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Ophthalmology group commits to medical bill transparency  

The Australian Society of Ophthalmologists (ASO) has joined other peak medical bodies in support of a new guide that aims to create greater medical fee transparency and prevent ‘bill shock’ for patients.

The ASO is one of 29 medical groups that has subscribed to the Informed Financial Consent: A Collaboration Between Doctors and Patients guide, which has been spearheaded by the Australian Medical Association (AMA).

Peter Sumich.

The guide is intended for practitioners to give to patients, so they have the confidence to discuss fees with their doctors before treatment, reducing the chance of unexpected bills.

ASO president Dr Peter Sumich said the catalyst for the guide was a series of news reports of urologists and orthopaedic surgeons whose charges were many times higher than their colleagues. There were also occasional cases in which grossly overcharging surgeons have caused financial harm to patients.

“This does not occur in ophthalmology because the out-of-pocket expenses are relatively small. However, it does identify a problem for consumers that a fair fee may be hard to determine,” he said.

“The first requirement is for patients to understand their billing and out-of-pocket costs. The second is to be aware that getting a second quote is not an unreasonable option.”

Sumich said the most common grievance among patients was unexpected out-of-pocket expenses. When patients are informed pre-operatively, he said they are more accepting due to there being no surprise element.

However, he believed such complaints were worse than previously because private health insurers (PHI) were not adequately indexing their contributions.

“The PHI gap policies have become exclusionary and punitive to patients who wish to choose their own doctor. I authored a full submission to a senate committee on out-of-pocket-costs which is available through the ASO website. The submission outlines how insurance could be improved and made fairer. Unfortunately, despite the senate committee finding in favour of these recommendations, the PHI have not changed their current gap cover policies.”

Sumich said most ophthalmologists already have an informed financial consent document. The AMA guide provides a template for educating patients on their rights and the causes of out-of-pocket costs.

A step towards health financial literacy

AMA president Dr Omar Khorshid said out-of-pocket medical bills are not the major cause of discontent for patients, but unexpected gaps were.

Omar Khorshid.

“When we launched this guide in July last year, it was co-badged with 14 medical groups. We now have 29 groups, showing that it has proven useful to doctors and patients alike,” he said.

“The fact that all these groups have agreed to partner on this guide and promote it to their members and patients sends a very strong signal that the whole medical profession is committed to greater transparency on fees and the cost of quality medical care and treatment.

“It is rare to see such a convergence of support for a single document, and demonstrates that the Informed Financial Consent guide is seen as a major step in building health financial literacy for patients.”

The guide is available on the ASO website.

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