Notice regarding professional fees

This practice values our relationship with our patients and would like to ensure complete transparency on the patient’s possible medical healthcare costs associated with this practice.
We herby inform our patients, insurance companies & 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.

In mid-2010, the High Court made a ruling that there is no longer a legal standardised medical scheme tariff guideline, previously called the National Health Reference Price List (RPL). In 2011 most of the medical schemes are now reimbursing at a percentage of their “scheme rate” and both the percentage and value of the “scheme rate “vary from one scheme to another e.g. 2010 RPL rates plus 55 or 2010 RPL rates plus 6%.

Competition law requires each medical practice to disclose its billing practice which is determined according to the practice’s own costing structures and which is also in line with the provisions of the Consumer Protection Act. The tariff charged for healthcare services rendered in our practice is as follows:

Gynecological patients:

Medical Aid Patients  

Hospital Plans: New Consultations: R 2800.00  

1st Consultation + yearly consultation: R 1000.00 co-payment and claim from medical aid. 

Follow-up consultation: (within 1 year, claim from medical aid provided that funds are available) 

  

Private Patients  

New Consultation: R 2800.00
Follow-up: R 1500.00

Mirena appointment: R 3500.00
Implanon appointment: R 3500.00  

Co-Payment: Minor surgery: R 2000.00
Major surgery: R 4000.00  

Co-payment is not applicable for Discovery Classic options, Bestmed and Momentum. 

 

Surgery for PMB conditions (including cancer)
Will be claimed directly at 200% tariffs. 

 

Pregnancies  

Discovery classic options: R 1000.00 co-payment + claim from medical aid.
Remedi comprehensive + classic plans R 1000.00 co-payment + claim from medical aid.
Delivery: No co payment
Bestmed & Momentum: No co-payments, claim directly from medical aid at scheme tariffs.  

All other medical aids:  

1st Pregnancy visit: R 2800.00 
11-14 Weeks (NT ultrasound): R 2500.00 
Follow-up visits (16 Weeks): R 1500.00 
Anatomy ultrasound (20-24 Weeks): R 2750.00 
Follow-up visits (24-38 Weeks): R 1500.00 
Follow-up visits (>38 Weeks): R 1500.00  

Co-payment on delivery (Payable from 32 – 34 weeks): R 7 500.00 
Private fees: Same as above 
Private delivery fee: (Payable from 32 – 34 Weeks) R 16 500.00 

 

Delivery Fees

Please be advised that the delivery fees for Dr. Van Aardt do not cover the following costs:

Hospital costs, Paediatrician costs or Anaesthetist costs.

Contracted Medical Aids:

Discovery Classic, Bestmed, Momentum

*Please make sure that you are aware of our fee structure. All payments must be settled on the day of your consultation. If you have any queries, please feel welcome to discuss it with our practice staff. We look forward to being part of your journey*

Procedures

This practice will provide a patient with a written quotation. It remains the patient’s responsibility to decide or ascertain with the medical aid, what will/will not be covered. Each quotation will provide a patient with the applicable procedure codes & fees. A day cooling-off period applies after the quotation has been accepted.

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 patients’ 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 will pay and any co-payments that may also be applied.

Important: The medical practitioner and the practice reserve the right to charge a set fee for prescriptions, consultations, telephonic consultations, and any additional requests from your medical aid/ Insurance companies e.g. motivations letters, chronic medication/PMB forms, prescriptions and reports. Charging for these services enables us to uphold our commitment to swift response times and enhance the quality of patient care through optimization efforts.

Even if the practice submits the account to a medical aid for re-imbursement, the patient ultimately remains liable for full costs, 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 treatment plan (e.g. anaesthetist charges, physiotherapy, pathology laboratory tests, x-rays, scans) directly to them.

Please note that you remain responsible for your account. Accounts must be settled on the day of your consultation. Should your day-to-day benefits be exhausted, we kindly request that you notify us and settle your account in its entirety prior to departing from the practice. We acknowledge the prevailing economic challenges faced by many at present.

Should your medical aid not be able to clarify at which rates you are insured at, submit your complaints to the Council for Medical Schemes at complaints@medicalschemes.com or contact them on, telephone 012 431 0500

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.

For any inquiries regarding your account, please do not hesitate to contact our Accounts Department during office hours. (8:00 – 16:00) at 012 679 9751 or email gynae22@medicharge.co.za

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