Dr charging double ma rate

[EigerSA]

 

Medical Practitioners think they can charge what they want - it's time that they wake up and realise that we are not there to make them get even richer than they already are

It's a free market. Professionals in SA can charge what they want. You can then decide whether you want to pay the price or choose another provider.

 

The problem is that people go into treatment not knowing the costs upfront (whether through their own fault or that of the provider).

 

How true is that really? It's seldom that you do get the costs upfront, you generally get a "ballpark" figure. And just how much freedom do you have to choose another provider between the approved specialists on the medical aid list and those available? Personally I think it's a disgrace that they get away with it.... when I rule the world (yes soon) I'm gonna change the rules.

 

 

[orbeaorca]

When I hear stories like I think man I must be doing something wrong here I am charging way to little for my services. Hell I dont even have a credit card machine.

I think female gynaes and surgeons are some of the worse for this. Because I serve mostly people from the lower socio economic areas even though they are medical aid they dont just have the money for this kind of co payment. I go to great lengths to find specialist who will see my patients at reasonable rates.

 

Dont speak to the receptionist insist on talking directly to the doctor if you want a discount.

We should all wake up before hand and ask what their rates are behorehand other get your GP to refer you to someone else.

 

The anaesthetist after your op when you query your account which like way over medical rates tells but if you had negotiated and paid him before the op you would have gotten this massive discount. YOu only see him like 30min before the op and who takes a wallet to theatre and they going to lie their naked.

 

 

 

[orbeaorca]

I forget you could possibly also contact HPCSA.

This is from their website

 

http://www.hpcsa.co.za/service-fees-and-tariffs.php

The NHRPL 2009 (National Health Reference Price List (RPL) - 2009) has been published by the National Department of Health. The National Health Reference Price List is intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equivalent to a specified percentage of the national health reference price list. It is especially intended to serve as a basis for negotiation between individual funders and individual health care providers with a view to facilitating agreements which will minimise balance billing against members of medical schemes. Should individual medical schemes wish to determine benefit structures, and individual providers determine fee structures, on some other basis without reference to this list, they may do so as well.

Practitioners are allowed to charge patients at the rate at which medical schemes are prepared to reimburse their claims. However, charges by practitioners above the rate at which medical schemes are prepared to reimburse their claims must be done with the patient's informed consent. Any charge up to and possibly exceeding the Council's ethical tariff must be negotiated and agreed upon with the patient.

 

 

Important ruling on ethical Tariffs

The Health Professions Council of South Africa (HPCSA) has taken a decision to scrap its ethical tariffs used by doctors as a ceiling for patient accounts in future. This decision will come into effect once the Department of Health has finalized its extensive consultative process with stakeholders in determining a new National Health Reference Price List (NHRPL).

As a regulatory body aiming at protecting the public consumers of healthcare services, the HPCSA will, however, still retain its authority to determine whether a practitioner has overcharged a patient or not, in terms of Section 53 of the Health Professions Act 1974.  In order to make this determination, the HPCSA has adopted the following principles:

a practitioner shall charge a non-insured patient the NHRPL rate except where the patient provides written informed consent for a billing higher than the NHRPL rate and any charge above the NHRPL rate without the patient?s consent shall be deemed to be overcharging;

a practitioner may charge a private-paying insured patient a rate payable by the Medical Scheme to which that patient belongs or is a member if it is higher than the NHRPL rate provided that any rate higher than the rate payable by the Medical Scheme shall be deemed to be overcharging, except where the patient has given written informed consent for a charge higher than the Medical Scheme rate; and

for the purposes of determining whether the patient has provided informed consent, the practitioner is required to indicate to the patient the prevailing NHRPL or Medical Scheme rate for whatever procedure the patient presents for as well as the difference between that rate and the rate the practitioner intends to charge as well as the amount that the patient may have to pay in addition to the stipulated rate

[Minion]

 

How true is that really? It's seldom that you do get the costs upfront' date=' you generally get a "ballpark" figure.[/quote']

That's the major problem and an area where I believe some specialists are unethical. A doctor is supposed to charge at the NHRPL rate or the rate that will be covered by the MA. If they don't, they're supposed to get the patient's informed consent. If I interpret Orbeorca's info correctly, this means they need to give you their exact rates upfront, not a ballpark figure.

 

And just how much

freedom do you have to choose another provider between the approved

specialists on the medical aid list and those available?

I was under the impression that specialists on the MA list were supposed to charge NHRPL rates (or the max that the MA will cover). If they're charging more' date=' shouldn't you take it up the the MA to get them removed from the list.

 

Personally I

think it's a disgrace that they get away with it....

As an engineer, a member of the profession with the highest value:cost ratio (mainly due to the exceptionally low rates that consulting engineers may charge), I have opinions of lawyers', doctors' and accountants' fees that would get me badly drugged, unable to find legal help and unable to count the costs if were to ever voice them

 

[Goodbadugly]

One way to force Dr Evil to work for government rates is to not support him/her. Anybody can visit any of the state hospitals. If you do not support private doctors or try to enforce certain fee structures on them, they might leave SA to wherever they go.

