ANAESTHESIA BILLING
Please take careful note of the following information regarding how the bill for your anaesthesia is calculated. Your account will be made up of four fees that are each assigned a value, and these values are then added together to determine the final anaesthetic cost:
Patients will receive an account from Dr Steyl for their anaesthetic, which is separate from all other accounts. Patients may also receive other accounts from the hospital, the surgeon, radiologists, physiotherapists, and pharmacies
CONSULTATION FEES
There will always be a pre-operative consultation fee. This is for the anaesthesiologist to review your medical history, results and physical examination. This information is used to make a risk assessment and to plan for the most appropriate anaesthetic technique.
In some cases, there may be a fee for post-operative consultations, especially if the patient is admitted to the high care unit or intensive care unit, or if the patient received a regional anaesthetic that needs a follow-up consultation.
CONSULTATION FEES
A basic fee is calculated according to the anaesthetic difficulty of the indicated surgical procedure.
There may be additional anaesthetic procedure fees, for example, if your anaesthesiologist has to place a central line or arterial line for monitoring during the surgery, or if your anaesthesiologist does a nerve block or epidural injection for pain relief after your procedure. Some of these procedures are done with ultrasound guidance to make them safer, and a fee may be charged for the use of ultrasound during the anaesthetic procedure. Other procedures performed by your anaesthesiologist may include placing a nasogastric tube or setting up a patient-controlled analgesia (PCA) pump.
TIME-BASED ANAESTHETIC FEES
Your anaesthesiologist is with you throughout the procedure to care for you while you are under anaesthesia, to monitor your vital signs and manage any potential problems that may occur.
Depending on the duration of your procedure/operation, a time-based anaesthetic fee is levied per 15 minutes (or part thereof) of your procedure. There may be a time-based fee for goal-directed blood pressure control during the procedure, especially for critical patients or during certain kinds of surgery.
In some cases, there may be a fee for post-operative consultations, especially if the patient is admitted to the high care unit or intensive care unit, or if the patient received a regional anaesthetic that needs a follow-up consultation.
It is not possible to predict accurately how long a procedure will take, and this makes estimating the cost of an anaesthetic extremely difficult. Any cost estimate is therefore based on the average time taken for a procedure. If the procedure takes longer than the estimated time the cost will increase according to the duration of the procedure.
ADDITIONAL FEES
There may be additional fees, depending on the anaesthetic risk and the monitoring and positioning that is needed for the case. All the risk modifiers are allocated specific unit values and each unit is then given a Rand value.
An emergency fee may be charged if your procedure was not booked before the start of a list, or if it is booked as an emergency case. This is not dependent on the time of day when the procedure takes place.
An emergency travel fee may need to be charged if the anaesthesiologist made an unscheduled trip to the venue where the procedure takes place
Some procedures are done in positions that make monitoring the patient more difficult, and may therefore carry additional risk. An additional fee may be charged when a patient is positioned for example in the lateral or prone position.
Patients younger than one year, or older than 70 years of age have a higher risk of anaesthetic complications. An additional fee may be charged based on this risk.
Patients with a body mass index (BMI) greater than or equal to 35 kg/m² have a higher risk of anaesthetic complications. An additional fee may be charged based on this risk.
Surgical procedures around the head and neck carry additional risk because the anaesthesiologist does not have easy access to the patient’s airway. An additional fee may be charged based on this risk.
Some orthopaedic procedures (bone surgery) have additional fees (modifiers) depending on the site of surgery.
Patients that have systemic illnesses causing functional impairment, or patients that are admitted to intensive care or on a ventilator before surgery have a higher risk of complications. An additional fee may be charged based on this risk.
Please take note, that previously the HPCSA had guidelines for reasonable professional fees, and the Council for Medical Schemes set up a “Reference Price List”. This was effectively the lowest tariff medical funders would pay However, since 2006, the Competition Commission has stopped all setting of prices.
and currently, each medical aid and doctor set their own prices. The rates that a particular medical aid will pay,depend on the individual funder and the plans they offer. To provide the quality of service that her patients deserve, Dr Steyl has linked her fees to the cost of delivering the service and has benchmarked this to other professional services. The rate is based on her training, expertise and experience as well as practice costs. Dr Steyl is contracted into some of the plans on Discovery Health and Fedhealth, but to no other medical aids.
Please note that a medical aid pays out at the rate they unilaterally determine according to the plan a patient takes out with them,
and this may be very different to the rate determined by the anaesthesiologist.
The medical aid may call this “the 100% rate” but this refers only to their rate, not to a standard rate.
Additionally, please note that every anaesthetic account has to include 15% VAT as the government has legislated that healthcare is a value-added item.
Further explanations of the codes on anaesthetic accounts can be obtained from
The Board of Health Funders: +27(0) 11 537 0200
Dr Steyl uses a professional billing company (Medical Accounts Company) that will assist with sending patient accounts to their medical aids to help with their claims. However, the patient remains responsible for payment of their anaesthetic account to their anaesthesiologist. Interest and all legal fees that arise from any accounts that are not paid in full within 60 days will also be for the patient’s account.