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Fees, Payments and Options

Initial Consultation

The initial consultation will incur a fee. Generally, our doctors are no gap for privately insured patients.

A quotation of this fee will be given at the time of your booking. This fee is payable at time of appointment and a receipt given for claiming back your Medicare rebate. 

As we are a busy practice, if a consultation appointment is cancelled without notice, you may be asked to pay the full amount at the time if rebooking.

An Explanation of Fees

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 Disbursements

There may be other charges involved in your care depending on which course of action you choose. You need to also 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.

Private Patients

Overview

If you have private health insurance that covers the types of procedures we perform, then your health fund excess is payable of the day of the procedure.

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 either an outpatient clinic or in my private rooms or will be referred to your local general practitioner.

Types of Private Patients

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

  • Private Health Insured
  • Department of Veterans Affairs (DVA)
  • WorkCover
  • Self Insured (Uninsured)
  • Overseas Patients

Private Health Insurance - No Gap Policy

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 private health cover, some health funds also require you to pay an excess. For Procedural Items typically there is No Gap payment required

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.

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

Workcover

Arrangements between our practice and the state government insurance regulator covers patients involved in workplace and motor vehicle accidents.

These state specific arrangements are designed to ensure that workers have priority access to orthopaedic surgeons.

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), however some of these services may be bulk billed to Medicare, that is no ‘gap’
  • Hospital accommodation fees (bed charge)
  • Surgically implanted prostheses
  • Dental Services

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

For further information about being a private patient, contact our rooms

Overseas Patients with Non Reciprocal Agreement

If you are an overseas visitor, you will be required to pay the full hospital fee on admission.

If you are an overseas patient from a country where there is no Reciprocal Health Care Agreement, you are not eligible for Medicare and you are responsible for payment of all fees and services.

Non-Medicare patients are billed for inpatient and outpatient services regardless if they choose public or private admission.

Reciprocal Health Care Agreement - If you are a visitor from a country where Australia does have a Reciprocal Health Care Agreement (RHCA), you may be eligible for treatment that is deemed immediately necessary for any health problem or injury whilst in Australia. RHCA does not cover pre-arranged or elective treatment. Overseas patients who are covered by the RHCA will not be covered if they choose private admission.

Please contact us for more information.

Private vs Public Fees

You may choose to be a public or a private patient. This page provides patients with the different options are for surgery in the private or public hospital system.

Public Hospital Patients

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 usually performed by a registrar (doctor training in CHOOSE surgery) 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.

Private Hospital Treatment

In the private system I will perform your surgery personally and will also look after you if you are advised to be an in-patient. All follow up appointments will be in my office. Payment Policy

Payment Options

Overview

Our reception staff will be happy to advise you of the consultation fee upon booking an appointment over the telephone. Fees for consultation along with other necessary forms will also be emailed to you for your convenience upon booking an appointment.

  • Surgical fees are billed directly to the Health Insurance Providers.
  • Where out-of-pocket co-payments are required which can vary depending on the type and complexity of surgery or procedure. Patients will be advised, in writing, after the consultation, the amount of gap payment.
  • Fees for uninsured patients are advised by the accounts manager upon request.

Payment on the day of consultation is much appreciated.

How to Pay?

For your convenience we accept a number of payment methods in the rooms, by post and online:

  • Cheque and Cash
  • Credit Card: VISA, Mastercard, Amex (logos),
  • Electronic other - (Credit Card, EFTPOS, BPay)
  • Website Payments (PayPal, Swipe etc)

Other Payment Choices

  • Medical Finance
  • Early Release of Superannuation
  • Tax Rebate Scheme

Medical Finance Options

There are various finance firms that specialise in finance for medical procedures.

Early Release of Superannuation

Patients may apply to Centrelink for an early release of superannuation funds to cover part or all of the costs involved. More details can be found on the Centrelink website.

  • Completed application form - click here to download
  • A letter of support from your General Practitioner
  • A letter of support from our clinic (we will provide this after your initial consultation)

Please note that processing time by Centrelink generally takes around 3 weeks, and allow a further 4-6 weeks for your superannuation fund to release the funds to your personal bank account.

Tax Refund Scheme

Tax Rebate Scheme for Medical Expenses

A significant rebate can be claimed through your end of year tax return if you incur medical expenses over $2,000 during the one financial year. Anyone can claim the tax offset: there is no upper limit on the amount you can claim, however it is now income tested. The rebate is currently 20 cents for every dollar over the $2000 threshold.

There is no upper limit on the amount you can claim, and it is not means or assets tested. Because this is a rebate rather than a tax deduction, you can claim this from the ATO even if you do not pay tax. As always, also check with your accountant or financial advisor.

Because this is a rebate rather than a tax deduction, you can claim this even if you do not pay tax. It is claimed at question T9 on your tax return. As always, be sure to check with your accountant or financial advisor. Further details can be found by clicking here.

No Private Health Insurance

If you are not in a Private Health Fund or DVA and you need surgery, you have two alternatives:

  • Go on a Waiting List at the Public Hospital, or
  • Pay for the operation yourself ("Self Insure")

Waiting List

However, the Waiting List for operations in the Public system is considerable, currently upwards of twelve months and patients are admitted to hospital on a "first come, first served" basis.

Self Insured

An increasing number of people are choosing to "Self Insure" or pay for their own surgery, so they don't have to wait. This is often a worthwhile investment as it means you can have your operation done straight away or whenever it suits you. This can allow you to get back to your work and sport as soon as possible.

The costs may not be as high as you think, especially for some less invasive surgeries.

  • Other Surgery
  • Watchful Waiting
  • Alternative Therapies

All the private hospital fees associated with your surgery are an out-of-pocket expense, but we will assist you in obtaining an estimate of costs from the private hospital before you go ahead with your surgical procedure.

Call my practice and they will be happy to provide you with an accurate costing. A proportion of my fees and the anaesthetic fees attract a small rebate from Medicare.

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