Dispute Private Hospital Medical Surgery Debts

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Alan Bron

Member
17 June 2014
4
1
4
I refer to some payment related complications/disagreements I have had regarding gap payments to a
surgical team who I would never have hired had I known they would charge me approximately $6000 in 'gap fees'.

In the beginning of March 2014 I was placed under emergency care at Gosford Public Hospital on the Central Coast of NSW. This was due to ongoing severe headaches, loss of memory, an inability to read and
write properly, as well as speech impediments. These symptoms had been getting gradually worse over the course of several months.

I was given a CT Scan at the Gosford Public Hospital and it was determined by the emergency team that I either had a large tumour in my brain or that I had a serious and large abscess. The chances of survival were not great and my partner (A [surname redacted]) was informed. She was told the news was bad, very bad.

Note: I was not aware of any of these matters - A dealt with them - I was literally 'out of my mind' due to what turned out to be a brain abscess and was being treated with large doses of morphine (or something similar) to stop the pain.

According to A, the emergency staff gave her two choices: send me to Sydney's Royal North Shore Public Hospital or Sydney's North Shore Private hospital - Gosford Public Hospital did not have the expertise to deal with my problem. She was advised by emergency personnel at Gosford Public Hospital that since we had private health cover with BUPA she should send me to the private hospital.

A was not made aware of any gap payments that might be payable, nor did she even know that such a thing existed - and when I arrived at the private hospital we paid the excess we were expected to pay ($500) and were not informed that further money would have to paid to the surgical team (A. even asked if there were any other fees and she was told by the private hospital staff 'not to worry about it'. Talking to A since the operation, she tells me she assumed that Medicare and BUPA would cover the payments since nobody told her otherwise.

I spend two weeks in the private hospital where I had a craniotomy and it was determined I had a "Nocardial brain abscess" (see Nocardial brain abscess. - PubMed - NCBI).

After the craniotomy I recovered and shortly after started receiving bills from the various surgical team members (1 bill from each member).

Medicare and BUPA have paid about one third of the sum I was invoiced - but the surgical team want full payment - even though I explained, in writing, my inability to pay because I work part-time and only make a small income (approximately $35K per year) and have no assets (not even a car). I also stated the following in a letter I sent them:

" It is my strong belief that it is UNETHICAL to charge people any amount where no preliminary estimate is made available to them, and agreed to, before services are provided. Therefore I feel no moral obligation to pay any amounts charged above and beyond what Medicare and BUPA paid.

Had A or I known in advance what charges were not covered by our healthcare plans, we would have insisted on treatment in a public hospital. Our current financial situation would have deemed that the only sensible choice."

Note: The surgical team's bills have been addressed to me, not my partner.

How do you advise that I proceed should they decide to continue harassing me for payment? (Which to-date they have done, especially the anaesthesiologist, [redacted by moderator])

Regards.
 

John R

Well-Known Member
14 April 2014
689
174
2,394
Sydney
Hi Alan,
  1. Do you or Angela have a copy of any paperwork that you (or I assume Angela on your behalf) may have signed on admission to Sydney North Shore Private Hospital? If yes, what does it mention in relation to costs?
  2. Have you complained to the North Shore Private Hospital? If yes, how have they responded?
 

Alan Bron

Member
17 June 2014
4
1
4
Hi John: Angela and I received no paperwork after we left the North Shore Private Hospital that was not immediately handed over to Gosford Public Hospital after I was transferred back so I could be closer to home.

Nor does Angela remember signing anything at North Shore Private. She only remembers signing stuff at Gosford Public just before they put me on the ambulance to North Shore Private - but she remembers that form as just being a release form of some sort - no mention of gap fees or other fees.

I only remember signing a credit card payment form for $500 to cover the excess hospital fees - as per our BUPA agreement - I signed this approximately 5 - 7 days after the surgery.

I have not sent a complaint letter to North Shore Private Hospital - they have not asked me for anymore money after they got the $500 excess payment - which we were happy to pay.
 

Alan Bron

Member
17 June 2014
4
1
4
Thanks John: It appears North Shore Private Hospital may be able to help me. They sent me the following email today:

"Thank you for your invoices. The doctors are not employed by NSPH, however we will follow up and try to assist you.
Will be in contact early next week. Kind regards [name withheld]"

The hospital also mentioned, when I spoke to them on the phone, that without an "informed financial consent" from either me or my wife the doctors can not bill be more than the amount covered by Medicare and my private health cover - if that is correct I should be OK because neither my wife or I made any "informed financial consent" - verbally or in writing.
 

John R

Well-Known Member
14 April 2014
689
174
2,394
Sydney
Hi Alan,
That sounds like a positive update. Please keep us updated.

The doctors may not have been employed by North Shore Private Hospital but I'd assume that the Hospital rents surgery rooms/facilities to the doctors and ultimately, those doctors require informed financial consent from you (or Angela on your behalf).

For further information on Informed Financial Consent, you may want to review:
  1. Ramsay Health's statement on Informed Financial Consent. Ramsay Health being the operator of the North Shore Private Hospital; and
  2. Australian Medical Association's (AMA) website on Informed Financial Consent.