Fees, Payments and Options
An Explanation of Fees
The standard fees charged by our rooms are in line with concept of 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. In certain situations, we also have a “known gap” arrangement with participating health funds which can help limit your out of pocket expenses.
If there is any problem, 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:
- Surgical Assistants
- Implants or Prosthesis
- Tests (Radiology, Pathology)
- Post-Operative Care
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 also if these benefits are applicable.
If you choose to be treated as a private patient, you will have access to all hospitals that our doctor is affiliated with. After discharge, your care will be followed up in their private rooms.
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
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 cover, some health funds also require you to pay an excess. 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 suggested 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/benefits-and-payments
Self Insured (Uninsured)
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
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, please contact our rooms
Non Reciprocal Health Care Agreement – 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 supervised by a Consultant 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 back to the rooms you originally came from.
In the public hospital, the surgery is usually performed by a Registrar or Fellow training in Urology. The senior surgeon overseeing the Registrar remains 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 be closely involved in your aftercare. All follow up appointments will be in my office.
Our reception staff will be happy to advise you of the consultation fee upon booking an appointment over the telephone. Payment on the day of consultation is required.
- Surgical fee schedule- please have your health fund details.
- Where out-of-pocket co-payments are required (which can vary depending on the type and complexity of surgery), patients will be advised before their surgery
- Fees for uninsured patients – please ask the Receptionist for a detailed schedule.
How to Pay?
For your convenience we accept a number of payment methods in the rooms, by post and online:
- Credit Card: VISA and Mastercard
- Electronic – EFTPOS
No Private Health Insurance
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 our practice and the staff will be happy to provide you with an accurate costing. A proportion of the surgical and anaesthetic fees may attract a rebate from Medicare.
If you require more information, please do not hesitate to call us on during office hours.
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