Surgery Assured for Specialists

Clear and simple fixed price surgery with Healthscope

Help your patients avoid public waiting lists and access private hospital treatment with one single fixed fee1
 

Another option for your patients

Surgery Assured provides a clear, simple option for uninsured or underinsured patients to avoid public waiting lists but still access private hospital treatment. This new program offers a range of elective surgical and diagnostic procedures for a fixed-price at participating Healthscope private hospitals.

Accredited VMOs can now offer suitable patients one fixed fee that includes all hospital, specialist and medical fees. All treatment costs are covered from the time a patient is admitted to hospital, through to their discharge, including up to two consultations after discharge.
 

Why partner with Sydney South West Private Hospital for Surgery Assured

More people are seeking alternatives to private health insurance (PHI).

The number of Australians with PHI continues to decline and the amount of exclusions in PHI policies is increasing. Waiting lists for many procedures in public hospitals are also facing substantial pressure.

We are seeing a significant increase in demand from uninsured patients to access private care. 

Healthscope continues to see significant growth in patients seeking and paying directly for private treatment in our hospitals. As a result, we are improving our approach for both patients and specialists.

Research indicates a strong interest from patients in a simpler and clearer way to fund their own private treatment.

Research conducted on behalf of Healthscope in 2020, with Healthscope patients2 and potential patients3, indicated significant interest in treatment packages that came with a fixed bundled fee. Hence the creation of the Surgery Assured product.

Of the survey respondents, 82% of previous self-pay patients at Healthscope hospitals and 66% of potential patients in the community preferred this approach. 

Patients and potential patients told us they were most concerned about getting the procedure done promptly and having an experienced specialist manage their care. The certainty of fees prior to admission and the
reassurance of no escalation of the fees, if further treatment was required, was also extremely important.

The majority (55%) of respondents were most interested in paying for relatively low-cost, day surgery procedures.


 

One fixed fee paid on or prior to admission to cover your patient’s care in hospital.

All parties agree that no additional fees will be charged to a patient for complications that may arise during their hospital stay.

For example, if the patient requires an overnight stay or a return to theatre, the patient will not be charged any additional fees by either the hospital or participating specialists.

In line with VMO feedback, we have selected day procedures which have historically low rates of complication.

In the event the patient requires re-admission to a participating Healthscope hospital within the first month after discharge, and the re-admission is required due to a complication that is directly related to the initial procedure, then no additional fee will be charged by the hospital or specialist to the patient.4

Up to two post discharge consultations are included in the specialist’s fee.

We have focused our Surgery Assured product on selected day surgery procedures only. This is based on feedback from many specialists who indicated lack of complexity and variation in day procedures allows them to confidently set their own procedure fee.

If you opt to participate in Surgery Assured you can elect to set your own fee for each of the day procedures listed. The list of procedures is available from your Hospital General Manager. These will be fixed for each 12-month period and are confidential to each VMO. Alternatively, if you do not want to set your own fees, Healthscope will remit a fee to specialists as a default that will apply to the patient’s episode of care. The default rate will only be applied when specialists do not set their own fee. The hospital default rate provides an attractive uplift on the medicare benefits schedule. For details please discuss with your Hospital General Manager.

Healthscope has provided indicative bundled fees for the selected procedures below, based on the Healthscope specialist default rate. Actual fees may vary, and the default rates applicable to the Surgery Assured product are subject to change by Healthscope from time to time.

Examples of Surgery Assured fees

As a partner in the Surgery Assured program, you will be on an accelerated payment cycle. Once an accurate invoice is received and approved by the hospital, it will typically be paid within 14 days.

Please note an invoice template will be provided to participating specialists. This is submitted via an easy to use payment portal.

The total fee charged to the patient is a gross amount. After their procedure, patients if eligible will receive a Medicare rebate. Specialists will trigger this rebate as normal when processing the MBS item numbers for the procedure undertaken and on receipt of full payment, in this case from Healthscope.

Our accelerated payment process will not only enable faster payments to specialists but also help patients to receive Medicare rebates as quickly as possible.

We will encourage patients to register on the MyGov website with their bank account details so they can automatically receive the Medicare rebate into their account.

Please contact Jenny Connor jenny.connor@healthscope.com.au if you want to take part or to find out more.

  1. If you are interested in partnering with us on this initiative, we will provide a more detailed outline of the product.
  2. Your hospital General Manager can share the list of day procedures that may be provided under Surgery Assured.
  3. If you and/or other specialists (surgeon/physician/anaesthetist) want to provide your own fees, we will require these fees by procedure. Otherwise, let us know that you will elect to charge as per the default rate as advised by Healthscope. This will either increase or decrease the total fee charged to your patient.
  4. An agreement will be provided with terms and conditions and further education will be provided to your Practice Manager. If you agree to opt in to the terms and conditions of the Surgery Assured programme, you can start offering the Surgery Assured package as your rooms undertake your theatre bookings.
  5. Healthscope will provide brochures and information on the websites of participating hospitals, including information about the total estimated fees and rebates to share with your patients.
  6. As the product develops, participating specialists will have the opportunity to be profiled and have their contact details on the website. We will require your consent to publish this information.
  7. As we develop and streamline the product and processes further, we plan to undertake a marketing and communications campaign to promote the offer to potential patients.


1. Price includes all hospital, specialist, radiology and pathology costs incurred within a single episode of care following admission to a participating Healthscope hospital, up to the point of discharge from the same participating Healthscope hospital. Price excludes all pre admission and post discharge costs (including medical, diagnostic and pathology costs), other than post discharge costs that are expressly stated by Healthscope to be included within the Surgery Assured product.

2. A sample of 72 patients who had been admitted to a Healthscope hospital within the previous 18 months, and who had paid for their care directly were recruited via a registered research panel and interviewed.

3. A sample of 1,210 potential patients were recruited via a registered research panel to be representative of the community, within the target demographic. They were aged 55 years or older, and had restricted private health insurance or no private health insurance and had the financial capacity to pay for elective surgery.

4. A re-admission is “directly related to the procedure undertaken” if the treatment received during re-admission is necessary because of a complication arising from the treatment provided under Surgery Assured during the patient’s initial episode of care at a Healthscope participating hospital. The cost of an eligible re-admission is only included within the Surgery Assured price if the patient is re-admitted to a participating Healthscope hospital. If a re-admission is not, or cannot be performed at one of Healthscope’s participating hospitals, the patient is likely to incur additional costs.

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