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Practice Billing

Consultation Fees

Initial Consultation

Medicare will refund some of this fee.

Follow-up Consultation

If you are being followed-up after surgery, a consultation fee is usually not charged.  Medicare will refund some of this fee otherwise.

Surgical Fees

Dr Sterling’s Fees

These depend on the type of operation you will be having done. Item numbers which Medicare use allow us to calculate costs. You will be given a full quote by Dr Sterling’s staff prior to surgery. If these are unclear or further explanation is required, please call our friendly staff.

The Assistant

The assistant is an essential part of any operation. Their fees are usually about 20% of the surgeons.

The Anaesthetist

The anaesthetist’s fees depends on the item numbers. A separate quote can be requested.

The Hospital

This is charged according to the number of days you are in hospital. It is calculated from midnight to midnight. A private hospital bed costs in the vicinity of $500-600 per day, depending on the hospital and the type of room.

The Operating Theatre

The cost of this varies according to the complexity of your operation and how long it takes.

Prostheses and implants

In orthopaedics, many operations use prostheses and implants, such as hip and knee replacements, plates and screws, and spinal rods.

Other costs

These may include medications, blood tests, x-rays and physiotherapy. Your doctor may ask another specialist to see you, especially if there are complications or health concerns. If you need to go to Intensive Care, there will be extra costs.

Can I get a quote?

Dr Sterling’s staff will provide you with an estimate of the proposed fee. In most cases it will be accurate but it may vary if something different or extra needs to be done at the time of surgery. The anaesthetist can also give you an estimate if you contact them and give them the item number or numbers.

What out-of-Pocket expenses should I expect?

If I have private insurance

There will be a gap between the fees that the surgeon, assistant and anaesthetist charge and the Medicare rebate. Some of this difference is covered by your private health insurance. Your insurance will cover the hospital bed, theatre fees, prostheses and implants, and may also cover some or all of the other costs.

If I do not have private insurance

Medicare will pay some of the fees that the surgeon, assistant and anaesthetist charge but there will be a gap to pay. You will have to pay the full cost of the hospital bed, theatre fee, prostheses and implants, and other costs.

How will I be charged and how should I pay?

The bills will come from different sources at different times:

  1. Booking fee
    The policy of this practice is to charge you a booking fee. This varies from procedure to procedure, and need to be paid at the time of booking your operation, in order to put your name on the operation list. Of course, the booking fee will be deducted from the surgeon’s fee.
  2. Surgeon fee
    This will be issued soon after the operation. In cases where gap-cover is used, it will be issued directly to your health fund, and in other cases it will be sent to you. If the bill is sent to you, there are two ways to deal with this. The first is to pay the bill to the doctor and then to take the invoice to Medicare to get the Medicare rebate back. If you have private insurance, you then take the invoice to the health fund to obtain a further rebate.
    Alternatively, you can take the bill to Medicare (and to your health fund if you have private insurance). Once you receive your Medicare cheque (and your health fund cheque if applicable), send these cheques together with the difference to the doctor.
  3. Assistant and Anaesthetist’s fee
    This will also be issued soon after the operation. This should be dealt with similarly to the surgeon’s bill.
  4. Hospital fee
    If you have an excess on your private health insurance policy, you will be required to pay this on admission. If you do not have private health insurance, you will be required to pay part or all of the anticipated hospital costs on admission. The remainder will have to be paid when you are discharged.