All Doctors set their own fees for private medical services
The Medicare Benefits Schedule (MBS) is the list of services and the dollar amounts that are subsided by the Australian Government through Medicare.
The Australian Medical Association prepares a guide of medical fees for private patients that is based off the MBS and incorporate costs such as medical Indemnity, staff wages and inflation.
Private Health Funds also use the Medicare Benefits Schedule as a base rate to calculate the private fund rebates.
Private Hospitals are funded by private health fund rebates and patient contributions
It is important to note that all health funds pay will rebates according to their own schedules calculated using the base rate of the Medicare Benefits Schedule
Dr Gill’s elective surgery fees are based on a percentage of the AMA fee.
The amount the health fund will rebate for the procedure varies between different funds.
The difference between the quoted fee and the amount the health fund will rebate is called the “out of pocket” cost.
There will an out of pocket fee for most procedures.
Your Anesthetist will also provide you with an estimate of fees that may also incur an out of pocket expense
You may have an “Excess” to pay to your Health fund depending on your level of cover.
Informed Financial Consent
Our staff provide a written quote for the procedure at the time of booking.
Your health fund will be able to provide the amount they will rebate for the procedure.
Uninsured Patients
Dr Gill has maintained his appointment to the Hunter Area Health service for over 19 years and continues to provide the people of Newcastle a high quality of care in both Orthopaedic Trauma and Elective surgery via the NSW public health service.
Australian residents who choose to be a public patient are entitled to free treatment under Medicare. Waiting times for treatment are currently in excess of 12 months. After discharge, your care will either be continued in an outpatient clinic or you will be referred to your local general practitioner.
Your GP can send a referral directly to Hunter New England Area Health Service.
Private Health Fund Members
The private system can offer patients more options, including reduced waiting times, scheduling flexibility and the doctor of your choice.
We appreciate that you have elected to join a Private Health Fund and are very happy to assist you to obtain the best outcome from using your Private Health Insurance.
You will be provided with a written quote for the surgical procedure at the time of booking.
The amount the health fund will rebate for the procedure varies between different funds. The difference between the quoted fee and the amount the health fund will rebate is called the “out of pocket” cost.
Depending on your level of cover, some fund policies may also require you to pay an excess on admission to a private hospital.
Not all funds and policies are equal and we would strongly suggest that if you are unhappy with the rebates from your health fund that you be aware of your right to change funds without being subjected to further waiting periods. As long as you are changing to an equal level of cover, further waiting periods will not apply.
Private Health Insurance Ombudsman, Ten Golden Rules for Private Health Insurance