Fees, terms & conditions

Dr Colin Padoa · Specialist Anaesthesiologist · Practice no. 0358827 · HPCSA MP 0467731 · copa.anaes@gmail.com

The Health Professions Council of South Africa (HPCSA) and the Consumer Protection Act require us to tell you about the fees for your anaesthetic. By agreeing to your anaesthetic with Dr Padoa, you confirm that you understand and accept the following.

Billing

1. Medical schemes and plans give different levels of benefit for anaesthesia, from full cover to partial cover, depending on the scheme and plan.
2. Anaesthetic fees are based on the time spent in theatre and the risk and complexity of the procedure, and may include modifiers for, for example, bone surgery, obesity, advanced age, blood-pressure control or emergencies.
3. The anaesthetist bills a time-based rate. Any quotation assumes an average surgical time and complexity and excludes modifiers and procedure fees (such as an epidural or nerve block). If any of these change, the final amount may differ from the quotation.
4. Any co-payment (the amount your scheme does not cover) depends on your scheme and plan. It is your responsibility to ask your scheme what the approximate shortfall will be.
5. As the patient — or the parent or guardian of a child patient — you are responsible for the cost of the healthcare received, even if you are not the principal member of the scheme, and are liable for the full account, including any portion your scheme does not pay.
6. If an attorney or collection agency is appointed to recover overdue amounts, you will be liable for those costs on the attorney-and-own-client scale.
7. You confirm that your postal address, email address and phone numbers are correct for receiving the account, and you will give one week's notice of any change.
8. Dr Padoa is not a designated service provider (DSP) for any scheme, so anaesthesia costs — including for prescribed minimum benefit (PMB) conditions — may not be covered in full.

Your information

9. Your information is stored securely and accessed only by the specialists and staff of COPA Anaesthesiology Inc, in line with the Protection of Personal Information Act 4 of 2013. See our Privacy Notice.
10. You agree to it being shared, where needed, with the practice's billing company, your medical scheme, a collection agency, the practice's medical protection society, and the South African Society of Anaesthesiologists (SASA) and HPCSA.
11. You authorise COPA Anaesthesiology Inc to act on your behalf with the Council for Medical Schemes (CMS) and others in complaints or disputes against your scheme or its administrators, including disclosing relevant medical details (underlying condition and procedure).
12. Before taking legal action over any claim, complaint or grievance, you agree first to request a free, confidential pre-mediation meeting with an accredited mediator appointed by SASA.

Your quotation

• Before your surgery you will receive a quotation. It is an estimate for a standard procedure; if the procedure is more complex or complications arise, a higher code and fee may apply.
• The quotation does not include the modifier for a body-mass index (BMI) over 35. If your BMI is over 35, the fee increases to 1.5 times the quotation, because of the extra complexity and risk.
• It does not include specialist procedures that may be needed, such as nerve blocks or central venous lines. Please ask about these before your procedure.
• The first 30 minutes cost more because they include the pre-operative assessment.
• Ask your surgeon's rooms for a time estimate. Anaesthetic fees exclude hospital, theatre and surgeon's fees. If the procedure takes longer than estimated, you will be billed for the actual time.
• Ask your scheme how much of the fee it will cover. If you have gap cover, make the necessary arrangements with your gap-cover provider and let us know.
• The practice is not contracted to any scheme but, as a courtesy, will submit the account to your scheme and then send you the balance.
• If your scheme pays its portion into your bank account, that amount is due to the practice immediately, and must be paid within 7 days.
• If you have no benefit for the procedure, authorisation was not completed, or the scheme does not pay for any reason other than a billing error on our part, the full account is payable immediately.
• Some schemes do not recognise or reimburse certain SASA and SAMA codes. You can query this directly with your scheme.
• Whatever your plan, you remain ultimately responsible for all fees.