Healthshare partners with nib on 'gap' transparency

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HealthShare has launched a new partnership with nib that will enable the insurer's members to quickly and easily determine their likelihood of being charged a gap payment by a medical specialist.

Through the partnership, nib members with their general practitioners will be able to make an assessment based on whether a medical specialist participates in the insurer's no gap scheme (MediGap) and the frequency with they charge a gap or out-of-pocket expense.

This information will be available at the point of referral, via GP consultation software, or during online research on and the nib website.

Specialists who participate in the nib MediGap scheme agree not to charge members an out-of-pocket cost for their procedure. This helps to minimise ‘gap’ payments for specialist fees in hospital, in turn lowering member’s out-of-pocket expenses.

According to nib managing director, Mark Fitzgibbon, “It’s a market failing that a member can receive treatment for a knee replacement and not be charged a gap, while another member is charged an almost $8,500 out-of-pocket by a different specialist for exactly the same procedure.”

“Just like TripAdvisor has revolutionised the travel industry, we have similar aspirations for the healthcare sector. That’s why we continue to seek new ways to correct the current information asymmetry by sharing information such as patient reviews and quality indicators,” he added.

HealthShare’s directory provides information about specialists, including sub-specialties, special interest areas, languages spoken, hospital affiliations, capacity to take on urgent appointments. It is also fully integrated into clinical software that is accessible to over 90 per cent of Australian GPs. 

HealthShare’s CEO, Rami Weiss, said a recent survey the company conducted found 95 per cent of GPs believe specialist fees were an important consideration when referring a patient and over 80 per cent said access to gap participation data would help their referral decision.

“We are thrilled to partner with nib on this important initiative to help their members and GPs who use our digital channels to do their research. We’ve seen a strong growth in usage of the gap scheme filter with more than 80,000 Australians accessing this data through our website every month,” said Mr Weiss.