PET - Plain English Taxonomy

Attribute:	PL18854
Concept:	Expense Insurance Benefits Paid Amount
Label:	Benefits paid
Concept Guidance:	This is the value, during the relevant period, for the benefits paid by the private health insurance fund.
Form-Specifc Guidance:	When reporting by age category, the benefits paid should be reported against the relevant age at the time the treatment was done, not the against the age of the person in the current reporting period, because sometimes claims are made and benefits paid long after the actual treatment. In Part 11 Total hospital treatment medical services statistics, only report medical benefits paid.

Dimensions

Dimension	Member	Description
GapAgreementDimension	(NoGapAgreement)	This dimension categorises the reported data according to whether there is an agreement between a medical practitioner and an insurer, in relation to the benefit paid by the insurer relative to the fee charged by the medical practitioner. The information reported is in relation to an agreement where a medical practitioner agrees to accept a payment by the insurer in full satisfaction of the amount owed so that there is no gap or no out of pocket expenses to be paid by the insured person.
RelativeFeeSizeDimension	(GreaterThan150PercentMedicareBenefitScheduleFeeTo200PercentMedicareBenefitScheduleFee)	This dimension categorises the reported data according to the size of the fee charged relative to the Medicare benefit schedule fee. The information reported is in relation to a fee charged that is greater than 150% of the Medicare benefit schedule fee and less than or equal to 200% of the Medicare benefit schedule fee.
TreatmentServicesDimension	(HospitalTreatmentOnly)	This dimension categorises the reported data according to the type of treatment services provided. The information reported is in relation to treatments that are only hospital treatment.