Fees and Payment

Consultation and in-room fees

Billing for Surgical Procedures

Surgical quotes are prepared for all patients and this quote discloses the payments required by our practice prior to your respective procedure.

Please note, we are not a ‘No Gap Doctor’. This means a ‘gap payment’ or ‘out of pocket expense’ will be required unless otherwise specified by us. There are exceptions to this, namely colonoscopy and gastroscopy, which Dr Renaut performs routinely with no gap.

Our fees have been developed in accordance with the Australian Medical Association (AMA) and the Medical Benefits Scheme (MBS) as set out by the Australian Health Service Alliance (AHSA) and Medicare.

This does include not any procedures performed in-rooms.

Payment Methods

We accept the following Payment Methods:

• Cash.
• Cheque.
• Credit Card – including VISA and MasterCard.
• Electronic funds transfer at point of sale (EFTPOS).
• Direct deposit via Electronic Funds Transfer (EFT) via:
  Dr Andrew Renaut
  St George Bank
  BSB: 114879
  Account No: 067696882

Private Health Insurance

We accept patients with and without private health insurance, Department of Veterans Affairs patients, WorkCover and medico-legal clients. If you are visiting from overseas and have travel insurance, it is a mandatory requirement that all expenses be paid in advance by you (reimbursement for this fee can then be organised by you through your insurer), unless a guarantee of payment can be provided by the insurance company.

Private Health System Fees

This section aims to provide you with some basic financial information about the Private Health system. There is universal health cover in Australia from Medicare. This means that all Australian residents are covered by the public health system.

The private health system offers the advantage of choosing your surgeon, reduced waiting periods and access to a better choice of surgery that may not be available in the public sector. The disadvantage is the financial costs associated with surgery. Most of these costs are covered by a combination of Medicare and health insurance companies, in particular the hospital costs. A “gap” will exist for Dr Renaut’s fee if the rebate falls well short of what the AMA believes is a reasonable fee for your particular surgery.

There are several costs when seeing a specialist surgeon:

• Initial Consultation Fee.
• Review Consultation Fee.
• Cost of Surgery.

Cost of Surgery

There are several costs to surgery. Most patients believe the bills they are paying are for the surgeons. In reality there are multiple providers who are sending out bills to the patients and the health insurance company:

• Surgeon’s Fees – Dr Renaut bills typically a proportion of the AMA Fee or a “Known Gap” Fee – this is typically less than $500 out of pocket
• Anaesthetist’s Fees (the specialist who provides the anaesthetic to the patient) – Most anaesthetists charge gaps varying from $250 to $1000. Your anaesthetist will contact you prior to surgery and obtain informed financial consent.
• Assistants Fee (this is the doctor who assists the surgeon) – Most assistants will charge gaps between $100 and $350.
• Hospital bed and Theatre costs – If you have private health insurance this is confined to your excess
• Pathology and Radiology – These are blood tests and imaging taken during your inpatient stay that may also incur added costs.
• Implants and Prosthesis – Most of these are covered by your insurance company, but once again it is important to check with them prior to the surgery

Surgeon’s Fees

All surgeries are covered by Medicare item numbers. These numbers have an associated rebate. The government determines these rebates and the private health insurance companies supplement these rebates by up to 25%.

Unfortunately, these rebates have not changed much since 1983 and have not kept up with inflation, let alone the costs of running a quality practice and the increasing cost of indemnity insurance. The difference between the costs and the rebates has given rise to the GAP. Most surgeons will charge AMA (Australian Medical Association) rates for the services. This is almost three times the Medicare rebate and reflects the true discrepancy.

Gap Payments

The GAP is the difference between what the health insurance rebate on a procedure is, and what the surgeon charges.  Dr Renaut aims to minimise this amount wherever possible.  Please discuss this with him at your consultation.

For further explanation of the GAP:

• Choice.com explanation
• AMA Patient information

Private Health Insurance and Junk Policies

So-called “junk policies” provide cover for restricted in-patient services; typically the minimum required to qualify as a ‘compliant health insurance policy’.  Having this type of policy allows the consumer to avoid paying the Medicare Levy Surcharge and Lifetime Health Cover loading. That’s why they are also referred to as ‘tax-avoidance’ policies. They typically have extensive ‘exclusions’, and anyone prior to taking out a policy should ensure that they read exactly what is included in their policy – including orthopaedic and joint replacement procedures.

In addition, even for the few services that are covered, they usually only provide benefits at public hospital rates. This means the patient either chooses a public hospital (with no out-of-pocket costs); or a private hospital with potentially significant out-of-pocket costs being the difference between the public hospital and private hospital fees.