The billing policy is part of the terms and conditions that you sign for when filling in the patient registration form. A link to this policy will be included in the copy of the registration form that will be e-mailed to you.

 

1. This Practice charges the fees it regards as appropriate in terms of the experience, services and training of the healthcare professionals working in the Practice, as well as the cost-base of the Practice. Competition law dictates that different Practices may not agree to charge the same or similar fees.
2. A general fees list of the most common codes we charge is available from reception, or alternatively you may obtain further details about our fees directly by e-mailing us at info@stellenboschpaed.co.za.

3. Fees are increased on an annual basis and patients will be made aware of changes in fees upon booking an appointment. You are also welcome to enquire about fee changes by telephone or e-mail before you make an appointment.

4. The consultation fee for the appointment is payable before you leave the practice. If you prefer, we can submit the fee for the consultation directly to your medical aid in real-time, however, if sufficient funds are not available or if the service is not covered or allowed by your medical aid, you will have to settle the account at the office before leaving our premises.

5. Accounts for inpatient services (e.g. when your child is admitted to hospital) will be submitted electronically to your medical aid by us, except in the case of patient who do not belong to a medical aid in which case the account will be sent to you directly after discharge from hospital. Please note that this does not guarantee payment by your medical aid and if payment is rejected due to whatever reason, you will remain liable for the full outstanding amount (see further detail at point 11).

6. The Practice will provide patients with a price of goods and/or services upon request, and where it is unable to do so, it will provide a cost estimate. It should be noted that healthcare is not an exact numerical science, and the duration of services, the types of services or the number of items used cannot always be exactly predicted in advance, as it depends on the specific patient’s health status, healthcare needs and sometimes factors such as weight, or possible adverse reactions.

7. In some cases, hospitals, theatres, clinics, other doctors (such as anaesthetists, pathologists, etc.), or other healthcare professionals (occupational therapists, physiotherapists, etc.) will be involved in the patient’s healthcare. Such facilities and professionals will charge their own fees in addition to the fees of this Practice if they also render healthcare services to you.

8. The Practice may contract to certain medical schemes (options) in a particular year. In such cases the Practice is obliged to charge at the fee levels so agreed with that scheme.

9. If the Practice has not contracted with a scheme (option), the fees that we charge, and the benefits awarded by your scheme may not overlap. This would mean that you may be required to pay the difference, or in some cases, depending on the patient’s medical scheme, pay for the treatment in full. Should you feel aggrieved by the decisions of your medical scheme, you can approach the: Council for Medical Schemes (CMS) at: complaints@medicalschemes.com or fax (086) 673 2466. Note that the CMS would want patients to exhaust internal remedies (appeals at the scheme) first.

10. In some cases, and especially for medical scheme, they may require pre-authorisation and/or a motivation prior to certain treatments. Pre-authorisation or scheme approval is, according to schemes, no guarantee of payment.

11. Should you (the patient, if you are an adult, or the parent of a child-patient) not pay your account within 30 calendar days, we will give you notice of 20 business days, where after we will refer your account to a debt collecting agency. This will attract additional collection- and other fees. We reserve the right to charge interest of 2% per month on overdue accounts.

12. Please ensure that we always have your latest contact details to prevent you from missing any important communication from us. We may contact the person(s) indicated on your personal information form if we cannot get hold of you and your account remains unpaid.

13. Patients are encouraged to approach us early on if they experience problems with the payment of the account.

14. Employment, insurance, Road Accident Fund and Compensation Fund (workplace injuries/disease) are dealt with according to the specific rules set by such bodies. Please inform us should you fall into these categories so that we can explain billing in these cases to you.