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Billing Policy

PainMedSA is a private practice and all accounts (including Motor Vehicle Accident claims) are required to be paid in full on completion of the consultation. PainMedSA is not a bulk-billing practice.
We have TYRO facilities to process your accounts. For private patients a Medicare rebate can be processed in the rooms on the day if you have a valid referral and if you have registered with Medicare, this amount is usually refunded within 24 hours. A discounted rate may be offered to patients with a valid pension or health care card. You are required to present this to administration staff when requested. Online verification is now possible and we will only be able to discount fees if your pension or health care card remains current.
Consultation fees vary according to which pain clinician you are reviewed by and the treatment that you require. The treating practitioner will provide administration staff with the appropriate item number for billing purposes at the completion of your visit.
You will be provided with the maximum anticipated cost at the time of making your appointment, or via our welcome letter. Please discuss with administration staff any questions you may have about fees and payments or if you do not receive this information.
Ongoing Motor Vehicle Accident (MVA) consultations are payable in full on the day of consultation and you will need to claim any rebate back from your Compulsory Third Party (CTP) Insurer. We will provide you with an invoice and receipt for claiming purposes. We are unable to invoice your insurer directly for MVA consultation services.  As from 1 January 2023 we no longer accept referrals for MVA consultations.
For WorkCover consultations we will only be able to review South Australia WorkCover claims and/or manage your accepted injury. We will generally request you obtain written pre-approval from your Claims Manager and provide this to administration staff before your scheduled appointment. Any other issues outside of your accepted claim would need to be managed separately and through private referral to our clinic.
All fees are reviewed by each practitioner periodically and any increases are entirely at their discretion.
If you require a procedure administration staff will prepare a Fee Estimate for you outlining the anticipated item numbers and any out of pocket expenses that may be payable, often referred to as the “Surgeon’s Gap”. This is not claimable through Medicare or your private health insurance and is payable one week prior to your planned procedure.

 If you have chosen an excess on your private hospital cover this may be payable on admission. Hospital staff will contact you regarding this. This is not claimable through Medicare. If an Anaesthetist is required for your planned procedure they will contact you directly regarding any costs associated with their service.
Self Funded Patients
Self funded patients are required to pay the amount quoted in the Fee Estimate IN FULL one week prior to admission to PainMedSA.
You will also be provided with Fee Estimate for the hospital and Anaesthetist. These are generally payable on admission to the hospital.
If you require any further information regarding our billing policy please contact admin staff on 08 8340 7733

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