Fee structure
Patients who are booked for elective surgery should receive an estimate of fees in advance. Note that this is not always possible with emergency operations and labour epidurals. (see section on anaesthetic and informed financial consent on labour epidurals and Caesarean section anaesthetics)
My fees are separate to the fees charged by the surgeon and the hospital. In most cases there will be an out of pocket expense (gap) required.
Anaesthetic fees are calculated predominantly by the type and length of procedure. This gives rise to a unit allocation which is based on a Relative Value Guide published by the Australian Society of Anaesthetists (ASA). The final fee is determined by a combination of the number of units for the procedure and the unit value. This unit value varies from anaesthetist to anaesthetist. The amount I charge per unit is discounted by 1/3 from the ASA recommended unit value.
The amount reimbursed to you by your health fund will depend on which fund you belong to.
There are 2 groups of funds.
1. Medibank Private, BUPA, HCF, NIB, Australian Unity and over 40 Australian Health Service Alliance funds. These funds cover more than 2/3 of the anaesthetic fee (including Medicare rebate) with their 'known gap' facility.
2. La Trobe. This fund pays a lower benefit.
Where possible, I will bill Medicare and the private health fund directly for their contribution.
Do I 'no-gap' patients?
Special groups of patients who I often do not charge a gap to include (but not exclusive to)
- fellow medical practitioners
- Workcover patients
- TAC patients
- DVA patients
- aged pensioners (dependent on which health fund)
Certain categories of patients will also need to prepay their anaesthetic fees, although the final bill may vary depending on the actual anaesthetic carried out on the day. You will get a prepayment notice if you are :
- uninsured
- from overseas
- undergoing a cosmetic procedure
My fees are separate to the fees charged by the surgeon and the hospital. In most cases there will be an out of pocket expense (gap) required.
Anaesthetic fees are calculated predominantly by the type and length of procedure. This gives rise to a unit allocation which is based on a Relative Value Guide published by the Australian Society of Anaesthetists (ASA). The final fee is determined by a combination of the number of units for the procedure and the unit value. This unit value varies from anaesthetist to anaesthetist. The amount I charge per unit is discounted by 1/3 from the ASA recommended unit value.
The amount reimbursed to you by your health fund will depend on which fund you belong to.
There are 2 groups of funds.
1. Medibank Private, BUPA, HCF, NIB, Australian Unity and over 40 Australian Health Service Alliance funds. These funds cover more than 2/3 of the anaesthetic fee (including Medicare rebate) with their 'known gap' facility.
2. La Trobe. This fund pays a lower benefit.
Where possible, I will bill Medicare and the private health fund directly for their contribution.
Do I 'no-gap' patients?
Special groups of patients who I often do not charge a gap to include (but not exclusive to)
- fellow medical practitioners
- Workcover patients
- TAC patients
- DVA patients
- aged pensioners (dependent on which health fund)
Certain categories of patients will also need to prepay their anaesthetic fees, although the final bill may vary depending on the actual anaesthetic carried out on the day. You will get a prepayment notice if you are :
- uninsured
- from overseas
- undergoing a cosmetic procedure