Fees, Payments and Options

Overview

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
  • Payment Policy
  • No Private Health Insurance

Initial Consultation

The initial consultation will incur a fee. A quotation of of this fee can 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. The Medicare rebate can also be claimed at the time of the consultation.

As we are a busy practice, if a consultation appointment is cancelled without notice, you may be asked to pay the full amount at the time if rebooking.

An Explanation of Fees

The standard fees charged by our rooms are generally in line with the Australian Medical Association recommended fee schedule. This means that in most instances there will be a ‘gap’ between our surgical fee and what is covered by Medicare and your health insurance fund.

If there is any problem with this it is important that you ask about this gap. 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:

  • Hospital
  • Surgical Assistants
  • Implants or Prosthesis
  • Anaesthetics
  • Tests (Radiology, Pathology)
  • Postoperative Care

Estimates

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 a if benefits are applicable.

Private Patients

Overview

If you have private health insurance that covers the types of procedures we perform, then your health fund excess if there is any is payable prior to the day of the procedure.

If you choose to be treated as a private patient, you will be treated at hospitals that Mr Crosthwaite is affiliated to or is a visiting medical specialist. After discharge, your care will be carried out in in Mr Crosthwaite’s private rooms.

Types of Private Patients

This practice caters for a range of Private patients, these include:

  • Private Health Insured
  • Department of Veterans Affairs (DVA)
  • WorkCover
  • Self Insured (Uninsured)
  • Overseas Patients

Private Health Insurance - No Gap Policy

Private Health Insurance allows you and your family to access the right health services at the right time. You have control of your health care 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 cover, some health funds also require you to pay an excess. We are not responsible for these costs but 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: www.dva.gov.au/benefits-and-payments

Workcover

Arrangements between our practice and the state government insurance regulator covers patients involved in workplace and motor vehicle accidents.

Self Insured (Uninsured)

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)
  • Surgically implanted prostheses
  • 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 Mr Crosthwaite’s office.

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 Fees

Payment Options

Overview

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 can be emailed to you for your convenience upon booking an appointment.

  • Surgical fees are billed directly to the Health Insurance Providers.
  • Where out-of pocket co-payment are 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 staff upon request.

Payment on the day of consultation is expected.

How to Pay?

For your convenience we accept a number of payment methods in the rooms, by post and online:

  • Cash
  • Credit Card: VISA, Mastercard, (logos),
  • Electronic other - (Credit Card, EFTPOS, BPay)

Other Payment Choices

  • Medical Finance
  • Early Release of Superannuation
  • Tax Rebate Scheme

Medical Finance Options

There are various finance firms that specialise in finance for medical procedures. Mr Crosthwaite does not have an affiliation with any particular firms.

Early Release of Superannuation

Patients may apply to Centrelink for an early release of superannuation funds to cover part or all of the costs involved. More details can be found on the Centrelink website.

If you chose to apply for this, three documents need to be lodged:

  • Completed application form - click here to download
  • A letter of support from your General Practitioner
  • A letter of support from our clinic (we will provide this after your initial consultation). Please note that processing time by Centrelink generally takes around 3 weeks, and allow a further 4-6 weeks for your superannuation fund to release the funds to your personal bank account.

No Private Health Insurance

If you are not in a Private Health Fund or DVA and you need surgery by Mr Crosthwaite , you have two alternatives:/p>

  • Take out private health insurance and wait for one year to meet the eligibility requirements or
  • Pay for the operation yourself ("Self Insure")

Self Insured

An increasing number of people are choosing to "Self Insure" or pay for their own surgery, so they don't have to wait. This is often a worthwhile investment as it means you can have your operation done straight away or whenever it suits you. This can allow you to get back to your work and sport as soon as possible.

The costs may not be as high as you think and you can ask for a quote.

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.

A proportion of my fees and the anaesthetic fees attract a small rebate from Medicare.

If you require more information, please do not hesitate to call us on during office hours.

  • Obesity Surgery Society of Australia & New Zeland
  • The International Society for Diseases of the Esophagus
  •  Australia &New Zeland Gastric & Oesophageal Surgery Association
  • The Centre For Bariatric Surgery
  • OSSAN
  • Epworth Healthcare
  • Fellow of the Royal Australian College of Surgeons
  • The Royal Melbourne