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Fees and Charges

Please note: The fees charged by the doctors within the Spring Hill Specialist Group are set by each individual doctor and are not listed here as they are adjusted in line with increases in the Medicare Benefits Schedule of Fees.

Consultations

We allow 30 minutes for a new patient consultation and 15 minutes for a review or post-op.  You must have a current referral, even for your post-op appointment.  Referrals from specialists are current for 3 months, and from GPs are current for 12 months, although an “Indefinite Referral” may be obtained from your GP and this will cover your total course of treatment.  We recommend this for patients who will be requiring ongoing review for a number of years. 

There may be a charge for your post-op appointment, as Medicare does not routinely include aftercare for all operations and procedures. 

Payment for your consultation is required at the time of your appointment.  We accept Visa, Mastercard, Eftpos or Cash. 

  • DVA patients will have their accounts sent directly to Department of Veteran’s Affairs.
  • WorkCover patients must have written approval prior to their consultation and be able to supply us with their WorkCover reference number.  If these are not available, you will be required pay for your consultation and then claim from WorkCover.  Any surgery offered will be subject to written approval by WorkCover.  These same guidelines apply to those employers who participate in their own workers’ compensation scheme. 

 

Inpatient Services:

Our doctors are not “No Gap” doctors so there will be an out of pocket expense for your inpatient services.  The fees we charge are set at a fair and reasonable level that enables us to offer you quality care.  The cost of providing good medical care is rising, but the Government’s contribution is falling away.  Your Heath Fund and Medicare are there to assist with payments towards your medical bills but will not cover the full costs of your care. 

Medicare makes no contribution to your hospital fees, but does contribute 75% of the Schedule Fee towards the doctor’s inpatient services fees.  (All our doctors currently charge less than the fee recommended by the Australian Medical Association but higher than the Medicare Schedule Fee).  The purpose of your Private Health Insurance is to cover the total cost of your hospital fees (subject to payment of the excess first, and also subject to you having a suitable level of cover).

Where possible we will provide you with an estimate of the doctor’s fee for your surgery prior to you going in to hospital.  This is not always possible when surgery is urgent (after hours, weekends, etc.) or booked at very short notice.  If you have any queries relating to your Estimate of Fees, please contact our Practice Manager prior to your admission and discuss your concerns.

 

ALL SURGERY FEES ARE PAYABLE SEVEN DAYS PRIOR TO YOUR ADMISSION.  Payments can be made by Eftpos, Visa, Mastercard, Cheque, Bank Cheque/Money Order, Cash or Direct Debit.

Payment Plan:

If you are experiencing financial difficulty, we would be happy to offer you our payment plan that may be of assistance. 

  • A deposit of 25% of the total outstanding is required within fourteen (14) days of the date of the agreement being forwarded to you.  Failure to pay this deposit will indicate you do not wish to participate in the payment plan offered.  Your Medicare and Health Fund rebate cheques can be accepted as deposit.  However they take approximately 4-6 weeks to process an unpaid account and this may be outside our requirements for your deposit. 
  • A minimum monthly payment thereafter of $200 per month until the debt has been fully paid. 
  • Credit card details are required to be lodged with this office.  Your card will be charged on the 1st day of each month (or the working day following) until the outstanding amount is fully paid.  A receipt showing the payment made and the balance outstanding will be issued with each payment. 
  • You may take your receipt to Medicare and your Health Fund for processing at any time.   However, if you do this before the account is settled in full, the cheques will be made out to the doctor and not yourself, even if you have paid over and above the amount to be rebated.

Health Funds

The health funds fall into two categories – the No Gap Funds and the Known Gap Funds.  The No Gap Funds will rebate only the Medicare Schedule Fee whereas the Known Gap Funds rebate the Medicare Schedule Fee plus an extra 30-40%. This reduces your out of pocket considerably.  (Refer to the example in the table below).

Fund Cost of Procedure Total Rebate Out of Pocket
No Gap Funds $1300 $740 $560
Known Gap Funds $1300 $1010 $290

* The No Gap funds include HCF, NIB, GMHBA, St Luke’s.  We cannot bill these health funds directly and so require the total cost of the procedure paid in full prior to your surgery. 

** The Known Gap Funds include Bupa, Medibank Private, AHM, and all funds covered by AHSA (Australian Health Service Alliance), approximately 25 funds currently.  These funds permit us to bill them directly, and so you need pay the out of pocket only prior to surgery.

Explanation of Fees, Terminology, Payment

Medicare Benefits Schedule – A list of all medical and surgical procedures compiled by the Government.  Each procedure or operation has its own number (the Item Number), and also its own fee (Medicare Schedule Fee).

Medicare Schedule Fee – The amount the government has set that Medicare will contribute towards the total cost of your medical care. 

Medicare Rebate – This is the amount Medicare will give back to you.  You will receive 75% of the schedule fee for inpatient services (that is, all services performed in hospital) and 85% of the schedule fee for all outpatient services (provided in the doctor’s rooms).  Your private health insurance will pay the 25% difference for inpatient services, but they make no contribution towards outpatient services. 

AMA FeeThe fee that is recommended by the Australian Medical Association (AMA) that doctors should charge.  This fee has been adjusted each year since 1985 (when the Government introduced the Medicare Benefits Schedule) to keep abreast of inflation.  Unfortunately the Schedule Fee has not been adjusted correspondingly.