for psychological services must be provided on or after the date on your doctor's referral letter, not before. Your doctor may allow you to request a specific psychologist or may refer you to a registered psychologist that he/she recommends.
Psychologists must also provide a written report to the referring doctor following the first six services and/or on completion of the course of treatment. This report will include information on any assessments carried out on the client, any treatment provided and recommendations on future management of the client's condition.
How can a psychologist help me?
Psychologists specialise in providing therapies for common mental health conditions to help reduce distress and to enhance and promote emotional wellbeing. This therapeutic process can provide you with a means to explore your personal and life issues in a confidential, respectful and supportive environment with a qualified and experienced professional.
For example, where a patient has a condition that involves problems with mood (e.g. anxiety, depression), cognition (e.g. memory, concentration), pain (e.g. headache, musculo-skeletal), adjustment problems (e.g. acute distress, grief) or behaviour (e.g. anger, self-management, sleep) they could benefit from psychological interventions. There is now well-validated evidence that many mood conditions are best managed by psychological as well as (or in place of) drug interventions.
What will it cost me?

Psychologists providing Medicare rebateable services may set their own fees, but the Medicare rebate for each item is a set amount. The cost to you and the rebate available from Medicare can vary depending on the:

Length of the session;
Type of psychologist; and
Fee being charged by the psychologist.

If the psychologist decides to bulk bill then you will not have to pay anything. However if the psychologist does not use the bulk billing method then you would pay the difference between what the psychologist charges you (which may be the schedule fee or a fee set by the psychologist) and the Medicare Rebate. This will vary and you must check this out with the psychologist before commencing your treatment.

What if I have private health insurance?
You cannot use your private health insurance ancillary cover to top up the Medicare rebates for these services. You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for psychological services you receive. You can either access rebates from Medicare by following the claiming process or claim where available on your insurer's ancillary benefits.Back to the top
Medicare rebates available

The Medicare rebates payable under the Better Access initiative for Focused Psychological Strategies services include:

Short consultation 20-50 minute consultation $54.30 rebate
Standard consultation > 50 minute consultation $76.65 rebate

Group programs

60 minutes plus

$19.55 rebate per person
Bulkbilling under Medicare Shelley Jackson offers bulkbilling by arrangement to clients referred under the Medicare Better Access to Mental Health Care initiative, who are receiving government benefits and not in paid employment.

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How do I pay?
If the psychologist charges the schedule fee or above, then the settlement of the account is your responsibility. You may claim a rebate by lodging a claim through Medicare. When billed you can either:
Pay the full amount of the consultation and use your receipt to claim a Medicare rebate; or
Pay the difference between the Medicare rebate and the total account amount, and then claim the rebate from Medicare to forward to the psychologist later; or
Claim from Medicare using your unpaid account.
Bulk billing
The decision to offer bulkbilling to clients rests with the individual psychologist. Shelley Jackson offers bulk billing to eligible clients by arrangement. (More info...)
You will be asked to sign a Medicare form in which you assign your right to a benefit to the psychologist, as full payment for the psychological service. The psychologist cannot make any additional charge for this service if it has been bulk billed, and he/she will receive the relevant Medicare rebate or 'benefit' directly from Medicare Australia for the service provided.
The Medicare Saftey Net
You are responsible for paying any charges in excess of the Medicare rebate for items under this initiative. However, these out-of-pocket expenses will count towards both the original and the extended Medicare safety nets. Once you or your family reach the relevant threshold in the calendar year, Medicare benefits will increase to 100% of the schedule fee under the original safety net, and 80% of your total out-of-pocket expenses for out-of-hospital services under the extended Medicare safety net. The Medicare safety nets are designed to protect high users of health services from large out-of-pocket expenses.
For further information about this program

The information contained on this webpage is meant to be a guide only, for the benefit of clients of this service and is not a substitute for direct information from Medicare Australia. It has been compiled from information provided by the Australian Psychological Society (for its members) and by Medicare Australia. It is understood to be correct at the time of submission on to this site. For further information about this program, please consult Medicare Australia, Ph 132 150, your GP, or visit the Medicare Australia website: www.medicareaustralia.gov.au

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This site and all contents © 2004-2008 Shelley Kim Jackson

 
 
 
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Contact Us

Ballina Wellbeing Centre

11 Norton St Ballina NSW

PO Box 1611

Ballina NSW 2478

Ph. (02) 6686 7093

Fax. (02) 6686 7983

Mob. Ph. 0438 867 093

Consultations available weekdays, evenings & Saturdays