Find essential information about your anesthetic care, billing policies, and what to expect during your treatment with us. We’re here to ensure transparency and comfort at every step.
Anaesthesiologists are not employed by hospital groups or surgeons, but work as independent service providers. Patients undergoing surgical procedures requiring the assistance of an anaesthesiologist will therefore be billed separately by the anaesthesiologist. What follows here are the published practice policies for Skoltramed Anaesthesiologists.
An anaesthetic account is constructed by using various codes associated with the surgical procedure and anaesthetic technique used.
It is required by law that a contract for service delivery is established prior to rendering said service. Patients or guarantors and service providers will be required to sign a contract stipulating the responsibilities of the involved parties. Patients will be provided with a “green form” prior to their anaesthetic. This legal document serves as a service agreement between the guarantor and the anaesthesiologist, as well as a means whereby patients give informed consent to the administration of an anaesthetic. This is in compliance with the Consumer Protection Act, the National health Act and the Protection of Personal Information Act. This document can also be downloaded from this website to be printed and completed prior to your admission.
Please remember that you, the patient, and/or guarantor, remain primarily responsible for settling any bill for services rendered by our practice within 30 days of service delivery. SKOLTRAMED though will provide some account management with selected medical aid providers on behalf of the patient. This service, as a courtesy, is delivered free of charge. You will be informed via email/sms that your bill has been submitted to your medical aid, as well as the progress of the claim. Should your medical aid not pay the account in full, the guarantor will be informed and a statement with the outstanding amount will be supplied.
Certain medical aids may be excluded from this arrangement – this means that individual members will be responsible to settle the anaesthesia bill with the anaesthetist and then claim the expenses from the particular medical aid provider on their own behalf. Regrettably, no account management will be undertaken by our offices in these cases. The following schemes are excluded from this arrangement.
Please note that claims submitted to Momentum, LA Health and Retail medical aids will be paid to the member, and not the service provider. In these cases, the member will remain responsible for settling the account.
Outstanding accounts will be considered for debt collection by a third party after hundred and twenty days.
It may happen that a member settles an account, prior to medical aid payout. The credit amount on the account will be repaid to the principal member of the medical aid only.
SKOLTRAMED anaesthesiologists have only a few reimbursement contracts with medical aids. These are the only instances permitted by law where the SKOLTRAMED standard tariff will not be charged but the contracted medical aid rate. In all other cases the standard tariff will be used and patients/guarantors will be responsible for the shortfall.
Please contact the practice prior to your procedure to find out if a contract between your medical aid and the anaesthesiologist is in place.
In certain cases medical aid providers may exclude certain medications or devices, as well as certain SAMA recognised codes from their patient benefits. The following is a non-exhaustive list of examples:
Anaesthesiologists will not be responsible for motivating the use of accepted codes, drugs or devices not covered by medical aids. We urge patients to contact the Council of Medical Schemes in these circumstances.
Tariffs for anaesthesia services rendered are determined by each practice individually and takes the following into consideration:
Tariffs are determined independently from medical aids and other funders and also separately from other anaesthesia service providers as regulated by the Competition Act. Annual tariff adjustments will be made at the beginning of each new calendar year and will be based on inflation and the average annual increase in medical reimbursement schedules of medical aids for anaesthesiologists.
| Skoltramed Standard tariff | GEMS (100%) | POLMED (150%) | 300% Medical aid |
Consultation Units | R62,63 | R31,43 | R50,06 | R94,29 |
Clinical procedure units | R38,52 | R19,94 | R27,66 | R59,82 |
Anaesthetic units | R273,46 | R112,63 | R173,63 | R337,89 |
Ultrasound units | R36,72 | R17.1 | R26,37 | R51,3 |
The following is an example of a cost estimate for a basic anaesthetic without modifiers of up to 30 minutes. The table also shows the difference between 100% scheme rate payout and the standard tariff of Skoltramed Anaesthesiologists. The guarantor will be responsible for the shortfall.
Description | Code | Units | Rand conversion factor – Standard tariff | Rand value based on Skoltramed standard tariff | Rand value based on 100% scheme rate(GEMS) |
Preoperative assessment | 0151 | 16 consultation units | 16 x R62,63 | R1002,08 | R502,88 |
Procedure specific basic value units | Lowest value procedure | 3 Anaesthetic units | 3 x R273,46 | R820,38 | R337,89 |
Time up to 30 mins | 0023 | 4 Anaesthetic units | 4 x R273,46 | R1093,84 | R450,52 |
Total |
|
|
| R2916,3 | R1291,29 |
Where anaesthesia care requires additional interventions above standard care or where procedures have more inherent risk due to surgical or patient factors, additional modifiers will be used. Time will also vary for procedures and impact on the total anaesthetic fee. We therefore urge patients to contact Skoltramed’s offices to obtain a cost estimate prior to their procedures.
With 20+ years of experience, our independent specialists offer affordable, high-quality anaesthetic care tailored to your needs.