Maybe that is the whole idea of the NHI. To get rid of private medicine in SA. Then we will all be equal.

Just an interesting question to the OP. What did the doctor charge you for the operation? (in Rand)

[Brakkies Sport Fotos]

Do you guys know that Female Gynaes CHARGES double that what Male Gynaes charges for the same service?

 

 

 

And they want payment directly after the consultation, because the know they screw the woman and dont want to have the medical aid only paying M/A rates.

[Spinnekop]

Maybe that is the whole idea of the NHI. To get rid of private medicine in SA. Then we will all be equal.

 

 

And without any legs.  Nice. 

[bikemonster]

News Just In: Skilled professionals in charging high rates shocker!     

[wpdeb]

Dear all replying on this post,

I am a specialist in private practice and I dont charge medical aid rates unless discussed with me beforehand by the patient and even then I will not charge medical aid rates except if the patient is a pensioner or I know the patient cannot afford higher rates - I do try however to charge what the medical aid pays out [Discovery 200% for example]

The medical aid rate for an appendectomy is R1243 - take of VAT and it leaves you with R1068 - take from that 40% for tax and it leaves you with R640.

Do you think that is a fair rate to get your appendix taken out - just to get an electrician or plumber to come to your house will cost you R500 and that is without any services delivered.

With the increases in doctors being sued and taken to Council, it is clear why we have a shortage of doctors in this country - it is just not worth the effort anymore to deliver a service at medical aid rates.

Why did you not discuss the rates before you went for surgery - doctors are good enough to come out at 2 in the morning to help you out and get you back into action with usually minimal complications but when it comes to paying the bill, there is always an issue.

In the Northern Suburbs of Johannesburg you will struggle to find any specialist not charging 3 times medical aid rates and this is the rate that has been set as acceptable by most of the professional societies.

It is time that patients realize that a medical aid is like an insurance cover - it is not a guarantee of full payment and there will usually be a top up.

Luckily for those who dont want to accept this type of charging there is always the NHI coming.

Regards

[mtbvip]

What a joke! Can't understand the logic - you will happily pay a hairdresser 1000 bucks every month to make your hair look nice, but b*tch and moan when someone gives you much needed (at times life saving) care. Not to mention the fact that this person probably spent 10y studying. In my opinion medical aid rates are a slap in the face of doctors

[bak2basiks]

 

I hold a Master's degree....I don't earn much money, but when I get paid for my expertise, I earn about R375/hour...

 

I was wondering if I can charge a doctor my hourly rate (or part thereof) when they are late for my consultation. Usually I get an appointment for 10:30. The docotr has no problem seeing you at 10:50, nevermind you having to be back at work at 11.

 

Don't get me wrong here, I think that doctors need to be paid well. But this demand/supply rule is really working for them.

 

EDIT: It still hurts me...

 

bak2basiks2009-12-04 12:20:37

[Guest Agteros]

 

 

 

unquote

unsaid

Agteros2009-12-04 13:35:56

[Goodbadugly]

It seems as if you have three options:

1. Get a better medical aid.

2. Shop around for a rookie doctor or go to a government hospital.

3. Keep your el cheapo medical aid and cough up when necessary.

 

The above mentioned fee sounds totally in line to me.

 

[Konaman]

Its your choice who you go to. I suggest you ask the doctor what is his/her estimated cost before the procedure or consultation is done. Will you have your car's engine replaced without finding out what it will cost? Negotiate with the doctor beforehand. The anesthetists are especially a problem as most of them don't charge medical aid rates. Ask the surgeon doing the procedure where you can contact the anesthetists, to find out about the rates they charge. Most doctors will drop the rates if you chat to them beforehand.

 

[Elvis]

I just paid a gynea R900 today for a consultation for my wife. He did tell my wife befoerehand what it would cost, and I suppose its fair and all, its just I am paying R4000 a month for medical aid and now I have to pay R900 cash. I am not sure who to be cross at but I suppose its the medical aid I have to blame. I just think that some of these doctors are riding the gravy train...

[wpdeb]

Henri,

Did the consultation include an ultrasound and a PAP smear - the ultrasound alone would probably account for about 400 of the consultation of which a part will go for repayment of the ultrasound machine.

If you pay R4000 a month for your medical aid, I presume you have a savings account - therefore you can submit your account of R900 to the medical aid and you will be reimbursed the full amount if your savings has not run out.

Why should the medical industry be any different from any other industry - you would not go to Woolworths to buy groceries and then tell them to get paid by a 3rd party.

The only time that this complaints about fees will stop is when the so called medical aid rate is scrapped and it becomes a market where you get a quote, the service is delivered and the money is paid by the patient to the doctor and the patient claims back from his medical aid.