Firstly before we outline our fees, it is important to explain how fees are charged.
In 1985, the Federal Government introduced a scheme called the Medicare Benefits Scheme that covers all medical procedures for which there is a Medicare rebate. It lists item numbers for operations and consultations, a schedule fee and a benefit (which you as a patient can claim under the Medicare scheme).
The Medicare rebate is set at 75% of the schedule fee for in-hospital expenses (such as operations) and 85% of the schedule fee for out-of-hospital expenses (such as consultations). Over the years, the Medicare rebate has not moved in line with inflation (the Consumer Price Index).
The Australian Medical Association ( AMA ), the peak medical representative body in Australia, sets its own schedule of fees, which has increased to keep pace with inflation. This fee is higher than the Medicare rebate. The Gold Coast Upper Limb Centre is an AMA practice.
Due to the increased cost of providing health care and meeting insurance premium costs, Gold Coast Upper Limb Centre ( GCULC ) does not “gap cover” and is not part of any health insurance alliance. GCULC does treat patients under WorkCover. Separate fee schedules are used for these patients and are typically billed directly to the appropriate organisation. GCULC does not offer discounts for Health Care Card holders. Dr Kalamaras attends the Gold Coast Hospital for those in financial need.
Our staff will outline the exact costs to you when you ring for an appointment. We ask for full payment at the time of the appointment and accept EFTPOS , most credit cards (not American Express or Diners Card) and cash. You will receive an invoice from these consultations and you take this to Medicare for a rebate. Private health funds do not cover treatments with medical specialists that are conducted outside a hospital setting, also known as Out Patient treatment.
If you are a WorkCover patient you must bring your claim number with you so we can make a claim on your behalf. If you do not provide this you will be responsible for payment.
When you visit Gold Coast Upper Limb Centre for the first time, you will be charged a first consultation fee. As the surgeon needs to spend extra time with you gathering your medical history and information to establish a diagnosis and formulate a plan for your problem. This fee is higher than follow up visits or subsequent consultations. You will receive a portion of this visit’s fee back through the Medicare rebate.
A lower fee is charged when you attend the Gold Coast Upper Limb Centre for a subsequent consultation. This is because less time and input is usually needed once the surgeon has become familiar with your condition.
Depending upon the operation, the cost of some of your postoperative appointments is included in the surgical fee.
If a procedure is performed at the time of the consultation (for example a joint injection) this may incur a fee. You may be able to use your detailed invoice and receipt to claim a Medicare rebate.
If you require surgery, our staff will give you an estimate of the costs for your particular surgery. Each operation has a different item number and fee. As well, each health fund has a different policy for payment to both patients and doctors. This makes the estimate and billing process all that much more difficult to navigate. It would be wise to talk to your health fund to ensure your level of cover prior to your surgery.
The estimate we provide to you will include the costs for Gold Coast Upper Limb Centre ( GCULC ) only. There will be three other fees you may need to consider as part of your treatment. One is for the Surgical Assistant. You will be given his/her contact details and an item number to quote over the phone. The Assistant fee is set at 20% of the surgeon’s fees. The other two fees will be from the Anaesthetist and the Private Hospital, depending on your level of cover.
GCULC ’s fee has to be paid in full at least three days prior to surgery. You will receive a receipt for your payment. Once the surgery has been performed, you will be given a detailed receipt with item numbers that you can take to your health fund and Medicare for your rebate.
We will also provide you with the Anaesthetist’s name and practice contact details and it is important that you make contact with this Anaesthetist to determine his/her costs. The fees charged by the Anaesthetist are separate from the fees charged by the hospital or by GCULC . The Anesthetist fees vary dependent upon the complexity and duration of the anaesthesia. It is your responsibility to pay the Anaesthetist for the services he/she provides. You may be able to claim a rebate from Medicare as well as from your private health fund (assuming you have private health insurance). Depending on the surgical procedure and your medical health, GCULC may require you to have a consultation with a Specialist Physician prior to your surgery. We can make this appointment for you. You will be responsible for the fee charged by this Physician.
Depending upon your level of private health insurance, you may also receive an account from the Hospital, Hand therapist, Radiology, Pharmacy or Physiotherapy. There may also be costs for rehabilitation devices such as braces or splints. These accounts generally arrive after your surgery and are separate and independent of GCULC ’s cost. Our receptionist will be able to advise you in relation to gaining quotes for such items.
Please remember that this is a quotation only and the surgeon may have to do more or less than initially expected which could cause a difference in costs to those originally quoted.
Orthopaedic trauma work can be quite difficult, often is not timed conveniently and can be distressing for the patient. Despite this, Dr Kalamaras has an interest in the management of trauma and has specialist skills in this area.
The Medicare fees are not commensurate with equivalent elective procedures. Added to this is the after-hours nature of this work and follow-up care. It is for this reason that the Gold Coast Upper Limb Centre charges the AMA recommended fees if performed on his routine operating list. If the procedure is done out of hours as a matter of emergency, the fees charged will reflect the complexity of the case and the surgical time.
Understanding surgical costs
Estimated costs for surgical procedures can appear complex and our staff will do their best to explain the healthcare environment to you. It is very important that you understand and are well informed regarding your financial commitment to Gold Coast Upper Limb Centre prior to your surgery. Please do not hesitate to contact our staff to discuss any financial concerns you may have.
Gold Coast Upper Limb Centre recommends you get in touch with your health fund and Medicare to obtain an estimate of your rebate on the fees charged.