PET - Plain English Taxonomy

Name: GapAgreementDimension
Label: Gap Agreement Dimension
TREF ID: DM807
Type: Predefined
Description:
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.
Usage:

Dimension Members
Name Label TREF ID Description
KnownGapAgreement Known Gap Agreement DV7734
The information reported is in relation to an agreement where the difference between the amount of benefit paid by the insurer and the fee changed by the medical practitioner is a known amount, which is the out of pocket expenses to be paid by the insured person.
NoAgreement No Agreement DV7735
The information reported is in relation to there being no agreement between a medical practitioner and an insurer in relation to the amount of benefit paid relative to the fee charged.
NoGapAgreement No Gap Agreement DV7733
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.