Effective 02/03/2022
Southern Medical Solutions strives to ensure a clear understanding of your financial responsibility with respect to the medical services we provide. These policies apply to all procedures and departments.
Our Anaesthetists work as individual practitioners and as such fees vary, with each Anaesthetist determining their own fee schedule.
Your anaesthetic fee is separate charge to those by any other doctor caring for you and separate to charges by the hospital or day surgery where the surgery is performed.
In some cases your anaesthetic fee will be higher than the rebate available from Medicare and your health fund. The difference between the combined rebate from Medicare and the health fund, and the total fee charged by your Anaesthetist is called ‘the gap’. This is the part of the fee that you will be required to pay yourself, sometimes also referred to as your ‘out-of-pocket expense’. Out of pocket expenses have risen because the Commonwealth Government has not indexed Medicare rebates adequately for the last 25 years.
The rebates that you receive from Medicare and your Health Fund represent up to 30% of the anaesthetic fee recommended by the Australian Medical Association. The amount that these rebates contribute to your bill will vary depending on the nature and duration of your surgery, the rebate policy of your health fund and your Anaesthetist’s billing policy. In most cases the rebate contribution from your health fund will be greater than the Commonwealth Medical Benefits Schedule (CMBS) which is the base amount Medicare and your health fund are required by law to pay to their members. The CMBS rebates for anaesthesia are the lowest for any medical specialist group.
Your anaesthetic fee may be derived from the CMBS or Relative Value Guide. The CMBS reflects the amount the government is prepared to reimburse people for medical services. All Australian citizens are reimbursed up to 75% of the CMBS unit value for anaesthesia services in private hospitals. Health insurance funds usually cover the other 25% but this generally still leaves a gap. Some insurance funds cover part of this gap but the amount varies depending on the fund.
Estimates
Estimates may be given for your operation which will include your out of pocket expenses. To provide you with the most accurate estimate possible, we need the following information. Please ask your Surgeon for the following details:
- The name of the operation and surgical item numbers
- An estimate of the length of surgical time
- The name of your health fund and if your level of cover includes hospital cover
It is important for patients to understand that a significant portion of their anaesthetic fee is based on how long your procedure actually takes. Although every effort is made to provide an accurate estimate of your surgery time, often the actual time required for your surgery differs from the estimate. Therefore, your final anaesthetic fee may differ from the initial estimate provided.
Australian citizens without private hospital insurance and all overseas patients are required to make full payment for their anaesthetic prior to the procedure.
Patients Undergoing Cosmetic Surgery
Patients undergoing cosmetic surgery are required to pay the full fee prior to their surgery. They will be contacted prior to the procedure to arrange payment.
Please note that although every effort is made to provide an accurate estimate, based on the above variables, the final account may differ to your prepayment and therefore an additional payment may be required.
Billing
Private accounts: Where possible we will electronically submit to both your health fund and Medicare for the maximum rebate that can be claimed. At the same time we will send you an invoice detailing the amount claimed on your behalf and also the out of pocket expenses that are your sole responsibility.
Workers’ Compensation and Motor Vehicle claims: Accounts for anaesthetic services will be sent directly to the relevant insurance company.
Veterans’ Affairs patients: Accounts for anaesthetic services for Veterans’ Affairs patients will be sent directly to the Department of Veterans’ Affairs.
Co-payment: Sometimes you will be require to pay a contribution towards your surgery, this is called a co-payment or known gap, this is your or out of pocket expense and is not claimable and the rest we will claim on your behalf to your fund and Medicare, provided you are covered there should be no more to pay, however in the event that your Health fund has rejected your claim then a further bill will be sent.
Overdue accounts
Southern Medical Solutions will send patients accounts to collections for balances not paid after receipt of two statements.
Any accounts sent for debt collection will incur the below additional fees on top of the original account:
- Accounts up to 12 Months old – 20% – 50% depending on value of invoice
- Accounts over 12 months old – flat rate of 60% of value of invoice
Payments
Unless other wise advised your anaesthetic fees are payable prior to your surgery.
For your convenience various payment methods are available and are listed below. These will also be listed on the text message you have received regarding your payment.
- Credit Card: We accept Mastercard or Visa, which can be made via this website or call us to make a payment over the phone.
- Direct Debit: please call the office to obtain bank details.
- Bank cheques, personal cheques: Personal cheques are not acceptable as prepayments for anaesthetic services unless sufficient time is available for these cheques to be banked and the funds cleared (at least 14 days prior to the surgery date).
Post Operation Accounts
If you have been advised that you will receive a post op account for your fees, then this will need to be paid with 7 days of the account being sent. Payments not made after 14 days will incur a late payment fee.
Late Fees
Accounts that are overdue will incur a late fee of $5.00 for every 14 days where the account has not been paid.
Please note: We will send a receipt to you for all payments made to your Anaesthetist approx. 2 weeks after your surgery date.