|Initial Consultation (pensioner)||$140|
|Follow up Consultation||$110|
|Follow up consultation (pensioner)||$80|
|Patient returning for same condition with new referral||$150|
|For an initial consultation (or with new referral)||You get $75.05 back from Medicare|
|For a follow up consultation||You get $37.70|
|This is done automatically for you through HIC online by our staff.|
All endoscopy procedures (gastroscopy & colonoscopy) are charged as a NO GAP through your private health fund.
A KNOWN GAP is charged for other procedures. This gap is capped at $600 for procedures other than bariatrics. The amount is usually based on the number of procedures, the total duration of surgery and the amount paid by the particular health fund (Different health funds pay better rates for particular procedures than others reducing the KNOWN GAP for their members).
This is well below the recommended fees by the Australian Medical Association (AMA).
The reasons for charging a gap are:
- Medicare (and therefore private funds) has failed to increase medical fees in proportion to the National CPI at least since 1985. The result is an increase in the CPI by over 330% with only a 160% increase in Medicare fees.
- Medicare (and therefore private funds) applies a so-called multiple procedures rule for general surgical item numbers. This means, for example, that if a bilateral groin hernia repair is performed, the surgeon is paid 100% of the fee for the right side but only 50% for the left side. If a third hernia (for example an umbilical hernia) is repaired at the same time, the surgeon is only paid 25% of that fee. This is despite the fact that the time taken to repair the subsequent hernias is not dependent on the first procedure.
- Medicare does not pay an assistant fee for some procedures that may require an assistant.
This is the SURGICAL GAP and is the only out of pocket amount charged by us for your procedure. It is paid at your first post-operative visit. If you have any financial concerns about this, please talk to our friendly staff.
The health fund EXCESS is an amount determined by your health fund and is paid directly to the private hospital on the day of your procedure.
The anaesthetist may also charge a known GAP depending on the surgical procedure. Our anaesthetists do not usually charge a GAP for endoscopy procedures. Any anaesthetic fees will be discussed with you by the anaesthetist pre-operatively
For un-insured patients (who have a Medicare card), the cost of a private procedure is three-fold:
- Hospital fees – This is usually the biggest cost but we aim to obtain the best quote for the patient.
- Anaesthetic fees – This is determined by the anaesthetist and once again we aim to obtain the best quote for the patient.
- Surgical fees – This amount is the difference between our fee and the MBS fee. Once again we offer very competitive rates.
- Surgical assistant – This amount is the difference between the private fee paid by most health funds and the MBS fee.
Our friendly staff can provide you with a quote to allow you to make a decision about self-funding your procedure in a private hospital.
All fees for consulting and operating are charged to Workcover at no extra cost to the patient.
All fees for consulting and operating are charged to DVA at no extra cost to the patient.
Public hospital procedures are at NO CHARGE as long as you have a Medicare card.
Consulting is at the same rate as mentioned above. Patients can claim it through their private funds. Some will reimburse most of this amount while others will not reimburse any consulting fees.
Operating is charged as per private health funds with a known GAP.
Consulting is charged at the same rate as mentioned above.
Operating is charged at private fund rates plus GAP.
Patients are given a quote prior to their procedure and payment is required prior to proceeding with surgery.
Payment for consultation fees is made on the day of consultation.
Payment of any out of pocket operating fees are made either prior to the procedure or on the first post-operative visit (see above).
We accept cash and major credit cards only.
We do not accept cheques, AMEX or Diners Club credit cards.