BILLING POLICY

To ensure complete transparency regarding possible medical costs, please read this billing policy.

Please note that this practice is not contracted to all medical aid schemes.

In-Room Rates

  • Payment for in-room consultations is due on the day of your appointment. Any exceptions to this policy must be agreed upon in advance. We will provide you with a statement that you may deliver to your medical aid to claim back for your consultation. Please contact your medical aid directly to understand coverage.
  • Some medical aids require a specialist referral and/or an authorisation for a consultation. You are responsible for ensuring the referral/authorisation has been received by the date of the consultation. We will assist you with all the information you will need to get the authorisation.
  • Procedures completed in the doctor’s rooms will be charged at 200% standard medical aid rates. This will require pre-authorisation, and you will be liable for any shortfall.

In-Hospital Rates

If you are on a medical aid that this practice is not contracted in to, the charge for in hospital care is at 300% standard medical aid rates. If you have an emergency condition or a condition that is deemed a prescribed minimum benefit (PMB) this may or may not be fully covered by your medical aid. You will be liable for any shortfall.

Authorisations

  • Pre-authorisation is needed for any planned procedure. Even if an authorisation is in place, this is not a guarantee of full payment. Every medical aid scheme has its own scheme rules, varying in tariffs and terms, even varying between different plans. The responsibility for payment of the account remains yours. Please discuss any queries relating to terms and tariffs with your scheme. You will be invoiced for any outstanding amounts.
  • If you obtain authorisation, please inform us if there is a hospital co-payment. There are occasions when part or all of this may be waived by the hospital manager but this needs to be applied for at least 7 days prior to the procedure and is on a case-by-case basis. If there is a hospital co-payment, this will need to be settled with the hospital on the day of the procedure.

General

  • If the medical aid pays you directly, then you will be responsible for paying the practice within three days of the money being deposited into your account.
  • If you require an estimate for any procedure or treatment, please request this well in advance. We will endeavour to give you one as accurately as possible. It is however an estimate, as all healthcare circumstances cannot be predicted. Should the practice become aware of the costs exceeding the estimate before the procedure or treatment, you will be informed of this as soon as possible. Please note that the cost estimate only refers to Dr Hannington’s costs.
  • The anaesthetist is not part of this practice, and their costs are charged separately. They may or may not be contracted into your medical aid. If not, they may charge above scheme rates, and any shortfall will be your responsibility. Please contact the anaesthetist about the costs involved or details of their billing policy.
  • The practice will submit the claims directly to the medical aid through its billing company, Axialmed. If you are aware of any reason the medical aid will not pay, it is your responsibility to inform us so that we can send the invoice directly to you.
  • If you do not want the practice to send an account to the medical aid, please let the practice know.
  • If you are on a GAP payment plan, please inform us so that Axialmed can send you the invoice for the outstanding amount as soon as possible.
  • All outstanding accounts must be paid in full within 30 days from date of service. If the practice needs to hand your outstanding account to the attorneys (Anthony Richards & Assoc) for debt recovery purposes, you will be liable for all legal and administrative costs associated with the debt recovery. Once the account has been handed over the practice reserves the right to charge interest and a service fee, and no further correspondence will be entered into.
  • Our billing company makes use of text messages, emails, and phone calls to inform you of outstanding accounts. Please ensure that the practice has your correct details to be able to do this. It is your responsibility to enquire about your account should you not receive one.
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