The Pregnancy Management Fee (PMF)
This fee is charged by all Obstetricians and is best described as your insurance membership. It ensures that Dr Lulania will be present at any time if you are ever admitted to hospital or delivering your baby.
The Medicare item number for this is 16590 and is defined as “Planning and management of a pregnancy that has progressed beyond 28 weeks provided the fee does not include any amount for the management of the labour and/or delivery, payable once only for any pregnancy that has progressed beyond 28 weeks where the practitioner intends to undertake the delivery for a privately admitted patient, not being a service to which item 16591 applies”.
It reimburses the Obstetrician for providing 24/7 cover and the disruption to their own lives and the lives of their family that this causes.
Some overseas private health funds will reimburse you a percentage or all of the PMF. It may be worthwhile checking with your fund.
If you have incurred more than $2 100 in out of pocket medical expenses (after you have claimed back from Medicare or your private fund) in a financial year, then, in normal circumstances, you will be able to claim 20% of any amount spent over $2 100 as a tax deduction.
This fee is claimable through Medicare once the amount is paid in full and you are 20 weeks gestation.
THEATRE ASSISTANCE FEE
This fee applies to all Obstetrics Patients and Gynaecology patients having a procedure at Calvary Hospital. Please be advised that this will be an out of pocket expense associated with your upcoming procedure or Caesarean. This fee is for the use of a theatre assistant.
Please note that this fee is NOT CLAIMABLE through either Medicare or your private health fund.
This fee is to be paid to our office at your earliest convenience, no later than 48hrs before your procedure. This amount may be varied at the time of surgery, if so an account will be issued to you for the difference after the procedure is performed.
FEES AND INSURANCE
Schedule of Fees and Practice Billing
Our fees reflect those recommended by the Australian Medical Association and the National Association of Specialist Obstetricians and Gynaecologists. They take into account my professional services, the cost of running a practice and medical insurance. Please note that fees are subject to change without notice.
Please call or e-mail our office for current fees.
You will be given written financial and practice information prior at your first visit so you can financially plan for your pregnancy care.
MEDICARE & HEALTH FUND CLAIMING
We offer Medicare electronic claiming facilities, so you do not have to stand in a queue at a Medicare office for accounts. We can automatically claim your rebate for you after your account is paid at the conclusion of each visit. You will need to claim your rebate on the Management Fees yourself at the local Medicare Office or via the “MyGov App”.
Provided you have your bank details registered with Medicare, your rebates will be deposited directly into your nominated account. If you bank details are not registered, you will simply receive your rebate via a cheque in the post. If you would prefer to claim invoices yourself, please let us know.
Consultations costs are only claimable through Medicare and are not claimable through your health fund.
We also have gap cover arrangements with health funds so we bill your fund directly for your delivery and postnatal care in hospital. Any hospital visits that are required while you are pregnant will also be billed directly to your fund with no expense to yourself. This saves you time and money.
The delivery fee is designed to minimise out-of-pocket expenses. Following birth, the delivery fee is directly billed to Medicare and your private health fund at their scheduled rates, so that there is NO ‘out-of-pocket’ or ‘gap’ component for you.
If you do not have Medicare or adequate private health insurance, you will be liable for out-of-pocket expenses. Please contact our office to discuss these fees.
The hospitals bill independently of this practice. Therefore, if you require a schedule of fees for your hospital stay please contact the accounts department of the hospital you are booked in to. If you require a caesarean section my fee will not change, however you will incur additional fees from the anaesthetist and assisting doctor. If an epidural is given during your labour, you will receive a separate bill from the anaesthetist. Similarly, if a paediatrician attends to your baby during your hospital stay, you will receive a bill directly from him or her.
Please note that we endeavour to be a cash free office. All major credit cards, EFTPOS and direct deposits are welcome.
If making a direct deposit, please pay to:
Riverina Women’s Health
BSB: 012 823 Account Number: 286005172 * Please put patient name as payment reference