Policies

BILLING POLICY FOR THE SERVICES RENDERED BY THIS PRACTICE

We value our relationship with our patients and would like to ensure complete transparency on the possible costs associated with this practice. We hereby inform our patients, insurance companies and colleagues that the billing policy of this practice does not necessarily follow the different rates at which the various medical insurance companies reimburse at, or with that of colleagues or any price reference lists.

  • The fee of this practice is determined by the practice (“Private rates”)
  • Please enquire about the consultation fees of  when making your booking. This will also be clarified on the day of the consultation. Fees may also increase further depending on the complexity of the problem and time spent with the patient.
  • This practice is contracted to SELECTED medical aids. It is still the responsibility of the member to be aware of their benefits from their scheme and to interact with their scheme. However, please be advised that in some instances (e.g. hospital in-patients) this practice may submit the account directly to your medical scheme. Even if the practice submits the account to a medical aid for re-imbursement, the patient ultimately remains liable for the full costs and service fees and the interest as specified in the National Credit Act, and for any costs incurred in the recovery process in the event of the account not being settled in full by the medical aid.
  • Because of the varying and different benefits and exclusions on the different medical aid plan options in the market, it remains the patient’s responsibility to validate with their medical aid what procedure codes and reimbursement tariffs are applicable on their plan. Even if the patient’s medical aid covers a certain procedure, it does not necessarily imply that the medical aid will reimburse all the procedure codes charged by the practice. Please inform the practice if there are any specific pre-conditions which you may have to adhere to on your medical scheme plan e.g. medicine formularies, preferred or designated service providers etc. These aspects can have an influence on the fees you might have to pay, what portion your medical aid will pay and any co- payments that may also be applied.
  • Every consultation/visit is charged for separately depending on what is done at that visit.
  • ALL FEES are to be settled before the consultation.
  • Procedures are charged for separately. The onus is upon the patient / guarantor to clarify these charges BEFORE any additional work is carried out. It remains the patient’s responsibility to decide or ascertain with their medical aid, what will/will not be covered. A quote will be gladly provided.

Each quotation will provide a patient with the applicable procedure codes & fees.

  • Quotations are merely an estimation of costs at this practice ONLY. Quotes are valid for 30 days (and are not valid for the following year if issued in December of a particular year).
  • Having an authorisation number for a procedure is NOT a guarantee for payment / reimbursement. Your medical scheme may still choose to honour none / part of the final account.
  • The medical practitioner and the practice reserve the right to charge for any additional paperwork requested by your medical aid, insurance company (or any other 3rd party) e.g. pre- authorisations, motivation letters, chronic medication forms or reports. The following tariffs are payable upon collection (not fax / e-mail) of these relevant items – Quotes will also be provided for these:
    •  Telephonic consultations (tariff code 0130)
    •  Should a repeat prescription be issued without a consultation, this will be charged for (tariff code-0132)
    •  The writing of special letters and motivations with/without the patient (tariff code-0133)
    •  The completion of Chronic medication forms (tariff code-0199)
    •  The provision of medical reports and results for insurance purposes / assessments.
  • Other service providers (e.g. for X-rays, blood tests, hospital admission, pathology and histology specimen analysis, other treating practitioners etc.) bill separately from this practice. Patients are encouraged to contact them regarding their tariffs and billing policies.
  • Reminders are sent out by SMS for appointments. Please be courteous to cancel / reschedule should you be unable to honour the appointment. Missed appointments and those not cancelled > 24 hrs in advance may be charged for.
  • A statement reflecting your full payment will be issued, with which you may claim back from your medical aid / scheme. It is therefore suggested that members submit this statement to their medical aid for reimbursement. Non-timeous submission may result in rejection of the claim.
  • Consultation time is allocated only to the patient for whom the appointment was made. It is not appropriate to consult more than one patient at that appointment. “While we are here...”, “Just by the way...” or “Just take a look at...” consults for accompanying persons are not acceptable. Each patient will be consulted & billed separately.
  • Please take note of other practice policies on our website and those posted in the reception of the practice.
Should any of the above be unclear, or should you have any further questions, please do not hesitate to ask the practice staff or doctor.
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