Terms and Conditions of Service

PRACTICE INFORMATION

Our practice charges our own tariffs. Our Anaesthetists are all Specialist Anaesthetists (trained for 12 years and with 10-20 years – or more experience) where a market related professional fee is charged. The tariffs are merely to state that we do not have a contract with any medical aid. Department of Health in conjunction with the Council of Medical Schemes has developed a National Health Reference Price List (NHRPL) to enumerate medical professionals.  The medical schemes will then decide what remuneration rate they will use. A significant portion of Medical Aids do offer 300% (of NHRPL) reimbursement cover for in-hospital treatments.  Your medical should be viewed as an insurance cover and the type of package one chooses will dictate what one’s excess will be.

PATIENT INFORMATION

A green Anaesthetic form will be given to you either at the Hospital or by your Surgeon. This form is to be completed and taken with you the day of your procedure. If handed to you in hospital, complete the document and this will be handed to our Specialist Anaesthetist. Please make sure you read the document and complete ALL the information which is required. (Patient information/Medical aid information/Medical History/Consenting to the procedure and Anaesthetics as well the Payment of the accounts.) The person (patient) should sign this document. If however, the patient is under the age of 18 years, the Main member of the medical aid should sign this document. In the case where the main member is not present, the Legal Guardian may sign the document, but should realize that the account will be sent to him/her.

ACCOUNT INFORMATION

For patients 18 years and older registered as dependants on a medical aid, please take note that you will be held liable for the services provided to you. This is in terms Section 17 of the Children’s Act, Act 38 of 2005 A child, whether male or female becomes a major upon reaching the age of 18 years.

All our accounts are generated in the name of the PATIENT and not the main member of the medical aid. The reason for this is because the SERVICES were provided to the patient and not necessary the main member. If however, the patient is under 18 years of age, the MAIN MEMBER of the medical aid will be held liable.

BILLING INFORMATION

ESTIMATES

On request of an estimate, we confirm that we have complied with the POPIA by securing the estimate by using a password. (Protection of Access to Information Act). PLEASE discuss FEES with our practice and/or with OUR ANAESTHETIST and NOT with your Surgeon, as we are a separate business. DISCOVERY patients please note: We have a payment arrangement with Discovery (Classic and Executive plans). Even in some cases Discovery (classic and executive plans) will advise you when phoning for authorisation whether your anaesthetic account will be covered in full or not. This estimate will be different to those arrangements as this is based on our standard tariffs. Please send this estimate to your medical to receive information from them as to what the amount is they will cover. Keeping in mind that we DO NOT CHARGE MEDICAL AID TARIFFS.

  • The tariffs are linked to time; thus, the actual amount may vary from the estimate.
    • An estimated time based on an average for the procedure is used when calculating the estimate.
    • The estimate is valid only for a particular patient and procedure.
    • The anaesthetist may use extra procedure codes during the operation that may influence this estimate.
    • BMI code may be added to your account if your BMI is more than 35

An estimate is NOT THE FINAL ACCOUNT, but a mere estimation.

PRIVATE PATIENTS

  • All private patients are to ensure that the estimated amount is paid prior to the date of the procedure.
    • The Anaesthetist will be advised on the day before of the procedure whether this payment has been received or not.
    • Non-payment of this amount could cause unnecessary delays for the Anaesthetist to proceed as scheduled.
    • When payment is made into our account, please reflect your SURNAME and the SURNAME of the Surgeon for easy reference.
    • Payment may be given to the Anaesthetist on the day of the operation or paid at our rooms.

PMB (PRESCRIBED MINIMUM BENEFITS)

If you have a procedure done which is classified as a PMB, ensure that you obtain a PMB AUTHORISATION prior to the procedure. We do submit the account to your medical aid. This account has been marked as a PMB (Prescribed Minimum Benefits).  Your medical aid may require further documentation in order to process the account. The documents required are to be obtained from your Surgeon, BY YOURSELF. We unfortunately do not diagnose the patient, and therefore will not be in a position to write any motivations on your behalf for your Medical Aid.

With the above information in your hands, we wish to bring your attention to the fact that you remain personally liable for the outstanding amount. PMB does NOT necessary mean “Guaranteed Payment”. There are certain criteria which should be met before your medical aid will consider FULL payment.

BANKING DETAILS

Please contact our rooms for the banking details. The banking details will be reflected on your statement of account and/or estimate.

POPIA (PROTECTION OF PERSONAL INFORMATION ACT 4 OF 2013)

Please be informed that in this medical practice we process all personal and medical information in accordance with the Protection of Personal Information Act. We have to make a balance between POPIA and the healthcare act and reasonable practice.

  • Sharing of information: As stated in the healthcare act, a medical professional must act in the best interest of his or her patient. To be able to perform our duties, we must communicate with other healthcare professionals such as your Surgeon. This communication happens over a telephone, smartphone, or e-mail. They only pertain the necessary information which enable us to function as a medical team. A theatre list with your name and procedure is of utmost importance.
  • We are all healthcare professionals, and we are familiar with medical privacy. No confidential information is shared with third parties.
  • We DO NOT provide any information to outside marketing firms.
  • We also DO NOT provide information to any family members without your consent.
  • Your personal information is stored in our offices securely. An electronic version of your information will be captured on our Billing system which is secured by ELIXIR. Our server is locked in a SAFE, securely. Elixir makes use of cloud services and have provided us with the necessary evidence to confirm that our data is secure and will not be distributed for any reason.