The doctor-patient relationship is a partnership that is built on shared decision-making.
Informed Financial Consent refers to the dialogue between a medical practitioner and a patient that enables the patient to understand and consent to the potential:
• fees for a medical service (procedure or treatment) that is to be performed
• costs for protheses and devices that may be used during the procedure
• applicable Medicare and private health insurance rebates that apply to the procedure or treatment
• variations in fees and costs that may occur.
Informed Financial Consent applies to medical services that:
• attract a Medicare rebate and / or are insured by the patient’s private health insurer
• are self-funded by the patient
Informed Financial Consent should be provided to and acknowledged by patients in writing prior to their procedure or treatment so patients are aware of what the likely out of pocket expenses may be. For emergency procedures or treatment this may not be possible and if it is not, the information should be provided as soon as possible afterwards.
Patients should, where practicable, be afforded the opportunity to ask questions about the likely costs of a procedure / treatment and may choose to seek a second opinion from another practitioner.
As a part of providing Informed Financial Consent, medical practitioners may also provide information to the patient about the potential fees of other medical practitioners (such as anaesthetists and assistants) who may be involved in providing the proposed services.
Medical practitioners are required under the Health Practitioner Regulation National Law to disclose to patients any direct financial interest they may have in the facility or facilities where the procedure or treatment is to be provided, and / or in devices that may be used.
While there is no legal obligation to provide Informed Financial Consent, doing so is sound ethical and professional practice and assists to minimise the risk of patient complaints. It is important to remember that failing to disclose information or obtain proper consent (including financial), may give rise to a professional conduct complaint. A patient who may have otherwise been unlikely to complain about a medical service may be more likely to do so if they are surprised following a procedure or treatment regarding the fees charged. Providing Informed Financial Consent also makes it more likely that a patient will settle their accounts with the medical practitioner.
A medical practitioner may delegate part or the whole of the Informed Financial Consent process to practice staff. That said, it is important that the medical practitioner is available to answer any questions patients may have of the practitioner.
Informed Financial Consent is not a one-way conversation. Patients should ask questions and let the medical practitioner (or practice staff) know when they do not understand what is being conveyed to them. Patients are also responsible for contacting other medical practitioners involved in their care regarding their fees and contacting Medicare and their private health fund to confirm the rebates payable.
Further information regarding billing and Informed Financial Consent can be found on the Federal AMA website. If you have any queries or require assistance, please contact the Workplace Relations Team at workplace@amansw.com.au or
(02) 9439 8822.
Contributed by AMA (NSW)’s Director of Workplace Relations, Dominique Egan and Workplace Relations Paralegal, Sarah Morian
