Financial Information
FINANCIAL INFORMATION & CONSENT
Dr Zilko aims to provides a premium quality service in a transparent financial manner. This information & consent sheet aims to assist you in identifying the costs that may be involved in your care, as medical fees in the private healthcare sector are ultimately your responsibility. If you are in doubt, you should always check with your insurer to work out if, and for how much, you are covered for medical services so you can decide if you can afford the treatment involved. Medical fees are usually greater than the rebate provided by Medicare or your health insurer, and in this case you will need to pay the difference between the rebated amount and the medical fees (this difference is known as a “gap”).
Outpatient Clinic Appointments (for each new referral/problem)
- $250 for an initial appointment/new referral (GP-referred Medicare patients will get $78.05 back)
- $350 for an extended initial appointment or a second opinion (GP-referred Medicare patients will get $78.05 back)
- $150 for follow-up & subsequent appointments, including video or phone telehealth consultations (GP-referred Medicare patients get $39.25 back)
- $100 for post-surgery follow-up appointments within 12 months of surgery, including video or phone telehealth consultations (GP-referred Medicare patients get $39.25 back)
The above fees are payable for appointments that you do not attend or that are cancelled within 24 hours of the appointment time. If you are late for an appointment, we cannot guarantee that Dr Zilko will be able to see you and the above fees will still apply. Please note that WorkCover and ICWA insurers do not cover cancellation or late attendance fees, which are your responsibility. Medicare will also not make any contribution to a non-attendance fee, and you will be liable for the full clinic fee if you don’t attend.
Your first clinic appointment following an operation is included for free, but normal fees usually apply from six weeks post-operatively.
Surgical Procedures
For operations, Dr Zilko’s fees are based on those recommended by the Australian Medical Association. Medicare and private health only rebate a portion of surgical fees, and the gap must be paid before the surgery. We will provide a written quote with the estimated gap prior to your operation. If the procedure turns out to be considerably less or more involved than originally anticipated, the actual gap may be different from the quoted gap (this is uncommon). During operations, implants such as joint replacements, plates and screws, or suture anchors are usually fully covered by your insurer, but if you are an uninsured patient these implants will be charged to you.
Anaesthetists: most of Dr Zilko’s anaesthetists do not charge a gap for HBF members, but may charge a gap for patients with other private health funds (excluding Workcover, ICWA or Veterans’ Affairs patients). We can let you know who your anaesthetist is and you should check with them whether a gap is payable.
Surgical assistants: Dr Zilko’s assistant doctors will rarely charge you a gap, and will usually bill your insurer directly. If there is no rebate available from the insurance company for their services, they will bill you directly in which case there is no rebate available for this fee and it is your responsibility.
Other Services
Other Doctors: whilst in hospital it occasionally becomes necessary to ask other medical practitioners to be involved in your care. These doctors set their own fees and should let you know if a gap is payable, although Dr Zilko has no control over this.
Therapy and Rehabilitation: podiatry and physiotherapy may be an important part of your treatment. For privately insured patients, often your extras insurance will cover a portion of these fees, but there is usually a gap.
Orthotic Devices & Splints: many operations performed by Dr Zilko require the use of a walking boot, post-operative surgical shoe and/or splint. Dr Zilko will determine the type of device required for your operation, and will usually supply and fit it pre-operatively. The costs for orthotic devices/splints are:
- Surgical shoe – $50
- VACOcast boot – $250 (Health fund extras provides ~40-80% back)
- VACOped Achilles boot – $385 (Health fund extras provides ~40-80% back)
- VACOtalus brace – $150 (Health fund extras provides ~40-80% back)
- Even-up shoe raise – $35
- Bunion Sleeve – $38
- Budin Toe Splint – $12-15
Depending on your level of extras cover, you will usually receive 40-80% back on the cost of the boots/braces. Please note that boots/braces purchased independently are usually not eligible for any health fund rebates as they are not an orthotic device prescribed by Dr Zilko, and second-hand boots are strictly not allowed due to infection control risks. If you require a plaster to be applied in the post-operative period, an orthotist or physiotherapist will do this and they usually charge a fee. A complete list of available products with pricing is available in the rooms and on request.
Medical Imaging: you may require X-rays, ultrasounds, CT or MRI scans, injections or other imaging techniques. The radiology clinics can provide you with details of the costs, but most imaging services will generate a gap. You may wish to call different radiology companies to obtain costs for any tests Dr Zilko orders. During some operations, especially for total ankle joint replacements, X-rays are taken intra-operatively and you may be charged a gap by the radiology company.
*Forms & Reports: *Dr Zilko is happy to assist you with the completion of insurance and other forms if requested, though a fee for this service is payable upfront. The fee varies depending on the complexity of the documentation and the time taken to complete it. A quote can be provided.
WorkCover / Insurance Commission of Western Australia / Veterans’ Affairs
Dr Zilko accepts payment from these organisations for your treatment, including clinic and surgical fees. The same should apply to hospital fees and the fees of other health providers, although you should check this with individual providers if in doubt. The costs of X-rays, other medical imaging, and orthotic devices, splints and dressings are normally fully covered.
If you have an approved workers compensation or motor vehicle claim then your medical expenses should be fully covered, but in the event that your insurer refuses to pay any of Dr Zilko’s fees, then ultimately they are your responsibility.
Please Note: All of the above fees are subject to change. If we enlist the services of a debt collector to recover unpaid fees, a 16.5% surcharge will be applicable to cover the debt collector’s costs.
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