Professional Fees, Treatment Costs, and Billing Options – these are just some of the biggest concerns of patients who seek professional help. Dr Danielle McCarthy (Clinical Psychologist), Director of Mind Potential Psychology, steps forward to clear billing inquiries of patients, Medicare rebates and who gets them, bulk billing, gap fees, and also a few topics about mental health and parenting.
Wayne Bucklar: Joining me on the program today is Danielle McCarthy. Daniel is the Director of Mind Potential Psychology, a psychology practice from the Sunshine Coast in Queensland. Danielle, welcome to the program.
Danielle McCarthy: Thanks Wayne. Good to be here.
Wayne: Now Danielle, the Sunshine Coast is a long strip of beach. Whereabouts are you exactly?
Rephrased Question: What areas do Mind Potential Psychology service?
Danielle: Yes. So we’re in a place called ‘Birtinya’ it’s in the Kawana Area so it’s just in between Maroochydore and Caloundra we’re kind of smacked bang in the middle.
Wayne: Those names just sound terrible to me as someone who doesn’t live in that part of the world because all I can think I is bronze surfers and cold beer. It must be a lovely place to live.
Danielle: It’s beautiful. Beautiful sunny, warm weather the majority of the time and we’re right in the beach so what more could you ask for?
Wayne: That’s true. Now Danielle, you’re a Director of Mind Potential Psychology. Give us a quick thumbnail sketch of what’s the average day like at Mind Potential Psychology. Who you’re seeing and how they come to be there?
Rephrased Question: Give us a brief overview of what’s the average day like at Mind Potential Psychology. Who are your clients?
Danielle: So the average day is that we have a practice that opens anywhere from 7:30, 8 o’clock a.m. around that time and goes through to about 6:00- 6:30 p.m. at night and we basically open the doors. We’ve got six offices and we have clients coming in with whatever their concerns are which can be anywhere from anxiety, depression, or trauma or chronic pain. So we work with clients with a wide range of different concerns.
Wayne: Now I was having a look on Google at what people type in when they’re looking at psychologists and one of the questions is bulk billing. So can you talk to us through what you do with funding there?
Rephrased Question: How does Mind Potential Psychology handle client billing?
Danielle: Yes, of course. So the majority of our clients come in under what’s called a ‘Mental Health Care Plan’ and that is a referral from the GP and that allows them up to 10 sessions in a calendar year where they get a Medicare rebate. So that Medicare rebate will vary depending on whether you’re seeing a general psychologist or clinical psychologist. And then there is typically what we call ‘Gap Fees’ so you pay say a certain amount of money and you get your rebate and you might be out of pocket say $50 or $60. If you’ve got a concession card, you might be out of pocket $20 or $30 dollars. Bulk billing is where you don’t actually have that gap fees. So you don’t actually make a payment so that full cost is covered by Medicare. We do have a small population where we agreed to bulk bill them when they’re in significant financial hardship but it’s definitely not what we do a lot and the reason being is that I guess there are many reasons – one, we do find it is a lot more beneficial for clients when they show up and if there is an out of pocket of payment and no matter how small it is, we just do find that the commitment of those clients tends to be greater in terms of showing up to their appointments doing the in-between session practice so all the homework tasks, whatever you want to call them, tend to commit to those a lot more and they tend to commit to their treatment a lot more and they get better outcomes. So that’s why we’re a bit reluctant to bulk bill. And then of course, there’s just the very fact that we as the practice says, a lot of cost that go into running a practice and the psychologist obviously have a lot of cost in their lives as well to cover and this is their job and they need at the end of the day to put bread and butter on the table for their family at home. So we just can’t always even afford to be a bulk billing practice because we just wouldn’t cover cost and be able to run it so to be able to run and be open and be able to treat clients and help them out, there is a gap fee for the majority.
Wayne: Danielle, it does sound like the fee is very predictable. So I’m just putting words in your mouth here. I’m assuming for anyone who’s concerned about costs, they could just come along and have a conversation and find out exactly what it’s going to cost before they commit.
Rephrased Question: Can people visit the Mind Potential Psychology office and ask for the cost of services before they commit?
Danielle: Yes, it is. Absolutely. There’s standard fee, there’s a concession fee for people who have a health care card or a concession card from Centrelink. So yes, it’s very predictable. There’s basically only a couple of fees that they may get charged and it’s really not an exceptional amount of money so it is really affordable because of that Medicare rebate which covers the majority of their session actually, they’re not out-of-pocket a whole amount. So Medicare does do a great job in covering most of the cost.
Wayne: Now I heard you mentioned earlier, ordinary psychologists and clinical psychologists.
Danielle: General psychologists and clinical psychologists, yes.
Wayne: Now being an inquisitive animal like I am, tell me the difference.
Rephrased Question: What is the difference between a general and clinical psychologist.
