HEALTH FUND TERMS CONDITIONS

Mandurah Dental Surgery Health Fund Terms Conditions

Special offer!

New Patients We are offering all new patients a Comprehensive Examination Now only $49 or “gap free” (no cost to you) if you have eligible health insurance!*

Offer at time of booking. To book an appointment, please call us on 08 9535 3620. *Click here for applicable terms and conditions.

Health Fund and Other Payment Provider Acceptance Terms and Conditions

Statements in this website to the effect that we accept health insurance funds and other payment methods refer only to the major health insurance funds and payment methods listed on our home page https://www.mandurahdental.com.au/

Any reference in this website to us accepting specified health insurance funds, health insurance funds in general or any other payment method (including payment by a Government Department or third-party payment plan provider) is subject to the additional qualifications below.

You can use a payment to us by a health insurance fund of which you are a member to pay us part of the cost of dental treatment supplied to you, or to reimburse you for part of the cost of treatment which you paid for, where you have a current health insurance fund membership that covers the particular dental service supplied to you. (A reference to a service supplied to you also includes a reference to a service supplied to a child where you arranged for us to provide treatment for that child.)

No health insurance fund pays us the full amount of the cost of any dental service which it covers. The difference between our fee for a service supplied to you and the amount which the health insurance fund pays us (or you) for that service is called the “gap”. The amount or percentage of the gap may differ between dental services, between health insurance funds and between different types of membership of the same health insurance fund.

Your health insurance fund may impose other conditions on whether it will pay us, or you, any and if so how much for the cost of dental treatment supplied to you.

Unless you have a special arrangement, our fee for dental service services supplied to you is payable in full by cash or other method that puts funds immediately into our account at the end of the treatment visit. Your health insurance fund membership can be used to pay us part of the cost of the treatment by the following method. If you supply us with a current, working health insurance fund membership card we will swipe that through our HICAPS machine. The HICAPS machine is supplied and serviced by a third party. We do not guarantee that it will be in working order at all times. Assuming that the HICAPS machine, the telecommunication network link between it and your health insurance fund and that fund’s systems are working properly and in accordance with the terms and conditions of your health insurance membership then a part of the fee payable to us will be paid directly to us by your health insurance fund. You remain responsible to pay the gap. You remain responsible to pay the entire fee if for some reason your health insurance fund does not credit the part of our fee into our account that your membership provides that it should at the time you are settling your account at the end of the treatment visit.

Australian Government Department of Veterans Affairs

If you are eligible to have your dental treatment paid for by the Department of Veterans Affairs (DVA) there will be no charge to you. In that case we will charge DVA the schedule fee which it specifies we may charge it for the service provided.

Department of Veterans' Affairs (DVA) will fund all dental services, provided under DVA arrangements, necessary to meet a clinical need for Gold Card holders. For White Card holders, dental treatment can only be provided in relation to your accepted disabilities.

Medicare Child Dental Benefits Schedule

You must produce a valid Medicare card for the child who receives the treatment at the time of your visit. Where the child is eligible for treatment under the Medicare Child Dental Benefits Schedule (Schedule Fee) and the conditions in these terms and conditions are met, we will charge only the Schedule Fee for the services provided to that child direct to Medicare – there will be no amount due by you.

You acknowledge that Medicare will only pay for treatment under the Child Dental Benefits Schedule to the extent that the child has a remaining amount available in their 2-year, $1000 treatment coverage cap (Treatment Cap) sufficient to cover the cost of the treatment. If we can see that the child has a sufficient amount left in their Treatment Cap to pay for the services by accessing Medicare online at the end of the visit, we will charge Medicare directly with no payment due by you. (Sometimes we are unable to access this information from Medicare online, however).

If there are no remaining funds in the child’s Treatment Cap, or we cannot find out the remaining amount in the Treatment Cap from Medicare online, you will be required to pay our normal fee for the services provided to the child at the time of the visit or, if those services are covered by another special offer which you claim which specifies a lower fee than our normal fee, you will be required to pay only that lower special offer fee, at the time of the visit.

If the amount left in the child’s Treatment Cap is greater than $nil but less than the fee for the treatment specified in the Medicare Child Dental Benefits Schedule (Schedule Fee) we will charge you the Schedule Fee, we will claim the amount remaining in the child’s Treatment Cap from Medicare direct and you must pay the difference at the time of the visit.