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Forums / Treatments, health professionals and therapies / Making a complaint to Health Complaints Commisioner

Topic: Making a complaint to Health Complaints Commisioner

11 posts, 0 answered
  1. PurpleRed
    PurpleRed avatar
    7 posts
    29 June 2020
    I was charged full price for five psychology appointments even though I'm on a concession card and the clinic offers concession rates. I brought up this issue with the clinic this psychologist works through, and they basically told me "too bad, so sad" and that they wouldn't be refunding me the difference. They never once asked for my concession card - Neither the clinic itself or my psychologist. They told me that as per their policy, I had to "show my concession card to my practitioner so they could make a copy". Couldn't exactly "show" my card as COVID-19 made all our appointments online and she wouldn't have been able to make a "copy".

    Am I being unreasonable in my request for a refund? Has anyone dealt with this before or with the Health Complaints Commisioner? I'm wondering if it's worth wasting my breath on it, or if there is a different organisation that may help. Thinking about local government/MPs as well. Thanks
    1 person found this helpful
  2. jess334
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    jess334 avatar
    395 posts
    30 June 2020 in reply to PurpleRed
    Hi PurpleRed,

    You could try a complaint. In the end you won't have lost anything for trying.

    I agree that they should have asked you during the first session if you have a concession card. I bet if you had gone in person it would have been on the new patient form.

    However, one of the reasons they might not be able to refund you is that a concession card doesn't just lower the price, it also increases the amount Medicare will pay towards your fee. If they don't have the concession card number at the time of claiming through Medicare, they will not be able to adjust the claim now.

    Kind thoughts, Jess
    1 person found this helpful
  3. Elizabeth CP
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    Elizabeth CP avatar
    2180 posts
    30 June 2020 in reply to jess334
    I think making a complaint is a good thing because even if it doesn't change the situation for you it may help alert the system that things need to change. I have made complaints re other situations in hospitals & been thanked with the comment 'We need to make sure this never happens again for anyone"
    1 person found this helpful
  4. Sleepy21
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    Sleepy21 avatar
    1311 posts
    30 June 2020
    I believe it could well be within your rights to complain and they may need to pay the difference, but it is such a tricky system. I wander if anyone here may have more info for you?
    I'm really sorry that happened to you, that sounds really disappointing and upsetting
    1 person found this helpful
  5. Croix
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    Croix avatar
    8930 posts
    30 June 2020 in reply to PurpleRed

    Dear PurpleRed~

    The downside of making a complaint to anyone about anything though any official system is that it can drive up stress and anxiety, this is something you should decide, knowing your ability to cope.

    The next thing is that your complaint sounds completely justified. As your original details are recorded for their system you should have been asked Medicare number and if you had any concession cards along wiht next of kin, DOB etc. This is particularly necessary if they state they do charge concession rates. Failure to do so may reflect upon their ability to charge Medicare for telehealth visits however should not affect you. There is a duty of care to you by all involved in that clinic.

    The Health Complaints Commissioner, in my state at least, has been most helpful to me and advised me what was and was not appropriate.

    If you leave the money to one side I doubt that the most important thing between client and therapist is not going to be present in the future, and that is trust.

    Truth be told I'd expect the office staff are not used to the new temporary bulk-bill telehealth rate currently in effect for selected patients and have made mistakes.

    Please let us know what you decide.

    Croix

    1 person found this helpful
  6. Sleepy21
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    Sleepy21 avatar
    1311 posts
    30 June 2020
    i agree it can be very stressful to make a complaint and also hard if too attachd to the outcome. I made a complaint but didn't have any evidence and they didn't act upon it... it was a hard process. I really wanted to be heard and wasn't. However in a case like this it may be different. I think if you can accept that you may not be successful its okay, for me it was very sad as I really wanted to see more done about the issue.
    1 person found this helpful
  7. blondguy
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    blondguy avatar
    10634 posts
    30 June 2020 in reply to PurpleRed

    Hi PurpleRed

    Excellent question and thankyou for the thread too

    I feel the frustration you are going through and making a complaint would be understandable..yet just from my own life experience it may be counter productive where your well being is concerned even if you do succeed

    The forums are a non judgemental and secure place for you to post PurpleRed

    Any questions are always welcome!

    My kind thoughts..Paul

    1 person found this helpful
  8. PurpleRed
    PurpleRed avatar
    7 posts
    30 June 2020 in reply to jess334
    Thank you to everyone who has responded. I received further correspondence from their "director" this morning that was condescending to say the least. The unprofessionalism in the way they've treated me and this situation is definitely cause for me to pursue this further.

    This has definitely affected my mental health, but at this point, I think it's worth alerting the Health Complaints Commisioner, just so they are aware of it. At least I won't feel like I brought this up for nothing, which would affect me even more mentally.

    You are all correct - It was the fact that trust was broken. Money is money - It comes and goes, and isn't the be all and end all. I find it very strange that they didn't at least have an initial phone consultation with me to discuss such matters. I want to turn up the heat on them a little with this complaint and let them know that their handling of this situation has been inappropriate.

    I paid over double what the Medicare refund was, so I don't believe the rebate rate would have been different. I'm no expert though.

    I'm going to pursue this, keeping in mind that I doubt I'll see the money again, but with the thought that it may help change some things. One can only try :)
  9. blondguy
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    blondguy avatar
    10634 posts
    30 June 2020 in reply to PurpleRed

    Hi PurpleRed

    Making the Health Complaints Commissioner aware of your situation is fine as its the principle involved..fair enough! Helping change a flaw in the system can be helpful to others so they dont experience the same

    We are here for you irrespective of the path you choose :-)

    you are amazing PurpleRed

    Paul

    1 person found this helpful
  10. PurpleRed
    PurpleRed avatar
    7 posts
    1 July 2020 in reply to blondguy
    Thanks Paul! I'm hoping it will avoid this situation happening to others :)
  11. geoff
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    geoff avatar
    13246 posts
    1 July 2020 in reply to PurpleRed

    Hello PurpleRed, go with all the help you've got and if you need to make complaint, then do so, especially as it won't happen to anyone else.

    You have to decide whether or not this psychologist has been helpful and if you do ant to go back.

    Are you able to scan your pension card and other necessary documents to the clinic but you will need a printer, or someone who does have one, can do this for you and then email it to you for future reference?

    Best wishes.

    Geoff.

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