Payment Options

The standard fees charged by our rooms are in line with the Australian Medical Association recommended fee schedule. This means that in most instances there will be a ‘gap’ between our surgical fee and what is covered by Medicare and your health insurance fund.

If there is any problem with this, it is important that you ask about this gap. Our staff are fully informed with charges and rebates and will be able to help you navigate through what can be a complex process. These fee explanations can cover:

• Consulting Fee
• Surgical Fee
• Treatment Estimates

If you require more information, please do not hesitate to call the practice during office hours.

Other Possible Costs

There may be other charges involved in your care. You need to check with your health fund to see what is covered for additional areas of service. Potential areas of cover are:

• Hospital
• Surgical Assistants
• Implants or Prosthesis
• Anaesthetics
• Tests (Radiology, Pathology)
• Postoperative Care

Estimates

We offer informed financial consent to all our patients prior to surgery. This is a pre-treatment estimate of your surgical costs. This estimate enables you to discuss with your health insurance company what you are covered for and if benefits are applicable.

Overview

If you choose to be treated as a private patient, you will be treated at hospitals that our doctor is affiliated to or is a visiting medical specialist. After discharge, your care will be carried out in private rooms.

Types of Private Patients

This practice caters for a range of Private patients, these include:

• Private Health Insured
• Department of Veterans Affairs (DVA)
• Self-Insured (Uninsured)
• Overseas Patients
• Work Cover

Private Health Insurance

Private Health Insurance allows you and your family to access the right health services at the right time. You have control of your health care and can choose the provider, facility and timing of your treatment. With the security and protection of private health insurance, you have access to an extensive range of private hospitals and can rest assured that your health is in good hands.

Depending on your level of cover, some health funds also require you to pay an excess. We are not responsible for these costs but our staff will do their utmost to guide you to better understanding.

Our practice accepts most private health insurance programs. Our staff can also help with your claim for benefits, but we remind you that your specific policy is an agreement between you and your insurance company.

Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with the AMA fee schedule.

You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.

“No Gap” Cover

All privately insured patients undergoing surgery in the public hospital will be treated under a ‘No Gap” arrangement.

Department of Veterans Affairs (DVA)

The Australian Government’s Department of Veterans’ Affairs (DVA) provides support to current and former serving members and their families through a range of benefits (including ongoing or one off payments). for further understanding on how you can apply these benefits to our service and the scope of cover please refer to: www.dva.gov.au/benefits-and-payments

If you are self-funded (no private health insurance), the full hospital fee is payable on admission. Patients may be able to choose private admission even if they do not have private health insurance. Self-funded patients will be liable to pay the following:

• The gap between the Medicare benefit and any specialist’s charge
• The gap for diagnostic services (medical imaging and laboratory), however some of these services may be bulk billed to Medicare, that is no ‘gap’
• Hospital accommodation fees (bed charge)
• Surgically implanted prostheses

Essentially this means you must meet all costs of the admission yourself except those covered by Medicare.

Australian residents who decide to be a public patient are entitled to free treatment under Medicare. Your treatment will be carried out by an appropriate specialist which will be arranged prior to your admission. After discharge, your care will either be continued in an outpatient clinic or you will be referred to your local general practitioner.

In the public hospital, the surgery is sometimes performed by a registrar (specialist in training) but the registrar is supervised by a senior surgeon who is responsible for your care.

There are no fees for surgery in the public hospital, however, there is a waiting list. Your position on the waiting list will be based on the severity of your condition. Your follow up visits after surgery will be arranged through the hospital or your specialist’s rooms.