Overview
Fees and insurance policies are the cause of a large amount of stress and confusion. Our commitment is to supply you with as much information as possible in the most open and transparent way we can. We are happy to provide estimates of out of pocket costs when you book your initial appointment so there are no surprises. Just let us know over the phone which operation you think you might need and the name of your insurance company, or whether you are self-funded.
This page is designed to explain some of the concepts involved and the likely costs which you may incur. It will cover:
- Consultation Fees
- Explanation of Surgical Fees
- Estimates
- Other Possible Costs
- No Gap and Known Gap policies
- Private Patients
- Department of Veterans Affairs
- Self-insured Patients
Consultation Fees
- Initial consultation $240 (Medicare rebate $84.15)
- Subsequent consultation $120 (Medicare rebate $42.30)
Full payment required on day of consultation.
Explanation of Our Surgical Fees
Fees are indexed annually based on nationally accepted rates.
Out of pocket amounts for patients with health insurance will vary depending on the actual surgery (item number dependent).
If you want an estimate of the out of pocket fee prior to your first appointment please contact my secretaries and let them know which operation you feel you may need. They will be able to provide you with a detailed estimate of the costs including out of pocket fees.
Prior to surgery the full surgical fee for the procedure will need to be paid in advance and then following surgery you will be sent a receipt to allow you to claim back rebates from Medicare and your health fund.
For further information on surgical fees please follow the link to the AMA site. https://feeslist.ama.com.au/resources-ama-template-letter-to-patients-about-increased-medical-fees
Estimates
We are committed to complete transparency regarding the cost involved in your surgery. If you require more information at any stage just contact us.
We also provide a formal informed financial consent to all our patients prior to surgery. This is a pre-treatment estimate of your surgical costs. This will include the total surgical fee, which you will need to pay seven days prior to the operation, and the amount which we estimate you will be able to claim back from both Medicare and your insurance company. The final amount which Medicare and your insurance company decide to reimburse may sometimes differ from our estimate.
Other Possible Costs
There may be other costs involved in your care depending on which type of treatment you require. You need to also check with your health fund to see what is covered. Potential areas of cost are:
- Hospital
- Surgical Assistants
- Implants or Prosthesis
- Anaesthetist
- Tests (Radiology, Pathology)
- Postoperative CareHealth Fund Excess
The out of pocket charges required by our anaesthetists and surgical assistants are not set by us. These often vary depending on you level of cover. We can give you an estimate of these costs prior to booking surgery. Once you are allocated to an operating list we will give you the contact details of the anaesthetist and surgical assistant should you wish to obtain the exact amount their services will incur.
Prior to surgery radiology and pathology tests may be required. These may require additional costs. Contact us and we will let you know if there are Bulk Billing options available.
Usually the hospital stay, any implants required, and the postoperative inpatient rehabilitation are all covered by your insurance.
If your private health insurance company requires the payment of an excess (often around $500) they will take this on the day of the procedure. Contact your insurer to check your policy and the excess.
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)
Private Health Insurance
Our practice accepts all private health insurance. Our staff have a good understanding of the private health insurance and if you have any concerns or questions please contact us. We will give you all the information you need to talk to your insurance company.
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). Our practice has a No Gap policy for DVA card holders. For further understanding on how you can apply these benefits to our service and the scope of cover please refer to:http://www.dva.gov.au/benefits-and-payments
Self Insured (Uninsured)
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)
- 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.
If you plan to self-fund we are able to give an approximate indication of the surgical fees and the total cost involved when you are booking your initial consultation. We will provide a detailed and itemised quote to you when booking surgery. This will include all specialist fees and all hospital costs. These costs are prone to change considerably between patients, particularly if the length of hospital stay changes due to complications or unforeseen circumstances.