YOUR APPOINTMENT

Frequently Asked Questions

Informed financial consent is the dialogue undertaken between the surgeon (or their practice representative) and the patient so that the patient understand and consents to:

1. A estimated fee for a surgical procedure that will be performed by the surgeon

2. Potential costs of any equipment used, prostheses and devices inserted, used during the procedure (e.g. robot, mesh, laparoscopic energy devices etc)

3. Medicare rebates that apply to the surgery being performed by the surgeon (i.e. CMBS item numbers)

4. Potential variation in fees and costs that might arise if the planned surgical procedure is changed for clinical reasons

5. Any upfront or out-of-pocket costs (i.e. a "gap")

It is important that you as the patient understand the cost of your medical care in advance. This may not be possible if you need emergency surgery, especially when the exact nature and extent of the surgery is unknown. If it is not possible, your surgical team should provide the relevant financial information to you shortly afterwards.

Providing IFC to patients is sound ethical and professional business practice and is strongly endorsed by our governing bodies, the Royal Australasian College of Surgeons (RACS), and the Australian Medical Association (AMA).

It ensures that you, as the patient, are aware of any likely out of pocket costs. Finally, medical practitioners who provide services in association with the surgeon (e.g. Anaesthetist, perioperative medical physician) are responsible for providing IFC to their patients about any potential costs.

My doctor (GP or non GP-specialist) has recommended I see a surgeon about having an operation. What are my options? 

Your GP will give you a referral to see a surgeon. You have a choice to go to a public or private hospital. The quality of care is the same in both public and private hospitals. The difference is in waiting times, choice of date, choice of surgeon and how much you will pay out-of-pocket. 

Public hospitals are free and may have longer waiting times for appointments and surgery. You may see a different surgeon every time you visit. 

Private hospitals are not free and may have shorter waiting times. You will see the same surgeon of your choosing, every time. Your surgeon and the private hospital will provide you with information about the cost of your appointment and for any surgical procedures (Informed Financial Consent, IFC, see above). If you find the cost of surgery in a private hospital is too much for you, talk to your GP or surgeon. 

Both Dr. Stokes & Dr. Hammerschlag both work at a number of public hospitals and are happy to refer you to a public hospital that they work at for ongoing care under their supervision. 

Before you agree to have surgery as a private patient, you should know all the costs. Your surgeon should provide you with Informed Financial Consent (see above).

Medicare will help you to pay some of the cost of your surgery. If you have private health insurance, it can help you cover part of the cost of the surgery and the private hospital. 

Typically in Australia, in the private sector, surgeons usually bill the patient directly, setting fees above the Medicare Benefits Schedule (MBS) rate. 

Patients are then able to claim a rebate (money) back from Medicare and/or their private health insurer, to offset the costs. These fees may be fully covered, or partly covered by Medicare and your private health insurance. 

Each private health insurer is different, so you will need to contact your own private health insurer to find out whether your PHI will cover part, or all of the cost of your surgery. 

Your surgeon should let you know an estimate of how much your surgery will cost. Your health fund will tell you what they will pay for and how much they’ll pay, and if you must pay an excess when you go to hospital. You should always check with your health fund if your level of cover will pay for your surgery, prior to having the surgery as well as what "excess" your private health insurer will charge for an inpatient stay in hospital. 

Medicare helps Australians with the cost of healthcare and is paid by the Australian Government. It does not pay for all medical services. The Medicare Benefits Schedule (MBS) lists the services that will be covered and how much will be paid by the government. 

If your surgeon charges more than what Medicare and your health fund will pay for, you will have to pay the difference which is known as the ‘gap’ or an out-of-pocket cost. Dr. Stokes & Dr. Hammerschlag typically charge a "gap" that reflects the true cost of providing high quality specialist surgical care in the private health system. 

These ‘gaps’ happen because the amount Medicare and the private health funds will pay is not enough to cover the rising costs of running a private medical practice. Your private health insurer may offer to pay for the entire gap (known as the ‘no-gap’ scheme) or part of the gap (‘known-gap’ scheme, which is usually capped at $500 and is paid directly to your surgeon). 

There may be other doctors involved during your surgery, including an anaesthetist. They will charge a separate fee (which may be fully or partly covered by medicare and your private insurer). Our anaesthetists will contact you prior to your surgery to discuss their services and fees. 

There may be other costs involved with your stay in hospital, such as pathology, radiology scans and medications.