Accessing Medicare Exercise Physiology services through Medicare’s Chronic Disease Management plan (previously EPC plan) can be a crucial step in managing chronic conditions.
Navigating the healthcare system can be complex, especially when it comes to understanding how services are billed and what out-of-pocket costs you might incur.
At Tailored Exercise Physiology, we aim to simplify this process by offering gap-free bulk billing Exercise Physiology services for patients who have a CDM plan.
This blog post will explain what this means, how you can access these services through Medicare’s Chronic Disease Management (CDM) plan (EPC plan), and why choosing Tailored Exercise Physiology ensures that you won’t face unexpected costs.
What is Bulk-Billing and Gap-Free Exercise Physiology?
Bulk-billing involves billing Medicare directly for services, so the patient isn’t required to pay out-of-pocket.
Some healthcare providers ask for an up-front payment that the patient can later claim as a rebate. At Tailored Exercise Physiology, we bill Medicare directly, ensuring you have no out-of-pocket expenses with your CDM plan.
A gap-free service is one where there are no additional costs or “gaps” between the Medicare rebate and the provider’s fee. While many Exercise Physiology practices might charge a fee higher than the Medicare rebate, leaving patients to pay the difference (the “gap”), Tailored Exercise Physiology ensures that there is no gap — what Medicare covers is the entire payment.
Medicare Exercise Physiology: The Chronic Disease Management Plan
Medicare provides rebates for Exercise Physiology services under the Chronic Disease Management plan, formerly known as the EPC plan.
This plan is designed to support patients with chronic medical conditions by enabling them to access allied health services, including Medicare Exercise Physiology or Medicare Physiotherapy, which can play a crucial role in managing and improving their condition.
What is the Chronic Disease Management (CDM) Plan?
The CDM plan is a Medicare initiative that allows patients with chronic or complex health conditions to receive Medicare rebates for up to five allied health services per calendar year.Who is Eligible for Bulk Billing Exercise Physiology?
To be eligible for a Chronic Disease Management plan, you must have a chronic medical condition. According to Medicare, a chronic condition is one that has been, or is likely to be, present for six months or longer. Common chronic conditions that might qualify include:- Diabetes
- Cardiovascular disease
- Arthritis
- Osteoporosis
- Chronic respiratory conditions
- Mental health disorders
- Musculoskeletal conditions
Accessing Medicare Exercise Physiology Services Under the Chronic Disease Management Plan
The process of accessing gap free, bulk billing exercise physiology services under the Chronic Disease Management plan is straightforward but involves a few important steps.
Here’s how you can get started:
Step 1:
Obtain a Referral from Your Doctor
Your first step is to visit your GP, who will assess your eligibility for the Chronic Disease Management plan. If you qualify, your GP will create a personalised care plan with a referral to Medicare Exercise Physiology.
Step 2:
Contact Tailored Exercise Physiology
Once you have your referral, the next step is to contact us at Tailored Exercise Physiology. You can do this by:
- Call our practice: Reach out to our friendly reception team, who will guide you through the next steps.
- Provide a copy of your referral: You’ll need to send us a copy of your GP’s referral, which you can do via email or by bringing it in person before your first appointment.
- Book an appointment: Our team will help you schedule your first appointment under the GP care plan at a time that’s convenient for you.
Step 3:
Initial Consultation and Assessment
During your first appointment, your Exercise Physiologist will conduct a thorough consultation to understand your condition, goals, and any specific requirements set out in your doctor’s referral. This allows us to create an individualised plan that aligns with your needs.
Collaborating with Your Doctor for Optimal Care
At Tailored Exercise Physiology, we believe in a collaborative approach to healthcare. Our Exercise Physiologists work closely with your doctor to ensure that your care is seamless and comprehensive.
After your treatment, we will provide your GP with a report outlining our findings, the proposed plan, and any progress or changes as your treatment continues.
Why Choose Tailored Exercise Physiology for Gap-Free Services?
Not all exercise physiology practices offer gap-free services under the Chronic Disease Management Plan. Here’s why Tailored Exercise Physiology stands out:Individualised strategies:
Every injury, condition and goal is different, and so are our strategies to achieve them. We will guide you through the most effective path forward for your specific needs.The experience to educate:
Our team draws upon years of diversified experience to educate and empower you from the very first consultation.Personalised and passionate care:
Our passion lies in seeing our clients healthier and happier. We will work hard so you can focus on the journey ahead.No Out-of-Pocket Costs:
We bulk-bill all eligible Chronic Disease Management plan services, meaning you won’t face any unexpected expenses.Convenience:
From easy booking processes to close collaboration with your GP, we make accessing care as smooth as possible.Common Questions About Chronic Disease Management and Gap-Free Services
What if I need more than five sessions?
The Chronic Disease Management plan provides rebates for up to five allied health services per year. If you require additional sessions, our team will discuss alternative options with you, which may involve private billing or rebates from private health insurance.
Can I use my private health insurance?
Yes, if you have private health insurance, you may be able to claim additional sessions or services not covered by the Chronic Disease Management plan. We can help you navigate this during your initial consultation.
Please note you cannot use your private health insurance in conjunction with the CDM plan.
What happens if I don’t qualify for the Chronic Disease Management plan?
If you do not qualify for the Chronic Disease Management plan, we still offer services on a private billing basis. Our team can discuss costs and payment options with you including private health fund rebates.
Final Words Bulk-Billing and Gap-Free Medicare Exercise Physiology Services
Utilising exercise physiology services through Medicare’s Chronic Disease Management plan can be essential for effectively managing chronic conditions.
At Tailored Exercise Physiology, we’re committed to providing gap-free, bulk billing exercise physiology services to ensure that you receive the care you need without the stress of out-of-pocket expenses.
If you have a chronic condition and believe exercise physiology could benefit you, talk to your GP about a referral and contact us today to begin your journey toward better health.
