How much should I pay for a colonoscopy or gastroscopy?

If you need a diagnostic procedure like a colonoscopy or gastroscopy, cost is an important issue. However, surgical fees are often the last thing to be discussed. General surgeon Dr Terence Chua believes it is important for patients to make informed choices about their care.

If you have private health insurance, you might also be surprised to learn that patients often pay more out-of-pocket expenses for the same procedures depending on which doctor you see and where the surgery is performed.

For example, according to a recent article in the Brisbane Times [1], patients on the north side of Brisbane pay an average gap of $150 in out-of-pocket expenses for a gastroscopy, while 94 per cent were charged nothing.

The gap is smaller for patients on the south side of Brisbane at $100, but 21 per cent of people from this group were left out of pocket.

Understanding surgical fees and out-of-pocket expenses

This raises important questions around surgical fees and out-of-pocket expenses. For some procedures, the Medicare Benefits Schedule (the amount paid by the Federal Government to doctors) and private health insurance will cover most of the cost. However, the Medicare Benefits Schedule has not changed significantly over the years despite the higher cost of running a business (e.g. due to rising inflation and higher staff salaries and overheads) in the current economic climate. 

Furthermore, the Medicare Benefits Schedule does not factor in any significant aftercare that may be required in patients undergoing major surgery. In some cases, a surgeon will need to set a higher fee to help cover the cost of running the business and the time spent on providing quality postoperative aftercare.

So how can you make more informed choices about your care? Here are some tips to help you work out if you are paying too much for your next surgery.

Always ask for a fee breakdown before any surgical procedure

If you need to have any procedure, always ask for a quote. Quotes are only provided by a surgeon after a consultation. Every procedure done outside the public health system will attract a surgeon’s fee, anaesthetist’s fee and hospital fee. Fees are partly covered by Medicare and partly by the private health cover rebates. Many doctors try to keep any ‘gap’ fees (the remaining out-of-pocket expense a patient must pay) to a minimum.

For example, experienced Colorectal Surgeon Dr Terence Chua offers no gap colonoscopy and no gap gastroscopy for patients in Brisbane and the Gold Coast, which means you will not be out-of-pocket for these procedures if you have Private Health insurance. If a patient does not have Private HealthInsurance, they will incur a fee for the procedure of which a portion will be rebatable through Medicare. For other surgeries, the amount you pay will depend on the surgical complexity and level of post-operative care. Read more about fees and payment for General Surgeon Dr Terence Chua.

Choose a general surgeon you feel comfortable with

It’s important that you feel comfortable with your surgeon. This means being able to ask questions about any aspect of your care – whether it be about fees, surgical procedures or post-operative care. While you may be referred to see a certain specialist by your GP, if you’re not happy for any reason you can always request another referral to see a different specialist.

Paying more doesn’t mean better care

Surgeon’s fees are based on the complexity of the surgical procedure, the expertise and experience required. Any unexpected findings will also have an impact. While some doctors choose to charge more for some procedures, paying more doesn’t always mean better quality of care.

Some of the most highly trained and experienced Colorectal Surgeons like Dr Terence Chua still offer fees that are fair and reasonable. Every patient is able to contact Dr Chua on his mobile phone should there be any additional questions or concerns during the aftercare. This personalised service is aimed at meeting every patient’s specific needs and expectations. Read about Dr Terence Chua’s General & Colorectal Surgical Expertise.

Check with your health insurer before any surgical procedure

Health insurance policies offer different levels of cover and may have specific arrangements with various hospitals so you should check with your insurer before you book any surgical procedures. Be sure to ask if there will be a gap to pay so you are aware of any out-of-pocket expenses (for example hospital excess) before you arrive for your procedure.

Book an appointment with general surgeon Dr Terence Chua in Brisbane & the Gold Coast

Dr Terence Chua consults and operates across Brisbane and the Gold Coast. If you’re looking for a colorectal surgeon in Redlands Coast or colorectal surgeon in Sunnybank or general surgeon in Brisbane or colorectal surgeon in Brisbane, see consulting locations for Dr Terence Chua. 

[1] Read the full article in the Brisbane Times: North vs South: The side of the river with the biggest health gap fees