INFORMED FINANCIAL CONSENT & PAYMENT INFORMATION
Please read the following information carefully.
When you indicate your acceptance of these terms you are acknowledging and agreeing to the following, which are conditions of admission. If another person (for example a spouse or family member) will be responsible for paying the account for your treatment at the hospital, that person should also read the following terms before acceptance is indicated, as.
(a) Actual expense incurred may differ from the estimate provided.
Whilst every effort has been made to provide an accurate estimate of the expenses you may incur, additional costs are sometimes incurred during your hospital stay. The actual expense incurred may differ from the estimate provided before your admission because, for example:
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The hospital relies on information provided by your health fund which may change;
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Your treating doctor(s) may vary the proposed treatment, procedure or the proposed length of stay;
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Medication costs may vary, due to a change in the medication prescribed by your treating doctor or a change in the medication price;
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You may incur sundry charges during your stay (eg visitor meals, boarder fees and phone calls); or
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Where prosthesis (an implanted medical device) is required for your treatment there will be at least one device that is fully covered by your health fund (if you are insured). However, based on your specific clinical need, your doctor may recommend a device that requires a gap payment by you. Though your doctor should generally advise you if this is the case, as with any medical procedure, if unforeseen circumstances should arise during the procedure it may be necessary for your doctor to use a different or more costly prosthetic device. If this happens there may be additional costs to you.
(b) You agree to pay any balance of expenses actually incurred
Your final account will reflect:
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The actual procedure performed, treatment and services provided and your length of stay at the hospital;
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Disposable and prosthetic items used in your treatment;
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Pharmacy (medication) costs;
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Fee for incidentals; and
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Any balance payable by you.
As noted on the “Estimate for hospital services” form, actual costs that are known and advised prior to your admission are payable before or on admission and any additional costs are payable on discharge.
As a condition of admission, once you have indicated your acceptance of these terms, you will be taken to have agreed to pay your final account. If you have genuine concerns, or a bona fide dispute regarding the final account (for example you did not receive a service or an item listed) you agree to raise this with the hospital as soon as possible after receiving the account and to use your best efforts to resolve any dispute at the time of discharge or within 7 days of discharge.
(c) You are required to pay the full amount or any outstanding balance if your insurer (or other payer) does not cover the cost of treatment
If the rates charged by the Hospital are higher than the reimbursement paid by your health fund / insurance company / Medicare / Workers Compensation insurer, you are responsible for paying the balance of the hospital’s rates. If for any reason health insurance benefits do not apply you must pay the charges that arise from your admission to the hospital.
(d) You are responsible for accounts from other providers
You are responsible for payment of other accounts you may receive, which may include:
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the treating doctor(s) or surgeons(s);
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the assisting surgeon(s) or resident doctor(s);
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the anaesthetist(s);
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pathology services;
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radiology services;
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physiotherapy;
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Pharmacy.
If you are unsure what services you may receive during your stay and wish to know what accounts you may receive, please contact your treating doctor and the hospital before your admission to discuss this.
Payment Information
It is very important that you approach your admission to hospital well informed of the financial consequences. Please read the following information and contact your hospital if you have any concerns or queries.
Privately Insured Patients - should confirm with your health fund prior to admission the following:
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Does my policy cover me for this procedure?
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Do I have an "excess" payment on my insurance policy?
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Are there any co-payments required for each night I will be in hospital?
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Does my policy exclude some treatments, for example cardiac, orthopaedic or rehabilitation?
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Are any prosthetic or disposable items used in the surgery not covered by my insurance?
Please note that if you have been a member of your health fund for less than 12 months your fund may not accept liability for the costs of this admission, e.g. if your condition or any symptoms of your condition existed prior to you joining your health fund. Any excess will be required to be paid on admission.
Repatriation (DVA) Patients - Gold card holders are covered for all care. White card holders are covered subject to approval by DVA.
Workcover Patients - total payment (aside from any ancillary charges) must be made on admission unless approval for admission has been confirmed by your insurance company.
Third Party Patients - total payment (aside from any ancillary charges) must be made on admission unless approval for admission has been confirmed by your insurance company.
Uninsured Patients - total payment (aside from any ancillary charges) must be made on admission. Please contact the hospital prior to admission for an estimate of fees and charges. As it is an estimate only, the event of unforeseen complications or variations from the proposed treatment the cost may vary.
How do I pay?
For your convenience, payment may be made by cash, EFTPOS, Bank cheques, MasterCard or Visa.
Prosthesis
Where prosthesis (an implanted medical device) is required there will be at least one device that is fully covered by your health fund. However, based on your specific need, your doctor may recommend a device that required a gap payment by you and will explain why the gap device may provide a better health outcome. In this case we recommend you contact your doctor before admission to the hospital. As with any surgical procedure, if unforeseen circumstances should arise during the procedure it may be necessary to arrange additional medical services, or use a different or more costly prosthetic device. If this happens there may be additional costs to you that are not covered by this estimate.
What costs could I incur that will not be covered by my health fund?
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Pharmacy (medicines required during your admission and discharge medications)
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Pathology (e.g. blood tests)
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Medical and allied health practitioner's fees will be billed separately by the practitioner. Please discuss these with your doctor before your admission. You may receive separate accounts for:
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Surgeon
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Anaesthetist
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Assisting Surgeon
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Other consultants
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If you have any further questions, please call the hospital’s Administration Officer on (02) 6331 7766