Billing and payment information
Our Anaesthetists work as individual practitioners and as such fees vary, with each Specialist Anaesthetist determining their own fee schedule.
The fee for your anaesthetic is separate from charges by any other doctors caring for you and separate to charges by the centre where the surgery was performed (e.g. the hospital or day surgery facility).
In most cases the fee for your anaesthetic 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 approximately 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 ($19.80) 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 can 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 – we do not require 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
When you have all this information, please contact us by phone or via our Contact Form.
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 inititial 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 before their anaesthetic.
You will be contacted prior to the procedure and payment is required at least 7 working days prior to surgery. If you are making payment using a personal cheque, please note that payment is required at least 14 days prior to surgery to allow sufficient time for the funds to be cleared.
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.