BILLING POLICY
- Prior to your anaesthesia you will be asked to read and sign a document that contains a quote and billing information. This quote is an estimate only and is inclusive of VAT.
- Please note that your Anaesthetic Fee is a separate account from your hospital and surgeon’s account.
- Each associate at AA determines the costs associated with the provision of anaesthetic services, by using the coding rules as determined by the South African Society of Anaesthesiologists (SASA) and the South African Medical Association (SAMA)
Tariff determination
- The anaesthetic fee is determined by the anaesthesiologist based on training, expertise, experience and practice costs and do not relate to any medical scheme rate. (Competition Commission ruling 2006).
The rates used to determine the fee (as required by the Consumer Protection Act) is applicable to all patients, irrespective of circumstances or medical aid membership. - The cost of an anaesthetic is dependent on time and procedure complexity. As it is impossible to predict how long a procedure will take, this makes estimating the cost of an anaesthetic extremely difficult –
If the procedure takes longer than the estimated time the cost will increase according to the duration of the procedure. - The cost estimate (quote) will as far as possible include additional costs for pain control, ultrasound, blood pressure control, invasive monitoring devices. Modifiers related to age, body region undergoing surgery, body position during anaesthesia might be added to the account. If deemed necessary costs eg. ICU admission, emergency surgery or cases not booked on routine lists (emergencies) will be added to bill.
- If your BMI (body mass index) is 35 or greater, you will be charged an additional 50% on the anaesthetic time unit fee.
To calculate BMI = weight(kg)/{height (m) x height (m)} - It is very important for you as a patient to understand that your medical aid will potentially not pay for your entire anaesthetic bill.
Your medical aid will reimburse you for your anaesthetic account at a rate based on the plan you have selected and the rules of your medical aid fund.
This can vary from 30% of the Anaesthetist Fee (most “100%” plans) to 100% of the Practice Fee.
You will be responsible for the shortfall. - GAP cover is a short-term insurance product designed to provide extra protection for those who already have medical aid. It covers the deficit/shortfall between what your specific medical scheme’s tariff and the actual rates charged by your anaesthesiologist.
Gap cover does pay for anaesthetic shortfalls, and we strongly recommend that patients investigate such insurance - Private paying patients are required to contact the practice for a quotation and make arrangements for payment.