Your Anaesthetic Fee

I understand that costs for medical treatment are a source of anxiety for many patients. As such, I am transparent in providing a fee estimate and obtaining your financial consent prior to your procedure.

If you are an ‘emergency’ booking, this is not always possible.

 

How is my anaesthetic fee determined?

Private health insurance funds differ in the coverage and rebates they each provide. The rebate will usually not cover the full cost of your surgery, requiring you to pay a ‘gap’ or ‘out of pocket' expense.

The factors contributing to your out of pocket fee are:

  • Operation type and duration

  • Complexity of anaesthesia

  • Your specific medical conditions

  • Anaesthesia performed for emergency surgery, out of hours, or requiring callback from home

  • Medicare rebate for your procedure

  • Your private health insurance status

If your health fund allows ‘co-payments’ to be charged, this generally reduces ‘out of pocket’ costs for patients and simplifies account payments. Most funds offer this, with the exception of NIB.

Further information on how private health funds calculate their rebates can be found here and in this factsheet, which was developed by the Australian Society of Anaesthetists (ASA).

 

How will I receive a fee estimate?

Assuming your surgery is elective, my office will contact you prior to your procedure to provide a fee estimate. We will also provide you with an online link which asks for your consent, followed by instructions for payment.

Please contact us on (02) 9550 4866, should you have any questions.

You can also request an anaesthetic quote through the link above.

 

How will I be charged? 

The Australian Medical Association (AMA) publishes a range of suggested fees for services. The fees I charge are generally less than two-thirds of the suggested AMA rates. There is usually a gap (out of pocket expense) between the health fund rebate and the total fee for each procedure.

For elective surgery, I request payment prior to the admission date. There are three different types of invoice:

1. Co-payment or ‘known-gap’ funds (e.g. Medibank Private, HCF, BUPA, AHM, Teacher's Health, CBHS, Peoplecare, Westfund).

I have agreements with most health funds, which allow co-payments to be charged. NIB is an exception as it does not offer this agreement.

The co-payment is the portion of the account which is not covered by either Medicare or your Health Fund. This ‘out of pocket’ or ‘gap’ amount is paid prior to your surgery.

Having a ‘known gap’ fund is beneficial for your anaesthetic fee for 2 reasons:

  • In general, your rebate is higher and your anaesthetic gap fee lower;

  • I settle the rebate portion of your account directly with the insurer, thus avoiding the need for you to ‘chase’ your rebate.

2. Total fee (NIB or overseas insured)

This invoice is for the full anaesthetic fee, which you pay to my rooms prior to your surgery. After your procedure, we will send you an itemised receipt. You will then be able to claim your rebate from your health fund.

3. Medicare + Uninsured (Medicare but no private health insurance)

This invoice is for the full anaesthetic fee, which you pay to my rooms prior to your surgery.

After your procedure, we will send you an itemised receipt. You will then be able to claim your rebate from Medicare.

 

How do I pay?

My office at Macquarie Anaesthetic Group (02 9550 4866) will contact you via an sms/email weblink or by phone prior to you operation. Payment can be made via credit card (Visa or Mastercard), BPAY, bank transfer or phone.

For emergency surgery situations (or other situations where prepayment is not required), your account will be due 14 days after your surgery, using the same payment methods.