Clinic Appointments
We have a standard consultation fee for both new and follow-up appointments. You will receive a medicare rebate for your appointment which we can process on your behalf. If additional procedures or biopsies are required an additional fee may be payable.
Surgical Fees
Generally, our fees are as recommended by the Australia Medical Association (AMA).
Before any surgical procedures, you will be given written informed financial consent. This will indicate the Medicare items that are relevant for your surgery. The more complex the surgery the more item numbers are used in the procedure. Medicare will reimburse the item number attracting the highest surgical fee fully. The second most expensive item number will be billed at half the listed fee and all further item numbers are billed at 25% of the original fee. The difference between Medicare reimbursement and the overall fee includes a portion covered by private health insurance and a gap fee. The gap fee is your out-of-pocket amount.
We can submit your claim for surgery payment to Medicare and your private health insurer on your behalf. Our practice does not generally participate in no-gap or known-gap schemes as often advocated by health funds, because it would not allow us to run a viable practice. As you can see in the graph below a gap fee is an essential requirement to run a practice.
Your Private health insurance provider
It is up to you and your family what health fund you choose. Some people choose a health fund that requires payments of small premiums only and these health insurance types sometimes require higher gap fees. By contrast, other patients pay higher premiums attracting no or smaller gap payments. I recommend you check with your health fund that the proposed item numbers are covered by your fund prior to surgery. These numbers will be itemised on your fee estimate.
Can I switch health funds immediately prior to surgery?
When you are out of your waiting period you can switch health funds even the day before your surgery to obtain a better deal. However, you can only switch to similar health insurance products.