Billing Policy
Understanding how your surgical care is billed makes the process simpler from the start. The information below covers consultation fees, medical aid agreements, and payment options for the practice of Dr Henning Pretorius, a specialist General Surgeon in Pretoria.
Consultation and Procedure Fees
Consultation fees are submitted to your medical aid at medical aid rates. Should your medical aid not cover the fees, the accounting bureau will inform you after submission.
| Service | Fee |
|---|---|
| Consultation fee | R868.20 / medical aid rates |
| Follow-up consultation (within 4 weeks after surgery) | No charge |
| Follow-up consultation (for scans, X-rays, or bloods) | No charge |
A Few Additional Notes on Fees
- Follow-up appointments up to four weeks after surgery are not charged.
- For a new, unrelated health issue, a first consultation fee applies.
- Follow-up appointments after Gastroscopy, Colonoscopy, or other non-surgical procedures are charged as standard follow-up consultations.
- When consulting about a new surgical problem, or if more than six calendar months have passed since your last appointment, the appointment is charged at the first consultation rate.
- Emergency, weekend, and after-hours consultations or hospitalisations are billed at emergency rates. Billing is processed during business hours and submitted to your medical aid. Any outstanding amounts will be sent to the patient by the accounting bureau.
Medical Aid Patients
For procedures performed on medical aid patients, the rates negotiated with your medical aid scheme will apply. The patient is responsible for obtaining authorisation from their medical aid before the procedure. The accounting bureau will submit the bill to your medical aid. Any outstanding amounts remain the liability of the patient.
The practice will provide the relevant procedure and ICD-10 diagnostic codes to assist with obtaining medical aid authorisation.
Contracted Medical Aids
The practice is contracted with the following medical aid schemes:
- Bankmed (Plus / Traditional / Core Saver / Comprehensive)
- Bestmed (all plans)
- Bonitas (excluding Bonitas Boncap and Bonitas Bonstart)
- Discovery Classic (all Essential patients are billed according to their medical aid rates)
- Fedhealth (all plans)
- GEMS (all plans)
- Keyhealth (all plans)
- Medihelp (all plans)
- Medshield (all plans)
- Momentum (all plans)
- Netcare (all plans)
- Polmed (Aquarium and Marine)
Being contracted with your medical aid means your bill is processed more easily and no co-payment is expected, as the practice adheres to the scheme's negotiated rates.
Patients who belong to a medical aid not listed above are billed at 217% of the standard Reference Price List (RPL) scheme rates. The patient remains liable for the portion not covered by their scheme. RPL values are available from the Department of Health or the Health Professions Council of South Africa.
Patient Responsibility
Patients are responsible for the following:
- Obtaining referral letters from their referring medical practitioner, where required by their scheme
- Being aware of their scheme's exclusions and penalties
- Obtaining authorisation numbers for specialist visits and procedures
- Understanding short payments and co-payments applicable to endoscopic and other procedures
Payment Methods
The following payment methods are accepted:
- All major credit and debit cards
- No cash payments accepted
- No cheques are accepted
External Accounts Department
Billing and accounts are managed externally by MFI. For queries relating to accounts or medical aid submissions, please contact MFI directly or through the practice.