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Patient Resources  >  Surgery & Private Health Insurance

Surgery & Private Health Insurance

WHAT TO EXPECT

What to expect after surgery

Following surgery, you will be provided with instructions for appropriate post-operative care. The initial post-operative review will be booked prior to surgery.

Should you require surgery, our staff will always provide a detailed quote of surgical fees and any out of pocket costs not covered by your insurance. Please check with your insurer to ensure you are covered for the procedure.

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Invoicing for surgery can be confusing and complex. There are many Insurers in Australia and they all have different criteria and rules for reimbursement. Basic/bronze policies do not cover all procedures.​

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Listed below are simplified explanations of the 3 main ways we invoice. Which one is used will depend on your insurer (some insurers do not insure to Industry standards/accepted fee schedules), your level of cover and the particular procedure being performed;​

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  1. Direct billing to the patient prior to surgery. The patient then claims from their Insurer.

  2. Known Gap, prior to surgery the patient is charged a ‘known gap” this is an ‘out of pocket’, non-refundable cost set by the Insurer. Our staff then send the surgery invoice directly to the insurer.

  3. No-Gap, all billing is done by our staff directly to your Insurer. There is no out of pocket cost.

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