30 July 2019

AMA guide helps patients avoid bill shock

AMA Patient Perspective

The Australian Rheumatology Association is throwing its support behind the AMA’s financial consent guide for patients.

The guide, published this week by the Australian Medical Association, helps patients start a conversation with their doctor about how much their treatment is going to cost.

The guide explains which medical services are covered by the three key funders: Medicare, private health insurance, and the patient.

The guide also suggests that patients should ask their doctors questions, such as whether there will be fees from other doctors, and if they can have a written estimate of the fees.

AMA president Dr Tony Bartone said the guide, ‘Informed Financial Consent – a collaboration between doctors and patients’, provided patients with clear, easy-to-understand information to help them navigate the health system.

“It will help patients in their conversations with doctors and practice managers about fees for their medical procedures,” he said.

The Australian Rheumatology Association supports the Informed Financial Consent Guide, which is officially backed by more than a dozen professional bodies.

Associate Professor Rob Will, the ARA director of Western Australia, said it was important for all patients to be aware of any out of pocket expenses they would incur following review by a rheumatologist.

“Providing patients with informed financial consent is simpler for consultant physicians than surgeons.,” he said.

“Generally, the only Medicare Item numbers that may be relevant are consultation item numbers, as rheumatologists as a general rule do not undertake procedures apart from joint injections.

“Some undertake ultrasound of joints and soft tissues, but generally informed consent can be provided to the patient prior to these procedures,” he said.

The final page of the guide is a form that patients can print out and take to their specialist appointments in order to establish a clear estimate of the out-of-pocket fees which may arise.

The AMA said this was a form doctors and patients could fill out together in a bid to achieve more transparency over costs which might arise. 

“Private rheumatologists would be able to complete the form at the end of the guide and provide this to patient prior to the consult,” said Professor Will.

But providing an estimate of total out of pocket expenses could be more problematic for patients in private hospitals being attended by a rheumatologist, due to the uncertainty of the length of their stay, Professor Will said.

Out-of-pocket costs came into the spotlight earlier this year when the family of a 12-year old girl set up a crowd-funding page to raise $120,000 for surgery to be performed by high-profile Sydney-based neurosurgeon Dr Charlie Teo.

Dr Teo was publicly criticised by some medical colleagues who suggested these fees were exorbitant.

Dr Teo rejected suggestions that he was overcharging, saying he was only paid between $8,000 and $15,000 for brain tumour operations, with private hospitals responsible for the vast majority of the fees, The Sydney Morning Herald reported.

Dr Teo’s claim was disputed by the Australian Private Hospital Association.