Types of invoices

There are several different categories of invoicing (detailed below) depending on your individual circumstances.   We use Medicare’s “Eclipse” software to electronically transmit invoices to Medicare, most health funds, and the Department of Veterans Affairs.   

SIMPLIFIED BILLING FOR “KNOWN GAP” FUNDS – Part invoice sent electronically to health fund and gap invoice sent to patient

Some major health funds pay increased benefits depending on your level of cover with the fund, providing that you received a written estimate of costs prior to your procedure.   In such cases we utilise the “Simplified Billing” method and send an invoice electronically to your health fund who in turn pay the combined health fund and Medicare rebate direct to the anaesthetist.

We send a gap invoice to you advising both the total cost of the anaesthetic fee and the gap portion that is now due.

HEALTH FUND ELIGIBILITY: If your insurer rejects any portion of the claim due to insufficient health insurance cover, you are within your waiting period or your health insurance has lapsed, you will be responsible for the short-payment by your health fund.   

“NO GAP” FUND – Doctor participates in health fund agreement.   Entire invoice sent electronically direct to health fund

Some of our anaesthetists have an agreement with various “No Gap” funds.    In such cases the invoice is sent electronically direct to the health fund, with no gap to the patient.

HEALTH FUND ELIGIBILITY: If your insurer rejects any portion of the claim due to insufficient health insurance cover, you are within your waiting period or your health insurance has lapsed, you will be responsible for the total anaesthetic fee.   

“NO GAP” FUND – Part invoice sent electronically direct to health fund and Medicare, and gap invoice sent to patient

If you are insured with a “No Gap” fund we require the total cost of your anaesthetic service to be paid prior to your procedure.   You will receive an invoice with your Informed Financial Consent letter which must be paid at least three days prior to your procedure (you cannot use the prepay invoice to claim a Medicare rebate).   After your procedure we send a “paid” claim electronically to Medicare and your health fund on your behalf, for the relevant Medicare and health fund rebates to be paid directly to your bank account.   

If the amount you prepaid is greater than the actual cost of the anaesthetic service, you will be issued with a refund from the anaesthetist.   Similarly, if the procedure is more complex or takes significantly longer than anticipated, on rare occasions there may be an additional fee requested after the procedure.

UNINSURED PATIENT – Prepay invoice sent to patient

If you do not have private health insurance we require the total cost of your anaesthetic service to be paid prior to your procedure.    You will receive an invoice with your Informed Financial Consent letter which must be paid at least three days prior to your procedure (you cannot use the prepay invoice to claim a Medicare rebate).

After your procedure we send a “paid” claim electronically to Medicare on your behalf, for your Medicare rebate to be paid directly to your bank account.    If the amount you prepaid is greater than the actual cost of the anaesthetic service, you will be issued with a refund from the anaesthetist.   Similarly, if the procedure is more complex or takes significantly longer than anticipated, on rare occasions there may be an additional fee requested after the procedure.

PREPAID PROCEDURES – Prepay invoice sent to patient

There are certain procedures where we require the total cost of your anaesthetic service to be paid prior to your procedure.    You will receive an invoice with your Informed Financial Consent letter which must be paid at least three days prior to your procedure (you cannot use the prepay invoice to claim a Medicare rebate).    After your procedure we send a “paid” claim electronically to Medicare and your health fund (if applicable), for the relevant rebates to be paid directly to your bank account.    If the amount you prepaid is greater than the actual cost of the anaesthetic service, you will be issued with a refund from the anaesthetist.

DEPARTMENT OF VETERANS AFFAIRS – Invoice sent electronically to DVA

For patients who are holders of a valid DVA Gold Card, we send a claim for the entire anaesthetic cost to DVA on your behalf.

WORKCOVER CLAIMS – Invoice sent to WorkCover insurer

If your procedure is covered by an approved WorkCover claim, your surgeon will provide us with the claim number, case manager and specific contact details to enable us to send an invoice for the entire anaesthetic cost direct to the WorkCover insurer.

TAC CLAIMS – Invoice sent to TAC

If your procedure is covered by an approved TAC claim, your surgeon will provide us with the claim number, case manager and specific contact details to enable us to send an invoice for the entire anaesthetic cost direct to TAC.