Patient Responsibilities, Practice Fees & Billing Policy
CONSULTATION & PROCEDURE RATES
- Payment for the consultation must be made in full by the patient before leaving the practice.
- 10% DISCOUNT is given for early settlement of any co-payment or out-of-scheme portion of procedural fees settled within 30 days of being invoiced. These include operations & endoscopic procedures.
- Follow up appointments up until 6 weeks after surgery are not charged for unless it is for a complication e.g wound infection, fluid collection etc. or if it is for a new health issue, for which the 1st consultation fee will apply.
- Follow up appointments after gastroscopies, colonoscopies and other non-surgical procedures will be charged as follow-up consultations.
- When consulting about new surgical problems or 6 calendar months after the patient’s last appointment, the appointment will be charged at 1st consultation rate.
- During emergencies, weekends and after-hours hospitalization or consultations, emergency rates will apply. The billing will only be processed during business hours and is then sent to the medical aid. Should there be any outstanding amounts, this bill will be sent to the patient by the accounting bureau for payment by the patient.
- For long consultations or 3rd party consultations a surcharge is added to the standard rate. Should it be necessary to give telephonic feed-back or to discuss results, it will be charged accordingly.
- For procedures on medical aid patients the rates negotiated with the medical aid scheme will apply and be charged. The patient must obtain authorization from the medical aid. The bill will then be submitted to the medical aid by the practice, should there be any outstanding amount the patient remains liable for payment.
- For procedures on patients who are on a medical aid that the practice is not contracted to (see list 4.1) must obtain authorization from their medical aid. These patients or private “cash” patients will be provided with a cost estimate for approval for elective (pre-planned) procedures prior to undergoing any treatment in the practice or in hospital. This excludes emergencies/ weekends/ after-hour admissions which will be charged/submitted without a cost estimate and then processed during business hours.
within 6 weeks after surgery
(T & C’s below)
For scans, x-rays, bloods etc
If booked within 7 days of receiving results
FOLLOW UP CONSULTATIONS & TEST RESULTS
- Consultations of imaging results/ special investigations must be scheduled by the patient within 7 days of result receipt.
- All results of any investigations done must be obtained directly from the service provider, these can include:
- Radiological investigations
- X-rays; Ultrasounds; CT scans; MRI scans; PET scans; DISIDA scans
- Taken during endoscopic procedures, gastroscopies, colonoscopies, Endo-Echo ultrasounds, etc.
- Excisions of lesions in theatre or in rooms,
- Needle biopsies in theatre
- Resections and/or surgical removal of organs
- Surgical removal of gallbladder, appendix, lymph node, spleen etc.
- Surgical resection (partial removal) of liver, pancreas, bowel
- Radiological investigations
FOLLOW UP CONSULTATION FOR SURGICAL PROCEDURES
- Patients must book and attended the follow up appointment within six weeks of their surgical procedure.
- Endoscopic procedures, gastroscopy and colonoscopies are non-surgical procedures.
MEDICAL AID CONTRACTS
- This practice is contracted to the following medical aids:
- Discovery Classic plans
- Bonitas & Boncap
- The contract allows your bill to be processed more easily with the medical aid and no co-payment is to be expected because the practice adheres to their negotiated rates.
- Patients who belong to Medical Aid’s not listed above are billed 217% of standard Reference Price List (RPL) scheme rates. RPL values for services are available from the DOH or from the Health Professions Council of South Africa (doh.gov.za). The patient will be liable for the portion not covered by their scheme.
- The patient is responsible for authorisation and claiming from the medical aid and it remains the patient’s responsibility to read the medical aid’s terms and conditions, regarding;
- referral letters from referring medical practitioners;
- medical scheme exclusions;
- authorization numbers for specialist visits and procedures;
- short and co-payments for endoscopic and other procedures;
- The medical practice will provide the patient with the procedure & diagnostic ICD10 (International classification of disease code) to be able to request and receive the medical aid authorisation.
- All major credit & debit cards are accepted.
- No cheques will be accepted.
- Cash is not a preferred method of payment, please make arrangement with us if you have no other option.
- Should payments of outstanding amounts not be possible, a payment plan and written agreement must be concluded with the accounts department.
ACCOUNT DEPARTMENT CONTACT DETAILS
- Tel: 010 3126553, email: firstname.lastname@example.org
- Please do not hesitate to contact the them if you do not promptly receive an account from our practice. Late submission to my medical aid may result in your claim being rejected.
ANAESTHETIC FEE & ACCOUNT