Section Where: j = group of equivalent episodes - Private Health Insurance (Benefit Requirements) Rules 2010 - Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;

Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;

i = group of the insurer's negotiated agreements in force on 1 August of the first year with comparable private hospitals in the State;

n= the number of the insurer's negotiated agreements in force on 1 August of the first year with comparable private hospitals in the State;

Rji = charge for episode of hospital treatment type j in the negotiated agreement i

Rj = average charge for episode of hospital treatment type j.

(6) In subclause (4), each episode of hospital treatment must be identified using the patient classification system and payment structure in the majority of the relevant insurer's negotiated agreements in force on 1 August of the first year with all comparable private hospitals in the State in which the facility is located.

(7) In subclause (4), for the purpose of calculating the average charge for the equivalent episode of hospital treatment in a State:

(a) the charge will include the sum of the amount payable by the insurer under that insurer's negotiated agreement and any excess or co‑payment amounts payable by members, in accordance with the insurer's rules; and

Note: Policy holders’ financial obligations under such levels of cover will still apply.

(b) must not include any charges:

(i) referred to in the insurer's negotiated agreements for prostheses; and

(ii) that are minimum benefits for prostheses as specified for the purpose of item 4 of the table in subsection 72-1 (2) of the Act, and

(iii) referred to in the insurer's negotiated agreements for hospital treatment provided to nursing-home type patients.

(8) Subject to subclause (2), if an insurer has less than 5 negotiated agreements in force on 1 August of the first year with a particular category of comparable private hospitals in a State, then all of that insurer's negotiated agreements with all classes of private hospitals in that State are to be used to calculate the minimum benefit.

Facilities

The hospitals specified in the table below are facilities for the purpose of this Schedule.

Table

Facility Name	Address
Abbotsford Private Hospital	61-69 Cambridge Street, WEST LEEDERVILLE WA 6007
Adelaide Day Surgery	18 North Terrace, ADELAIDE SA 5000
Adelaide Eye & Laser Centre

Where: j = group of equivalent episodes Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;

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Where: j = group of equivalent episodes of hospital treatment under the insurer's negotiated agreements;