All fees for surgical procedures are based on rates set by the Australian Medical Association (AMA). Our practice adopts a “gap” surgical policy.
What is a gap? A gap is the difference between the combined amount paid by Medicare and your private health fund for a medical service and your doctors’ fees.
The payment process for this practice is that full payment of the fee estimate is required two weeks prior to your surgery date. This payment will confirm your booking and a receipt will be forwarded to you. Once the surgery has taken place an invoice will be issued, this invoice reflects the actual work done on the day. In some instances this invoice may differ from the fee estimate, the difference will need to be settled with the practice, this may either be an additional payment by you or a refund from us. The itemised invoice can then be forwarded to you for you to obtain your refund from Medicare and your health fund.
For some procedures and certain health funds the Practice may offer a known gap arrangement. In a known gap arrangement your health fund will pay a higher amount and the gap will be less. If your health fund and procedure fulfill our criteria and a known gap is offered, an invoice for surgery, (actual fee less known gap), will be sent directly to the health fund after your surgery. In this instance only the known gap amount and not the full fee estimate will be required to be paid two weeks prior to your surgery date.
You may also have an out of pocket expense for your anesthetic and hospital charges. We will provide you with the name and contact number for the anesthetist that will be involved in your surgery. If you do not receive a fee estimate from the anesthetist and hospital we suggest you contact them.
We highly recommend that you contact your private health fund to find out what level of cover you have and which items are covered prior to your surgery.