Fees and Payment Options
This page outlines our explanation for patients’ payment options depending on their circumstances. The page covers the following explanations and payment options:
- Explanation of Fees
- Private Patients
- Public vs Private
- Dept of Vet Affairs
- Workers Compensation
- Payment Policy
- No Private Health Insurance
The initial consultation will incur a fee.
A quotation of this fee will be given at the time of your booking. This fee is payable at time of appointment and a receipt given for claiming back your Medicare rebate.
An Explanation of Fees
For our weight loss surgery, there will be a standardised ‘gap’ between our surgical fee and what is covered by Medicare and your health insurance fund. It is important that you ask about this gap as it is applicable in most instances for our bariatric surgery.
For revisional weight loss surgery (in patients who have had previous weight loss surgery), there will be a different ‘gap’ charge to the standardised ‘gap’ as it is technically more challenging to perform. However, there may be no out of pocket expenses charged by our surgeon if your initial weight loss surgery was performed with Melbourne Weight Loss Centre.
For endoscopy and most general surgery procedures, there will be no gap charged by the surgeon.
Our staff are fully informed with charges and rebates and will be able to help you navigate through what can be a complex process. These fee explanations can cover:
- Consulting Fee
- Surgical Fee
- Treatment Estimates
If you require more information, please do not hesitate to call the practice during office hours.
Other Possible Disbursements
There may be other charges involved in your care depending on which course of action you choose. You need to also check with your health fund to see what is covered for additional areas of service.
Potential areas of cover are:
- Surgical Assistants
- Implants or Prosthesis
- Tests (Radiology, Pathology)
- Postoperative Care
We offer informed financial consent to all our patients prior to surgery. This is a pre-treatment estimate of your surgical costs. This estimate enables you to discuss with your health insurance company what you are covered for and if benefits are applicable.
If you have private health insurance that covers the types of procedures we perform, then your health fund excess is payable on the day of the procedure.
If you choose to be treated as a private patient, you will be treated at hospitals that our doctor is affiliated with or is a visiting medical specialist.
After discharge, your follow-up care will be carried out in the private rooms and then you will be referred back to the care of your local general practitioner when suitable to do so.
Types of Private Patients
This practice caters for a range of Private patients, these include:
- Private Health Insured
- Department of Veterans Affairs (DVA)
- Self-Insured (Uninsured)
- Overseas Patients
Private Health Insurance
Private Health Insurance allows you and your family to access the right health services at the right time. You have control of your healthcare and can choose the provider, facility and timing of your treatment. With the security and protection of private health insurance, you have access to an extensive range of private hospitals and can rest assured that your health is in good hands.
Depending on your level of private health cover, some health funds also require you to pay an excess. For Procedural Items typically there is a Gap payment required
You are responsible for these costs and our staff will do their utmost to guide you to better understanding.
Our practice accepts most private health insurance programs. Our staff can also help with your claim for benefits, but we remind you that your specific policy is an agreement between you and your insurance company.
Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated.
Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with the AMA fee schedule.
You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.
Department of Veterans Affairs (DVA)
The Australian Government’s Department of Veterans' Affairs (DVA) provides support to current and former serving members and their families through a range of benefits (including ongoing or one-off payments). For further understanding on how you can apply these benefits to our service and the scope of cover please refer to http://www.dva.gov.au/benefits-and-payments
Arrangements between your employer and the state government insurance regulator cover patients involved in workplace accidents.
These state-specific arrangements are designed to ensure that workers have priority access to surgeons and other benefits.
Please make sure that you can provide evidence that you have successfully lodged your claim with Workcover to ensure that you are appropriately covered for the health services you require.
If you are self-funded (no private health insurance), the full hospital fee is payable on admission.
Patients may be able to choose private admission even if they do not have private health insurance.
