Evaluation of the National External Breast Prostheses Reimbursement Program

4.3.3 The reimbursement process

Page last updated: 05 November 2010

Just over half of respondents (59%) reported that their reimbursement had been processed within ten business days. This is indicated in figure 15 below. A further 15% said that the processing time was longer than ten business days. The remaining respondents were either unsure of the processing time or did not answer the question. These results are in accordance with feedback given by stakeholders about the processing times of the reimbursement, and (as discussed in section 3.2.4) suggest that Medicare Australia has achieved its obligations as set under the business rules for administration of the program.

Although survey respondents did not overwhelmingly report that claims were processed within ten business days, they were very satisfied with the timeliness of the process. As shown in figure 16, 88% of respondents gave a rating of 3 to 5 out of 5 to both the timeliness of the reimbursement and the ease of obtaining the reimbursement following lodgement of their claim.

The following were noted.

  • Respondents who had previously accessed a state/territory based prosthesis program rated the ease of reimbursement under the national program less favourably (79%) than others (91%). They also rated the timeliness of reimbursement less favourably (80%) than others (87%).
  • Respondents aged 70 years and over rated the ease of reimbursement under the program less favourably (70%) than those aged 50 to 69 years (90%) and those aged up to 49 years (91%). These respondents also rated the timeliness of reimbursement less favourably (80%) than those aged 50 to 69 years (87%) and those aged up to 49 years (85%).

Figure 15 – Approximately how long did it take to receive reimbursement for the breast prosthesis into your bank account after you had lodged the claim? (n= 207)

Note that the above figures do not add to 100%. The remaining 21% of respondents completed a postal version of the survey and did not answer this question.

Text version of figure 15

Up to 10 business days - 59%
More than 10 business days - 15%
Not sure - 4% Top of page

Figure 16 – On a scale of 1 to 5, where 5 is the best score, how would you rate the following aspects of the program? (n=214)

Text version of figure 16

The ease of obtaining the reimbursement following lodgement of your application

Rating
Percentage
Not sureSmall percentage
18
23
312
418
558

The timeliness of receiving reimbursement

Rating
Percentage
Not sureSmall percentage
110
25
317
424
544