How are your fees calculated?
My fee is determined by the AMA (Australian Medical Association) scheduled list of fees that is updated annually. A quote will be forwarded to you before the surgery by my billings secretary. Surgical fees include some of your aftercare appointments. The costs of surgery vary with the particular operation required, and with the level of insurance cover. In general, health funds cover the large majority of the costs of your hospital stay, including theatre fees, prosthesis costs, medications, and hospital admission fees. These costs are often significant, and usually comprise the majority of the total costs of the treatment. Most patients will also have a co-payment determined by their health fund policy by which there is a fixed payment per night of hospital stay, which the patient has to pay out of their own pocket. The details of this can be found by contacting your fund.
The fees for surgery and for the anaesthetic are covered only up to a certain amount by Medicare and your health fund. The difference between this amount and the fees charged is called the “gap”. Both the surgical fee and anaesthetic fee are likely to entail a gap if your surgery is performed at a private hospital.
Patients who are not in a health fund may choose to either request surgery via the public hospital system, or alternatively fund the costs of surgery and their hospital stay themselves. My secretary can provide a quote incorporating hospital and prosthetic costs if required. Patients may alternatively choose to join a health fund and proceed with surgery once the relevant waiting period has passed.
Although your in-hospital costs are not covered by the Medicare Safety Net, your out-of-hospital costs may be covered if they exceed certain thresholds. For more information, visit http://www.humanservices.gov.au/customer/services/medicare/medicare-safety-net.If you wish to discuss the costs of consultation or surgery, please call my secretary Pauline on 0287110109