Informed Financial Consent

Prior to your surgery, you will receive an estimate of fees through an informed financial consent document. This will notify you of any gap and outline your rebates, the claiming process and when your invoice will be issued. If you are planning on having surgery and would like to obtain a quote from us at the time of your surgery booking with your surgeon, please feel free to contact our wonderful admin staff in our rooms, who would be happy to provide this to you. This can be done by either phoning (03) 62231610 - option 1 or by emailing us at accounts@thegroup.com.au

How will I know if I will receive an invoice and when my invoice will be sent?

Following your procedure, an account for anaesthesia services will be emailed to your email address if one has been provided to us, or otherwise, will be mailed to your home address (as listed on your hospital records). This email will come from accounts@thegroup.com.au and will occur roughly 1-2 weeks post your surgery and only if a gap is applicable for your Anaesthetists services. (Your informed financial consent sent prior will note if a gap is applicable).

*In certain instances, your invoice may be emailed/posted prior to your procedure for a request of a pre-payment to take place 48hrs prior to your surgery.

How will my gap be calculated?

Your Anaesthetic account is separate from your surgeon and hospital account/s.

The degree in out-of-pocket expenses will vary depending on: The fee structure of the Anaesthetist allocated to you, your health funds agreement with your Anaesthetist, your level of cover, the complexity of your surgery and your surgery’s duration.

Anaesthetic invoices do have a time item included as part of their composition. This estimate you will be provided with will either be based on the average time taken for your planned procedure or the time given to us by your surgeon. There are instances when the time taken for the surgery may vary from the estimated time in this estimate. This may occur if the surgery is more involved than anticipated. For this reason, the final invoice total along with the health fund and Medicare rebates and the subsequent gap amount may vary to this estimate.

If you have any concerns at all regarding a fee you have been quoted for your surgery, please reach out to our admin team PRIOR to surgery taking placed by either email or phone.

Why is there a ‘gap’?

Our Anaesthetists are an integral part of patient’s procedures.

While cost of living has risen for both Drs and their patients, the cost of running a medical practice has also dramatically increased.

The Government’s indexation of Medicare rebates has never kept pace with the rising cost of medical practice. On average AWE and CPI increase by 3% per year. Practice costs rise by a similar amount. Medicare rebates only increased between 1.2% to 2.5% from 1995 to 2012 – noting that all pathology and most diagnostic imaging services received no indexation during this period. From 2012-2017 all MBS rebates were frozen with no indexation. Indexation only recommenced in 2017, when GP bulk-billing incentives were indexed at 1.4% and then from 2018-2021 with GP standard attendances and specialist consultations indexed at 1.5%, 1.6%, 1.5% and to 0.9% (respectively).

Please take a look at the AMA information on “"Why Medicare indexation matters” using the following link:

Can I claim on Medicare and my health fund?

Patients with private health: Yes.

No Gap Accounts: Our practice will place an electronic claim with your health fund & Medicare for the claimable portion of your account. The health fund will then pay us directly for the invoiced service with no patient involvement.

Out of pocket Accounts (Known Gap): Our practice will place an electronic claim with your health fund & Medicare for the claimable portion of your account. The health fund will then pay us directly for the invoiced service. A separate invoiced for the out of pocket/gap will be raised and emailed/posted to you. This invoice has no further claimable component.

Uninsured Patients: Yes (Medicare if applicable).

Our practice will put together your invoice and either email or post it out to you. Once this invoice is paid in full by you, we will send an electronic claim to Medicare to notify them that the invoice has been paid in full by you. Medicare will assess the claim and refund any applicable rebates into the bank account you have noted with them 24-48hrs later. Claiming on an invoice cannot take place until paid in full and post-surgery (not at the pre-payment point before surgery if a pre-payment is required).

Overseas Patients: Yes (Only if you have private health insurance cover).

Our practice will put together your invoice and either email or post it out to you. Once this invoice is paid in full by you, we will send you an itemised receipt showing you have paid the invoice in full. You may at this point lodge the paid invoice with any applicable private insurer to receive a rebate.

Works Compensation or MAIB Claims: No.

Workers compensation Claims are not eligible to receive a Medicare rebate. Details will be obtained in relation to the responsible party for your Workers Compensation Claim prior to your surgery. Post your surgery, your invoice will be sent directly to them for payment. You will still receive an estimate prior to surgery noting that Anaesthetic instructions and that we are aware your Anaesthetic invoice will need to be sent to a third party.

Department of Veteran Affairs Claims: No.

DVA patients are not eligible to receive a Medicare rebate. Your DVA status and Member number will be obtained prior to your surgery through your surgical referral. Post your surgery, your invoice will be sent directly to them for payment. You will still receive an estimate prior to surgery noting that Anaesthetic instructions and that we are aware your Anaesthetic invoice will need to be sent to DVA for payment.

Royal Outsourced Scheme Invoices: No.

Patients having their procedure carried out in the private sector under the Royal Outsourced Scheme are not eligible to receive a Medicare rebate. Your surgeons’ rooms will make us are that you are a RHH patient prior to your surgery. Post your surgery, your invoice will be sent directly to your surgical hospital for payment. You will still receive an estimate prior to surgery noting that Anaesthetic instructions and that we are aware your Anaesthetic invoice will need to be carried out under the scheme.