What is informed financial consent?

No one likes receiving a nasty financial surprise, especially when you are feeling at your most vulnerable.

That is why it is important to talk to your treating doctor and St.LukesHealth about the costs you may incur before you undergo treatment as an admitted in-hospital patient.

What is informed financial consent?
Before you receive care, your treating doctor should provide you with information about what costs you can expect from your treatment and identify if there will be any out-of-pocket costs. This is called informed financial consent.

This ensures that you are aware of:
  • The fee for a medical service, treatment or procedure that will be performed by your specialist or surgeon;
  • Any costs for surgically implanted prostheses and devices that may be used during your treatment; and
  • A variation in costs that might arise if your treatment is changed for clinical reasons.
Is this all I have to pay?
As part of providing informed financial consent, your treating doctor may also provide you with information about the potential fees of other doctors involved in your treatment, such as the anaesthetist or assistant surgeon.

Specialists or surgeons work in healthcare teams. This means that while you can choose your treating doctor, you may be unable to choose the other specialists who will provide service during your procedure. It is important to talk to your treating doctor if you have any concerns.

In this instance, if your treating doctor is unable to provide you with information about the healthcare team’s potential fees, they are responsible for providing you with their names and contact details so that you can find out the costs.

Can I get a second opinion?
If you are not happy with the amount you will need to pay your treating doctor for your treatment, you are also entitled to receive a second opinion.

In this case, your treating doctor should help you to do this by referring you to another doctor for assessment.  Alternatively, Healthshare is available on the St.LukesHealth website to help you locate another treating doctor with the same speciality in your area.

Remember, your treating doctor should also provide you with the relevant Medicare Benefits Schedule item numbers for each proposed treatment or procedure. This will enable you to confirm the benefit you will receive from St.LukesHealth.

Does the cost change for emergency procedures or treatments?
For emergency procedures or treatment, it may not be possible to obtain informed financial consent before the service is performed as you may be unconscious or incapable of receiving or understanding the information.
In this instance, informed financial consent may not be appropriate if it were to delay or compromise your care.
In emergency situations where it is not possible to provide informed financial consent before the service is provided, information about the costs should be provided to you as soon as possible afterwards. Alternatively, it may be appropriate to provide the information to a close relative or person acting on your behalf.

What questions should I ask those involved in my treatment?
Before you are admitted, you should ask your doctor or specialist:
  • What is the expected cost of treatment? Ask your doctor for a written quote that includes the Medicare Benefit Schedule item numbers.
  • Ask what other doctors will be involved in your treatment and ask how you can find out about their fees.
  • Does your doctor participate in St.LukesHealth Medical Gap Cover?
  • If you require a surgically implanted prosthesis, ask if the prosthesis attracts a patient gap or whether there is the option to use a no-gap prosthesis.
Ask your hospital:
  • Are there other out-of-pocket costs you should be aware of that are associated with your hospital stay?
  • Will there be costs for items like newspapers and television?
  • Is this hospital contracted with St.LukesHealth? If not, what impact will this have on my hospital bill?
Ask St.LukesHealth:
  • If your treatment is covered under your current private health insurance policy.
  • If all waiting periods have been served for the treatment you require.
  • if you have an overnight or same-day hospital excess and how much it is.
  • What are the expected out-of-pocket costs?
If you need help understanding your rights, hospital or medical bills, please contact St.LukesHealth on 1300 651 988.
 
 
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