Self-funded patients will be liable to pay the following:
- The gap between the Medicare benefit and any specialist's charge
- The gap for diagnostic services (medical imaging and laboratory), however some of these services may be bulk billed to Medicare, that is no ‘gap’
- Hospital accommodation fees (bed charge)
- Use of surgical equipment, consumables, inpatient medication, theatres and other charges whilst in hospital
Essentially this means you must meet all costs of the admission yourself except those covered by Medicare.
For further information about being a private patient, contact our rooms
Overseas Patients with Non-Reciprocal Agreement
If you are an overseas visitor, you will be required to pay the full hospital fee on admission.
If you are an overseas patient from a country where there is no Reciprocal Health Care Agreement, you are not eligible for Medicare and you are responsible for payment of all fees and services.
Non-Medicare patients are billed for inpatient and outpatient services regardless if they choose public or private admission.
Reciprocal Health Care Agreement - If you are a visitor from a country where Australia does have a Reciprocal Health Care Agreement (RHCA), you may be eligible for treatment that is deemed immediately necessary for any health problem or injury whilst in Australia.
RHCA does not cover pre-arranged or elective treatment. Overseas patients who are covered by the RHCA will not be covered if they choose private admission.
Please contact us for more information.
Private vs Public Fees
You may choose to be a public or a private patient. This page provides patients with the different options are for surgery in the private or public hospital system.
Public Hospital Patients:
Australian residents who decide to be a public patient are entitled to free treatment under Medicare. Your treatment will be carried out by an appropriate specialist which will be arranged prior to your admission. After discharge, your care will either be continued in an outpatient clinic or you will be referred to your local general practitioner.
In a public hospital, the surgery is usually performed by a registrar (surgical doctor in training) but the registrar is supervised by a senior surgeon who is responsible for your care.
There are no fees for surgery in the public hospital, however, there is a waiting list. Your position on the waiting list will be based on the severity of your condition. Follow up visits after surgery will be arranged through the hospital.
Private Hospital Treatment:
In the private health system, I will perform your surgery personally and will also look after you if you are admitted as an in-patient. All follow up appointments will be in my office.
Our reception staff will be happy to advise you of the consultation fee upon booking an appointment over the telephone. Fees for consultation along with other necessary forms will also be emailed to you for your convenience upon booking an appointment.
- Consultation and Surgical fees are billed directly through to Medicare, but you will be required to claim back payment from your private health insurer
- Where out-of-pocket co-payment is required which can vary depending on the type and complexity of surgery or procedure. Patients will be advised, in writing, after the consultation, the amount of gap payment.
- Fees for uninsured patients are advised by the accounts manager upon request.
Payment on the day of consultation is much appreciated.
For your convenience we accept a number of payment methods in the rooms:
- Credit Card: VISA, Mastercard (No AMEX)
- Electronic other - (BPay)
Other Payment Choices
- Medical Finance
- Early Release of Superannuation
- Tax Rebate Scheme
No Private Health Insurance
If you are not in a Private Health Fund or DVA and you need surgery, you have three alternatives:
- Go on a Waiting List at the Public Hospital, or
- Pay for the operation and other related hospital costs yourself
- Access your super to fund for your obesity surgery (this requires an application for Early Release of Superannuation which we can help you with)
However, the Waiting List for operations in the Public system is considerable. It is currently upwards of 5 years for bariatric surgery in Victoria and upto 12 months for many of the benign conditions in General Surgery. Patients are admitted to hospital based on the urgency of their condition as well as a "first come, first served" basis.
An increasing number of people are choosing to "Self Insure" or pay for their own surgery, so they don't have to wait. Whilst this can be a worthwhile investment as it means you can have your operation done quicker or whenever it suits you, it is generally not recommended for most bariatric procedures (with exceptions in a small minority of cases).
However, the costs may not be as high as you think for certain (non-bariatric) procedures.
All the private hospital fees associated with your surgery are an out-of-pocket expense, but we will assist you in obtaining an estimate of costs from the private hospital before you go ahead with your surgical procedure.
Call the practice and they will be happy to provide you with accurate costing. If you require more information, please do not hesitate to call us on during office hours.