Dear Valued Patient,

The cost of health care in Private Practice includes the fees paid to the doctors responsible for your care, hospitalization, the cost of special investigations and medication. There is no longer a standardized tariff recommended by a Medical Association and currently used recommended tariffs are a guideline for costing and unfortunately are outdated. The contract you enter into with your doctor is independent of your arrangement with the Medical scheme you have signed up with and the fees charged by the practice remains your responsibility to settle.

The Medical aid cover that you have is based on the Scheme that you have joined and the plan/option you have chosen. Our practice is contracted to be designated service providers with a number of schemes but not with all of them. We charge fees based on the agreements signed with these Medical Aids except for consultations and for certain procedures.

In the case of Medical Schemes we are not contracted with or for private patients the following policy will apply.

WHAT DOES YOUR MEDICAL AID COVER?

Your treatment, healthcare costs, and quality of your professional care can be severely affected by the type of medical plan you belong to. It remains your responsibility to familiarise yourself with the benefits and terms and conditions associated with your chosen medical aid benefit option.

Ascertain the exact amounts your scheme provides for, in terms of consultations, procedures and treatments as well as what your medical aid will cover. Where a designated service provider has been appointed by your medical aid, it remains your responsibility as the patient to familiarise yourself with any medical and financial restrictions when consulting a non-designated service provider.

With increasing interventions from your medical scheme, please be aware that the practice will not allow the medical scheme to violate the healthcare professional’s clinical independence. Where a medical aid or its advisors intervene to overrule your healthcare professional’s preferred diagnostic approach or treatment, your healthcare professional accepts no responsibility for consequent adverse outcomes. You may be requested to allocate responsibility to the medical aid and its medical advisors in the event of adverse treatment outcomes.

You remain responsible for any amount that your medical scheme or Funder does not pay for any services rendered and invoiced for, by the practice.

SETTLING OF ACCOUNTS, CO-PAYMENTS AND PERSONAL DETAILS

The practice staff will inform you should the practice have any arrangements in place with your medical aid.

The practice reserves the right to claim directly from you in which case you will be provided with a detailed invoice that is payable within 30 days from date of service. You have the option to claim this back from your medical aid should you wish to do so.

Please take note of this practices’ billing policy in relation to costs for services rendered. Where an exact price cannot be presented, a quotation could be provided, subject to its own terms and conditions. Due to the billing policy, a co-payment may be levied by the medical aid or the practice. Such charges above the medical aid policy coverage, will be payable by you.

You (or your parent / guardian) remain liable for the account at all times, for services rendered by the practice even if you are covered by a medical aid or any other third party. This contract does not prevent the practice from taking all reasonable and practical steps to recover any outstanding amounts from any obligated party. You hereby consent that your personal information may be provided to attorneys or debt recovery agencies to recover from you any amounts due if they remain unpaid. The practice reserves the right to charge interest on your outstanding account that is due from date of service up to maximum interest allowed in the National Credit Act No. 34 of 2005 (“NCA”).

It remains your responsibility to inform and update all personal and medical aid information with the practice and to keep the practice regularly informed with regard to any changes on your contact details, benefits and list of dependants. Please note that the use of someone else’s medical aid card with or without such a person’s consent or knowledge, constitutes fraud. The practice will report such instances to the medical aid concerned to protect the practice from being regarded as a cooperative in committing fraud.

The practice reserves the right to charge a service fee for any credit given in terms of the provisions of the NCA.

The practice relies predominantly on email for communication regarding appointments, instructions before procedures, sending of reports and other day-to-day communication. Please ensure that the email address provided is correct, is a private email address and that receipt of emails is acknowledged. Other forms of electronic communication such as SMS or WhatsApp will not be answered unless in an emergency. All account queries must be done via email – please email accounts@drsonday.co.za

In the case of elective or emergency procedures we charge three times the recommended rate for PMB conditions. For non-PMB conditions we will reduce the rate according to the problem.

CONSULTATIONS:

Elective consultations will be billed according to the length of the consultation and if there are any procedures or tests done in conjunction with the consultation:

• <10min consult – R 700
• 10-15min consult – R 900
• 15-30min consult – R 1400
• >30min – 1500
• First month post-op is free if pertaining to the original problem.
• Results post biopsy/scans or endoscopy are free unless consultation is over 10min. Then there will be a R600 charge.
• An admin fee of R300 to cover for time and resources will be charged if authorization, letters of motivation or reports have to be done.
• All consults to be paid on day of appointment.
• Telephonic scripts for a known condition for the first 3 months is free. Thereafter there will be a R300 charge.
• This practice is only contracted with to Discovery Classic and balance bills all other schemes/plans based on private rates, depending on the complexity of the problem and after-hour work. We will endeavour as much as possible to retrieve the funds from the schemes, but the onus falls on the patient/main member or guardian to pay any outstanding balances. We can do payment arrangements if you enquire.
• As specialists, we charge more than medical aid rates. If you do not have GAP cover, you are liable for the payment of the shortfall. For this reason, you should consider taking out GAP cover.
• Private procedures must be paid upfront.
• Reduces rates according to Doctor discretion.
• 15% discount for pensionners.

We do offer discounts to pensioners and you can negotiate the rates or payment options with our accounts manager. Discounts will fall away if the account is not settled timeously. Payment of your account within 30 days of receipt remains your responsibility unless other written arrangements have been made. Overdue accounts are handed over to a debt collection agent.

We provide assistance with all the required documentation and the procedures for obtaining authorisation from your medical aid and you will receive a detailed statement of your account. Please discuss any issues with our practice secretary.