Patient Responsibilities, Practice Fees & Billing Policy
CONSULTATION & PROCEDURE RATES
- Consultation payment must be made in full by patient before leaving practice.
- Receive 5% DISCOUNT for early settlement of co-payment or out-of-scheme portion of procedural fees include operations & endoscopic procedures, settled within 30 days of being invoiced.
- 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 gastro-/colonoscopies & other non-surgical procedures are 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 hospitalisation or consultations, emergency rates will apply. The billing will only be processed during business hours and is then sent to medical. 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 authorisation from medical aid. The bill will then be submitted to the medical aid by practice, should there be any outstanding amount the patient remains liable for payment.
- For procedures on patients who are on medical aid that the practice is not contracted to (see list below), patients must obtain authorisation 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. - Second Repeat prescription will be charged for.
- PAYMENT METHODS include all major credit & debit cards are
accepted. Cash is accepted, please do make arrangement with
us if it is a large amount. No cheques are accepted.
| 1st consultation | R1200 |
Follow-up consultation within 6 weeks after surgery | No charge (T & C’s apply) |
Follow-up consultation For scans, x-rays, bloods etc | No charge If booked within 7 days of receiving results |
| Follow-up consultation | R700 (T & C’s apply) |
OUR EXTERNAL ACCOUNT DEPARTMENT:
Maritza
Tel: 010 012 6896
Email: account5@qlpp.co.za
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.
MEDICAL AID & FEES
THE PRACTICE IS CONTRACTED WITH THESE MEDICAL AIDS
BANKMED / BESTMED / BONITAS
DISCOVERY CLASSIC / FEDHEALTH
GEMS / KEYHEALTH / MOMENTUM
MEDIHELP NETCARE / POLMED
The patient is responsible for authorisation/ claiming from their chosen medical aid and for reading their medical aid’s T&C’s regarding;
- referral letters from referring medical practitioners;
- medical scheme exclusions & penalties;
- authorisation numbers for specialist visits & procedures;
- short & co-payments for endoscopic & other procedures;
- 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 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.
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
- Biopsies
- 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.
ANAESTHETIC FEE & ACCOUNT
- This is separate from your hospital & surgeon’s account.
For more info kindly contact their account
Eloize
Tel: 012 333 5950
Email: Eloize.mac01@gmail.com