$430,599 charge tops Medibank’s claims list in 2016

Medibank’s claims list for 2016 shows shows substantial increases in hospital admissions and benefits paid.

The average total cost of childbirth has increased from $7868 in 2012 to $9421 in 2016. Picture: via Getty Images.

Australian insurance major Medibank paid out a $430,599 hospital claim in 2016, its highest claim for the year, according to a new report, which also shows substantial increases in benefits the insurer paid.

The company’s health cost and utilisation report for the 2016 financial year revealed that seven of the top 10 hospital claims it processed during that period were from Queensland, two from NSW — including the $430,599 claim for the care of a newborn infant — and one from South Australia. The top 10 payouts were all for neonatal or tracheostomy.

Medibank’s data also highlighted that the average total cost of childbirth had increased from $7868 in 2012 to $9421 in 2016.

The Australian-listed company said its latest report showed substantial increases in admissions and the benefits it paid out on behalf of its customers. The out-of-pocket cost to patients was also on the increase.

“In many cases, we are paying for our customers’ healthcare at rates that are well above the fees set by the Government’s Medicare Benefits Schedule,” chief medical officer Linda Swan said.

“It’s important to discuss potential out-of-pocket charges with your surgeon or specialist, as providers can charge very different out-of-pocket costs and many don’t charge extra fees at all.”

Childbirth, rehab, joint replacements and shoulder procedures topped the list of Medibank’s most commonly claimed surgeries, with knee replacements up by 11 per cent in the last four years and inpatient rehab admissions up by 15 per cent in the same period.

The five most common same-day hospital services were colonoscopies, chemotherapy, dialysis, rehab and cataract procedures. In the last four years, chemotherapy admissions increased 8 per cent and cataract procedures increased 7 per cent.