The Australian Patients Association (APA) has expressed concern and called for action on what it describes as the systematic overcharging of patients.
The APA said its call for action follows the experience of one mother who was recently told she would be charged more than double the recommended fee for her daughter’s upcoming adenoid surgery.
It said the Australian Medical Association recommends a fee of $400 for the adenoid procedure. However, the mother will be charged $830.90 by the surgery despite having private health insurance.
The patient’s private health insurance provider and Medicare will pay a combined $330.90 towards the surgery while the patient will be out of pocket by $500 - an amount that is more than the entire AMA recommended fee.
APA CEO Stephen Mason said, “These practices are abhorrent and amount to rorting and should cease.”
“Unfortunately, this is a common practice where the surgeon charges the patient the full out of pocket amount agreed by the health fund, within their “known gap” arrangements,” said Mr Mason.
The APA said it encourages people to check the AMA recommended fee before they proceed with surgery.