--- title: "Anaesthetic Fees" slug: "fees" description: "Information about anaesthetic fees, gap payments, fee estimates, account types, and payment methods at Anaesthetic Services." eyebrow: "Anaesthetic fees" heroH1: "Understanding your anaesthetic fees." heroLede: "How anaesthetic fees are calculated, why a gap may exist between health-fund rebates and the anaesthetist's fee, and how to request an estimate before your procedure." --- The information below covers commonly asked questions about anaesthetic fees. If you have a question that is not covered here, please [contact us](/contact) and we will endeavour to clarify your situation. ## How are anaesthetic fees calculated? When an anaesthetist provides a service to a patient, they are not doing this in the role of an employee of the hospital or the surgeon. The fees paid to an anaesthetist are paid by the patient, usually in conjunction with their insurance provider. Each anaesthetist is an independent practitioner, and calculates their own fees independently of other anaesthetists, which is the reason why patients may receive different charges for different operations, or for the same operation by different anaesthetists. The Australian Medical Association (AMA) and Australian Society of Anaesthetists (ASA) prepare a list of medical services and fees for private patient anaesthesia services, and index this each year. Most anaesthetists base their charges on this indexed list of services. Fees for anaesthetic interventions vary depending on many different factors, including the time and nature of the pre-anaesthetic assessment, the complexity of the operation, and the time that the operation takes. Additional fees may apply for patients who are more complex, more frail, or for whom the operation is performed as an emergency or “out of hours”. The anaesthetist is present during the entire operation, and their role is not constrained to the start and end of the procedure. They make decisions while the patient is anaesthetised in order to keep the patient safe at all times. ## Why is there a “gap” between health fund rebates and the anaesthetist’s fee? It is not uncommon for the rebates provided by Medicare and the private health funds to fall short of the total fee charged by the anaesthetist. The difference between these fees causes a “gap”, and is an out-of-pocket expense that is met by the patient. There are a variety of reasons why this gap has grown over the past few decades, but the major reason is inadequate indexation of the Medicare (and consequently health fund) rebates over a prolonged period of time. Many anaesthetists will offer discounted fees in order to reduce the out-of-pocket expenses for Australian government pensioners. Please discuss this with our rooms if you feel that you are eligible for consideration. Where possible, anaesthetists will endeavour to reduce your fees by using the “known gap” provisions of health funds when applicable. The different policies of health funds and their rebates can mean substantial differences in patient fees for the same operation and the same anaesthetic fee. If you are to be charged an out-of-pocket expense, a member of our staff will attempt to contact you prior to your operation to provide you with an estimate of fees for your anaesthetic. Given that fees vary with procedure time, it is often impossible to provide an exact figure prior to your surgery. ## Can I request an estimate of fees? Absolutely. Patients whose fees are greater than the rebates from health fund and Medicare will be asked to pay a “gap” payment. These out-of-pocket expenses usually vary with the length of the operation. As a result, it is often difficult for anaesthetists to accurately predict the out-of-pocket expenses in advance. Anaesthetic Services’ anaesthetists feel that patients should be provided with an estimate of fees before their operation, and patients will usually receive a letter or a telephone call prior to their surgery in order to clarify any additional expenses. If you are booked for surgery with an anaesthetist of Anaesthetic Services and have not been informed of your likely out-of-pocket expenses, please [contact our rooms](/contact) if you wish for a fee estimate in advance. Please note that surgeons frequently use many anaesthetists, and the independent nature of practice means that an anaesthetist’s fees will likely vary between operating lists. ## What is the process for account estimates? The fee for your anaesthetic is determined by each individual anaesthetist in Anaesthetic Services. Each anaesthetist has individual fees. ### Estimates Estimates can be given on your “out-of-pocket expense”. To provide you with the most accurate estimate possible we need the following information: - Do you have insurance? If yes, which fund? - What operation are you having done? - An estimation of the length of time the operation will take? This information can be provided to you by the surgeon who will be performing your operation. We encourage patients to contact us to obtain an estimate regarding their surgery. ### Patients without private hospital health insurance Patients who do not have private hospital cover are required to make some payment before their anaesthetic. Depending on who your anaesthetist is, you may be asked to pay the total account or the “out-of-pocket” expense. You should receive an estimate of fees in the mail, which you are required to pay two working days prior to surgery. Personal cheques are not accepted for these payments. If you have not received an account, please [contact us](/contact) for an estimate. ### Patients having cosmetic surgery or a procedure not covered by Medicare These patients are required to pay the full fee before their anaesthetic. You should receive an estimate of fees in the mail, which you are required to pay two working days prior to surgery. Personal cheques are not accepted for these payments. If you have not received an account, please [contact us](/contact) for an estimate. ## What account will you receive for your anaesthetic? The fee for your anaesthetic is determined by each individual anaesthetist in Anaesthetic Services. Each anaesthetist has individual fees. There are a number of factors which determine your account, including: - Whether you have private hospital insurance or not - Whether your insurer allows anaesthetists to charge “co-payments” - How long your operation takes - The type of operation you are having - Whether or not your operation is classified as cosmetic - Whether your operation is covered by Medicare (your surgeon will advise you if it is not) A co-payment is a fee in addition to the health fund and Medicare payment. This is an out-of-pocket expense to you. Some health funds allow co-payments, some do not — please check with your health fund. Because of all these varying factors there are a number of different accounts that you may receive: **Simplified billing.** If your anaesthetist chooses to send your account directly through to your private health fund (which includes the Medicare rebate and does not include a co-payment) you will not receive an account from us. The relevant bodies will pay the anaesthetist directly and they will advise you once the account has been paid. In addition, some patients are covered by agencies who will have their accounts paid for in full and will not incur any “out-of-pocket” expense. These include: - Department of Veterans’ Affairs - WorkCover (with an approved claim) - Third-party insurance (with an approved claim) **Account for co-payment.** Your “out-of-pocket expense” — you need to pay this money. This cannot be claimed. The rest of your account is sent directly to your health insurer. **Account for total fee.** These accounts can be claimed through Medicare and your private health fund (if applicable). Your Medicare office will be able to provide you with the appropriate form to complete. Your cheque(s) will be sent directly to you, made payable to your anaesthetist. You will need to forward them to our office along with any out-of-pocket expense. **Account for balance.** You have paid your “out-of-pocket expense” prior to your anaesthetic. You have a balance that is payable by Medicare and your private health insurer (if you have one). Your Medicare office will be able to provide you with the appropriate form to complete. Your cheque(s) will be sent to you directly and will be made payable to your anaesthetist. You will need to forward them to our office to settle the balance of your account. **Account already paid (or paid prior to surgery).** You will be sent your paid itemised statement after your surgery for you to claim your rebates. These accounts should be taken to Medicare and your private health fund (if applicable). Your Medicare office will be able to provide you with the appropriate form to complete. ## How do I pay? Payment can be made by BPAY, credit card, or cheque.