NIB is a no-gap only fund, that is, they don't allow copayments to be charged to patients when using their no-gap billing arrangements.

 

We have become aware (Dec 2020) that NIB has started a system with orthopaedic procedures where payments above the no-gap amount are paid to surgeons and anaesthetists. This is only for knee and hip replacements, and the 'known-gap' amounts paid to anaesthetists by NIB are from $550 to $800.

 

Further details are available at the following links.

 

https://www.nib.com.au/the-checkup/health-cover/planning-a-hip-or-knee-replacement

 

https://healthdispatch.com.au/news/intermediaries-call-for-aligned-codes-of-conduct

 

If we find out any more, we'll post it here.