Danielle: I guess the difference is really that the clinical psychologist has got an additional supervised training in clinical presentations and mental illnesses versus the general psychologist. A clinical psychologist has either done their masters or a doctorate level training at university and then they’ve gone on to how to do additional supervised practice whereby they have to get regular supervision, offered trained psychologists for a set period of time before they can be classified as a clinical psychologist. Where a general psychologist might not have had that additional training. So through Medicare, Medicare’s got a two-tier system and actually there’s a lot of debate around it but I’ll just actually give you the facts. So because it’s a two-tier system, it means that Medicare recognize clinical psychologist as having additional training and have a higher Medicare rebate as opposed to the general psychologist.
Wayne: And from a client’s point of view, I guess it doesn’t matter because the decision about supervision or unsupervised rest you at the practice level and it’s all going to be fine whoever is dealing with you.
Danielle: Yes and I guess at Mind Potential Psychology, I value every single psychologist who works in this practice and there’s a mixture of general psychologists and clinical psychologists. And in my eyes they’re all exceptional psychologists, I’ve got an amazing team of people who work here who do an amazing job and have had many years practicing. And so with the fees, when it comes to the fees, the actual gap fee is kept aside because in my eyes, they do an equally amazing job in treating them and they’re very good at what they do whether they’re deemed to be a general psychologist or a clinical psychologist. So the fee here is the same for both.
Wayne: Now Danielle, clients who were coming to you, you mentioned a lot of them come with a plan as a GP referral. But I understand people can just walk in the door as well?
Rephrased Question: Can people visit Mind Potential Psychology as a walk-in client?
Danielle: Yes, exactly. So maybe 60% to 70% of our clients coming through GP referral and then we have other clients who we call them ‘Private Clients’ and they can just call up and walk through the door and they may be covered by private health and have some of their session paid for by that or some of them don’t have that private health and they just pay out of pocket. So yes, we can see them and you don’t have to have a referral from a GP. It’s just commonly done because the GP might be the person who picks up on the mental health difficulties and they might be the first point of call for that person who then directs them to us.
Wayne: Now at the risk of being controversial, what about parents and partners who are concerned about someone’s mental health? Can they come along and have a chat to someone there about what’s going on, how does that work?
Rephrased Question: Can family members and/or partners come along during the visit at Mind Potential Psychology?
Danielle: Of course, they can come along and talk and they would be the client and they would work with the psychologist I guess on strategies to how to maybe best manage the situation with their loved one under Medicare or through a GP referral. They wouldn’t be able to get a referral under a mental health care plan because they’re not the person, you have to have a diagnosable mental health concern to be able to get a mental health care plan. They can certainly come in privately and chat to the psychologist. And we do have clients who may be struggling or have an issue with one of the relationships in their life and they are themselves, the client and come in and the work would be around helping them with that and help them navigate that.
Wayne: Yes. I can certainly see that if you got perhaps older dependent children or even the independent children, you expect that they’ve got an issue. It can be very lonely without someone to talk to about how do you progress this, how do you approach and how do you move forward?
Rephrased Question: Can Mind Potential Psychology help people with parenting or those who are lonely and wanting to talk to someone on how to move forward?
Danielle: That’s it. And then maybe really effective coping strategies for how to best help that person or work with that person. So there might be things that the actual client that we see can actually do and ways of communication or being with that person that can still really assist even though it’s not the person themselves coming in to see us for treatment.
Wayne: And you don’t think shouting would be the ideal solution, that’s just my parenting coming out in me.
Danielle: I think going down that road at times, but generally that’s not what we would recommend. But my duty is charged at times.
Wayne: And see, my children are 35 so I really can’t claim the terrible twos as a defense here. In addition to the obvious things like depression and maybe sleeplessness and anxiety, what are the other common presentations that people make?
Rephrased Question: What are the common presentations people visiting Mind Potential Psychology have?
Danielle: Yes, so we have a number of clients who might be experiencing chronic pain. We have some with some kind of trauma and then within the anxiety, you’ve got a wide range of different concerns so you could have anywhere from a specific phobia say somebody who’s got a phobia of spiders and won’t leave the house as a result to social anxiety where they become extremely anxious in social situations. To even generalised anxiety where they just worry about anything and everything. So the anxiety can be broken down into a number of different concerns and as well as obsessive-compulsive disorder as well so we have clients with that as well. Common, we have a few with say body image concerns or eating issues and then with the children, we’ll get things like behavioral concerns from the parents. We work with children with ASD. We have some children with emotional issues.
Wayne: You get a lot of substance abuse clients?
Rephrased Question: Do you have substance abuse clients?
Danielle: We get a few, not a lot. But we certainly see those clients and we have a couple of psychologists who work with that population and those concerns. But that’s not as common a presentation as some of the other ones.
Wayne: Danielle, it’s been lovely having a chat with you today. I do appreciate you making yourself available.
Danielle: That’s okay. Thanks Wayne.