Billing

Billing Policy

  • Your anaesthetic fee is separate from that of the hospital and surgeon.
  • Each associate of ACT determines their own costs associated with the provision of anaesthetic services by using the coding guidelines provided by SASA (South African Society of Anaesthesiologists) and SAMA (South African Medical Association).
  • You will be requested to read, understand and sign a document containing a cost estimate and billing information prior to your anaesthetic. This is an estimate only and is inclusive of VAT.

Professional Fee Determination

  • The anaesthetic fee is determined by the anaesthesiologist based on training, expertise, experience and practice costs and do not relate to any specific medical scheme rate. (Competition Commission ruling 2006). The rates used to determine the fee (as required by the Consumer Protection Act) is applicable to all patients, irrespective of circumstances or medical aid membership.
  • The cost of an anaesthetic is dependent on numerous variables including time and procedure complexity. Cost estimates are provided based on average operation duration but may change if procedure duration is longer or shorter than anticipated.
  • The cost estimate will, as accurately as possible, include additional costs for special pain control measures, usage of ultrasound equipment, blood pressure control and invasive monitoring devices. Modifiers related to positioning, areas of body undergoing surgery, emergency surgery, ICU admission and age may be added to the account.
  • If your body mass index (BMI calculated: weight (kg)/{height (m) x height (m)}) is 35 or greater, 50% will be added to the anaesthetic time unit fee.
  • Your medical aid may only pay 30% of the anaesthetic fee depending on the medical aid fund and type of plan and you will be responsible for the shortfall.
  • GAP cover is a short-term insurance product that provides additional protection for patients who already have medical aid. It covers any potential shortfall between your anaesthetic fee and what your specific medical scheme pays, and we strongly recommend that patients investigate such insurance.
  • Patients without medical aid/insurance cover should contact the practice for a quotation and make arrangements for payment