Schedule of Fees: OBSTETRICS 1st July 2011.

This document describes – in detail – the fees that I charge for your care throughout your pregnancy, for your birth and for your postnatal care.

PLEASE NOTE:

  • 1. This document does not include or cover fees that other doctors or hospitals and other providers will charge you.
  • 2. Apart from office expenses (rent, equipment, salaries etc) my biggest expense is professional indemnity insurance – in the 2010 calendar year I paid over $100,000 in indemnity insurance (and this is not because I am a bad doctor – this is the set rate for an obstetrician. I have had no complaints or claims made that could affect my premium.)
  • 3. Like many obstetricians I “No Gap” the delivery (birth) fee but charge a “Planning and Management” fee mid-way through your pregnancy. My overall fees are around $7,250 per pregnancy (depending upon the number of visits and the complexity of your pregnancy and / or birth) and your total out of pocket expense – after Medicare and Health Fund rebates – is around $5,500.
  • 4. While it is impossible to provide care for an entire pregnancy without out of pocket expenses I try to lessen these expenses by “No Gap” billing the delivery fee aspect of your care. This in turn means that the “planning and management” fee is comparatively large (see below). This approach maximises the Health Fund contribution to your expenses and minimises the out of pocket component to your fees as best I can.
  • 5. By taking this approach I can limit the total out of pocket costs – to me – of your entire pregnancy to around $5,500.
  • 6. Once you have paid your Planning and Management Fee the only bills you will receive from me will be those for your antenatal visits. This is regardless of the complexity of your pregnancy or birth.
  • 7. If you wish to pay your Planning and Management Fee in installments over the course of your pregnancy I can accommodate you.
  • 8. I recognise that it is counter-intuitive to bill a large amount for what – in essence – is a retainer (the Planning and Management Fee) and then comparatively little for the Delivery Fee. This reflects:
    1. The low value Medicare and your Health Fund place on the birth itself, and
    2. The fact that if I bill your Health Fund directly for your birth they will pay a little more than if you claim directly from them and this in turn keeps your overall out of pocket expenses for your pregnancy as low as possible.
  • 9. My midwifery colleague Amanda Bartlett can perform some of your visits and we do not charge for her services. This is a way of lessening the cost of my care without compromising quality.
  • 10. I discount my fees modestly for patients who are returning to me for their second and subsequent pregnancies.
  • 11. Medicare will pay rebates on fees charged while you are not in hospital (i.e. those relating to your visits in my office and the overall management of your pregnancy) and your health fund covers your in – hospital treatment (usually the birth itself).
  • 12. With the rescinding of the Medicare Safety Net by the current Federal Government your total out of pocket expense for my care for your entire pregnancy will be approximately $5,500. If you think this is excessive I agree with you. Unfortunately out of pocket expenses exist because the federal government’s official schedule of fees is inadequate with respect to the true costs of providing your care. The current government has rescinded the Medicare Safety Net for obstetrics, hence the large out of pocket expense associated with my care. For the sake of perspective however my out of pocket fee is approximately equivalent to one term’s secondary private school fees.
  • 13. The Baby Bonus ($5,000 from Centrelink) still exists but is now means tested.
  • 14. The Federal Government has introduced its paid maternity leave scheme.
  • 15. You can claim up to 20% of your out of pocket medical expenses as a tax deduction. You will find more information about this deduction in the info section of my website.
  • 16. As a general rule your total out of pocket expenses for the whole pregnancy can be slightly lower if you have your baby at The Royal Hospital for Women rather than Prince of Wales Private Hospital.
  • 17. This fee schedule presupposes that you are an Australian resident with a Medicare card and a Private Health Fund with which you are covered for obstetrics. If you do not have one of these components please contact Rebekah for a quote for your fees.

FEE SCHEDULE (OBSTETRICS):


A “complicated pregnancy” is broadly defined, but includes pregnancies complicated by:

  • Multiple pregnancy,
  • Premature birth,
  • Significant diabetes,
  • Significant high blood pressure,
  • Other medical conditions and complications,
  • Placenta praevia,
  • Fetal distress and
  • Prolonged labour.

STOP PRESS: If you prefer an uncomplicated way of paying your fees that minimises claiming and maximizes certainty you can pay:

  • Your First Visit Fee of $350 (with just under $100 back from Medicare)
  • $5,000 for your Planning and Management Fee (with around $265 back from Medicare)

Then we will bulk bill all of your other antenatal visits and we will claim your delivery fee directly from your Health Fund (as long as you have a Medicare Card and belong to a Fund that “no Gaps”). This lessens your overall out of pocket expenses to around $5,000.

My fees do NOT include the following costs (and the figures mentioned below are VERY rough estimates):

  • A.Ultrasound scans performed by specialised ultrasound services (you will require at least two such ultrasound scans per pregnancy).
  • B. Laboratory tests.
  • C. Hospital accommodation (although this should be covered by your Health Fund).
  • D. Anaesthetists’ fees. Depending upon the situation – and the time of day or night – anesthetists’ fees can range from approximately $1,500 for a straightforward epidural insertion to over $3,000 for involvement in  complicated labours that involve epidurals then caesarean sections or complications after the birth. Your Health Fund will refund approximately half of these fees.
  • E. Surgical assistants fees for caesarean births (Prince of Wales Private only – approx $700, with approx $200 from your fund).
  • F. Paediatric services.

The providers of the above services (a – f) will bill you separately. Their costs are beyond my control and are additional to the fees that I charge.

GYNAECOLOGY

Schedule of Fees:  GYNAECOLOGY 1st November 2009 My gynaecology fees are based on those recommended by the Australian Medical Association (AMA). Unfortunately gap fees exist because the federal government’s official schedule of fees is inadequate with respect to the true costs of providing your care. In part the previous government addressed this by providing some support for our indemnity insurance premiums and through the Medicare safety net.

All of the above fees are associated with Medicare Item numbers and accordingly attract Medicare and / or insurance rebates. Medicare alone rebates for the out of hospital expenses while your fund rebates for your in hospital treatment. These fees do not include the following costs: Ultrasound scans performed by specialised ultrasound services

  1. Laboratory tests, particularly THINPREP smears
  2. Hospital accommodation
  3. Anaesthetists fees

The providers of the above services will bill you separately. Their costs are beyond my control and are additional to the fees that I charge.