Fees & Account Guide
As required by legislation, we have determined a unique billing policy for Dr Versace and Partners. Due to the wide range and confusion around medical scheme rates, we do not base our rate on any particular medical scheme rate, but rather on complexity of the procedure and expertise required. We will submit the same account to you and your medical scheme.
- Complex cardiothoracic and vascular procedures, as well as complex urological procedures needing specialized knowledge and expertise will be billed at our standard rate. In 2024 this is set at R262.44 per anaesthetic unit. This would include all heart, vascular and many lung operations.
- Cases under general anaesthesia carrying a smaller risk will be billed at about 65 % of smaller operations or procedures e.g. urology in the “scope theatre” or diagnostic lung procedures on otherwise healthy patients.
- Cases under monitored anaesthesia care or sedation which often do not require a general or “gas anaesthetic” will be billed at just over half of our standard rate or R141.51 per anaesthetic unit in 2024. Many of the cardiology procedures or “angiograms “would be covered here unless there is there further intervention e.g. “stenting” in which case the rate is R262.44 per anaesthetic unit.
- Private patients are required to contact the practice for a quotation and make arrangements for payment.
- Dental and maxillofacial patients should also request a quotation from the practice. Most medical schemes have separate payment conditions for dental work and do not usually authorise them on the same basis as other operations. That is why there is often a significant extra payment or limit at the dentist.
Our policy is thus to charge a higher rate for more complex procedures and not necessarily the same rate per anaesthetic unit for all the different operations. We do however reserve the right to make exceptions for and give discounts to certain patients.
We do not bill at any particular medical aid rate. We are often not sure what and if your medical scheme will pay us. We may be able to give you an estimate, but the final decision is with them.
We do not bill at any particular medical aid rate. We are often not sure what and if your medical scheme will pay us. We may be able to give you an estimate, but the final decision is with them.
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Quotations
It is recommended that you obtain a quotation from us if you are uncertain about the cost of the anaesthetic – see contact us. Alternatively, the Anaesthesiologist will be able to give you an estimate of cost. However:
The total anaesthetic account is ultimately determined by time spent in theatre and this cannot be calculated accurately in advance. The procedure may turn out to be shorter or longer than planned or additional procedures may be necessary.
Furthermore: the benefits that the many different medical schemes and their plans offer are changing constantly, unfortunately often downwards, and we simply cannot keep track of this on your behalf.
We can provide you with a quotation but the exact amount and the contribution of your medical scheme may change significantly.
Procedures and medicines that may be a problem:
It is recommended that you obtain a quotation from us if you are uncertain about the cost of the anaesthetic – see contact us. Alternatively, the Anaesthesiologist will be able to give you an estimate of cost. However:
The total anaesthetic account is ultimately determined by time spent in theatre and this cannot be calculated accurately in advance. The procedure may turn out to be shorter or longer than planned or additional procedures may be necessary.
Furthermore: the benefits that the many different medical schemes and their plans offer are changing constantly, unfortunately often downwards, and we simply cannot keep track of this on your behalf.
We can provide you with a quotation but the exact amount and the contribution of your medical scheme may change significantly.
Procedures and medicines that may be a problem:
- Any new or novel therapy is often rejected by the medical schemes on the basis that they may not be “cost effective”. Whilst we do agree that everything that is “new” is not necessarily “good”, why should you be denied a potentially better or even lifesaving therapy because the actuaries at the funder are concerned about the cost to them? It is however their right to state this up front and you will have to make the decision to proceed and pay for it yourself in consultation with your doctor. Examples here would include the therapy and the anaesthetic for Endovascular Repair of the Aorta (EVAR) or Trans-Catheter Aortic Valve Replacement (TAVI / TAVR).
- A minority of medical schemes (currently the administrators of Profmed and Keyhealth) will not pay for the attendance of an anaesthetist at certain heart catheter procedures, e.g. angiograms. It is all very well when everything goes smoothly, but may be a problem when there are complications or an advanced procedure is initiated. Furthermore, some patients may require sedation to tolerate the procedure. The Cardiologist cannot always predict this and in the interests of safety they invariably ask us to be present. Note: We are there at the request of the Cardiologist and not on our own initiative. You may have to pay for our service yourself or the Cardiologist may write a special motivation. This is however an inordinate volume of extra work and not part of their duties for the majority of medical schemes. You may request this of them, but consider it a favour and not an obligation!
- Since the advent of the breakdown in negotiations between medical schemes and doctors, a certain number of new codes have come into use by doctors... if you can call codes in use for more than 10 years NEW? These mostly relate to new technology and risk which some medical schemes choose not to acknowledge. We subscribe to the Coding Guidelines of the South African Society of Anaesthesiologists (SASA) which we believe fairly reflects developments in health care.
- Newer medications may be a problem, e.g. there is a new reversal drug for muscle relaxants called sugammadex which achieves the full return of the ability to breathe independently faster and more reliably than the older medications. This comes at a cost of approaching R1 000 when used, but may be worthwhile to save your life or save ICU costs. Again here we also abide by the guidelines of SASA and do not use it routinely. Again you will have to trust your doctor to act on your behalf when safety is a concern regardless of the rules of medical schemes.