How do Accounts work?
Escalating health care costs is of major concern to us all. Anaesthetic costs covered by medical aids vary from scheme to scheme, and within a scheme between the different options. The level of cover and excess (co-payment or ‘gap’) is determined by your individual medical aid and plan option. This choice is yours as the consumer and it is important to remember that we have a contract with you, the patient, and not the medical aid. It is your responsibility to understand your medical aid benefits. It must be remembered that the medical aid societies have no right to decide what a doctor may charge for his professional services. They may decide what they will reimburse to their policy holder. We advise all patients to investigate getting Gap Cover to avoid a potential co-payment.
We, at Tyger Anaesthesia, endeavour to render top quality, cost effective and ethical anaesthesia without overburdening our patients financially.
Your anaesthetic fee is a separate account from your hospital and surgeon’s account. Your surgeon has chosen to work with us as they feel we offer the anaesthetic service that allows him/her to get the best possible surgical outcome for you.
This practice charges a private rate. This rate is in line with some of the largest medical aid schemes in the country. Our fees are viewed by most medical aids as reasonable.
You will personally be responsible for payment of your account if there is any shortfall in payment from your medical aid, or where your medical fails to pay for any reason. Our tariff is also linked to inflation.
If you have Gap Cover Insurance, our bill will be covered in full. We do however have payment arrangements with a few specific medical aid plans. In addition we have direct payment arrangements with some of the larger medical aids which avoids co-payments completely if you are a member.
Anaesthetic fees are a summation of the preoperative consultation and a time based procedure fee. Additional clinical modifiers may increase the fee as they place the anaesthetic in a higher risk category and require certain advanced components to be added. If your procedure is unplanned, or an emergency, it will attract an additional fee irrespective of the time of day.
The preoperative consultation is needed to assess your risk factors to enable planning of a safe, appropriate anaesthetic. Anaesthesiologist are forced to assess patients on the day of surgery (as most Medical Funders have blocked admission the night prior to major surgery) and in a limited time period prior to the commencement of the operating list. While the anaesthesiologist may only spend 5-10 minutes with you this time is used effectively to assess your recorded medical history, to perform an examination to exclude any anaesthetic risk factors and to plan the nature of the anaesthetic.
Anaesthetic cost estimation and Preoperative consultation
It is often difficult to discuss finances in a busy general ward. We advise you to contact us for an anaesthetic cost estimate no later than 2 days prior to your procedure.
We also offer a pre-admission consultation service for those high-risk cases that need investigations and medical management prior to the elective surgical procedure. This service has reduced the risk of cancellation of your booked procedure due to being medically unfit for an anaesthetic
Statements are mailed to patients every month.
All claims will be submitted electronically to medical aids registered at the QEDI system. It remains the patient’s responsibility to determine the amount payable by their medical aid, and whether payment will be made to the service provider or directly to the member.
Amounts outstanding for more than 120 days will be handed over to our debt collectors for collection, and the patient will be responsible for additional costs incurred.