Fees and Rebates FAQ

• Fees are charged depending on the service provided. For all new patients when you make your booking we can give you an accurate estimate of the fees for your initial consultation.
• Reduced fees are offered to all pensioners and health care card holder.
• Payment is required at the time of service
•  For all extended services, in particular foot orthoses and surgery, a written estimate will be provided including the item number so that you can check with your health funds for out of pocket expenses. We are unable to give you accurate estimates for out of pocket expenses as private health rebates vary greatly, however we will assist you getting the correct information.
• Time payments may also be offered by negotiation for extended services with large out of pocket expenses such as surgery.

Private Health Insurance

• Private health funds provide rebates for a range of podiatry services under the extras or ancillary tables. Some tables do not include podiatry so you are advised to check with your health fund to see if you are covered
• We provide HICAPS for “on the spot claims” processing and accept most forms of payment including EFTPOS, Visa and Mastercard.
• Rebates vary greatly depending on the tables you are on, and the type of services provided.
• Referrals are not required for private health insurance rebates

Medicare

• Medicare rebates are available for a limited number of consultations only, to patients under the Enhanced Primary Care Program.
• Podiatric surgery and foot orthoses are not covered by Medicare
• A referral is required from your general practitioner

 Veterans Affairs

• A comprehensive range of podiatry services are fully covered for Department of Veterans Affairs card holders
• A referral is required from your general practitioner.

Worker Compensation and Third Party Injury Claims

• If the treatment you are being provided is the subject of a third party or Work cover injury claim we will require the billing address for your claims coordinator or solicitor and claim number
• We also suggest that before making an appointment you clarify that your claim has been accepted as you will be responsible for the cost associated with any treatment.

• Apart from the surgeons fees there are a number of costs associated with surgery.  The majority of these costs are associated with theatre fees, hospital bed stay fees (where applicable), anaesthetic fees, pathology, and radiology services.
• Podiatric surgery is currently not covered under Medicare.
• Part of the Podiatric surgeon’s fees are covered under the extras tables of most private health funds.
•  All health funds are required to pay for some of the hospital costs and any prostheses (screws pins joint replacements) used during the surgery
•  The rebates for podiatric surgery as well as hospital and theatre fees vary greatly between funds.
•  It is often our experience that while other providers of foot surgery such as orthopaedic surgeons do attract a Medicare rebate, the fees they charge are generally much higher so the out of pocket expense can often be similar.
• Podiatric surgeons also provide more comprehensive after care and include all bandages, dressings, casts, post-operative shoes, and other requirements in the cost of your surgery.
•  You should also keep all of your receipts for other services such as hospital, anaesthetist, x rays and other imaging services as once you have reached a threshold amount a tax deduction for medical expenses can be claimed. Speak to your accountant for further advice.

• The disparity of funding for podiatric surgery has been of concern for a long time.  The Australasian College of Podiatric Surgeons is continuing to lobby the government and private health insurance industry to redress what is essentially an anti-competitive and discriminatory practice. While this issue has been recognized as an area for concern, governments and industry are slow to react
•  In July 2004 changes to the federal legislation required health funds to pay for some of the hospital costs and any prosthesis associated with podiatric surgery.

Summary of the Federal government Hansard during the debate on the Health Legislation Amendment (Podiatric Surgery & Other Matters) Bill 2004

Mr ABBOTT Minister for Health and Ageing

“I commend the bill to the House and present the explanatory memorandum”.

EXPLANATORY MEMORANDUM

“The objective is to ensure greater competition amongst providers of foot surgery by allowing for greater recompense for consumers of private health insurance.”

“The intention is to ensure that an admitted private patient being treated by an accredited podiatrist (Podiatric Surgeon) is able to access benefits, under an applicable benefits arrangement, for the hospital treatment costs as they would if a medical practitioner provided a professional service.”

Ms GILLARD  Shadow Ministerfor Health and Ageing

“the opposition is prepared to support the bill in its entirety and will be doing so today”

Ms WORTH  Parliamentary Secretary to the Minister for Health and Ageing

“Podiatric surgeons have been around for a long time. They are accredited under state and territory legislation. They are highly experienced in their craft and are subject to rigorous professional and clinical standards. They are accountable for their work.”

“It makes private health insurance a product that is so much more comprehensive and attractive to the hundreds of thousands of Australians who need podiatric treatment at least once in their lives. It gives those people more choice in their treatment options. No longer will they have to be treated by a general surgeon simply because one practitioner attracts a private benefit and the other does not.”

• The amendment while welcome did little to normalize the rebate for podiatric surgery with those of other professions.  If you are as unhappy about this situation as we are then we would suggest you write a letter of complaint to your local Federal Member of Parliament and send copies to the Federal Health Minister and the Health Insurance Ombudsman to request that more action be taken.

Federal Minister for Health

Department of Health & Aged Care

Canberra

Private Health Insurance Ombudsman

31 Market St.SYDNEY.

PH: 1800 640695

FX: 02 9261 5937

www.phio.org.au

• Change your health insurance to one that does choose to cover some or all of this service. We can give you some ideas of which health funds provide better rebates.
• Lobby your fund to change their policy or provide you what is called an “ex-gratia” payment.

Health funds often do not live up to their promises particularly when you consider the premiums you pay for private health insurance. One reason people have private insurance is so that they have a choice as to their health care provider.