Billing Policy
Prior to your anaesthesia you will be asked to read and sign a document that contains the following information. This information serves as reference for the published practice policies of Haumann and Partners.
Section 1
A. Coding
- The Anaesthesiologist determines the costs associated with the provision of anaesthetic services by using the coding rules as determined by the South African Society of Anaesthesiologists (SASA) and the South African Medical Association (SAMA)
- The Anaesthetist regard the Coding Guidelines published by SASA (most recent edition) and the Medical Doctors Coding Manual published by SAMA (most recent edition) as the only legitimate source documents when determining coding rules for the practice.
- Medical Aids may dispute the validity of the codes as used by the anaesthesiologist. The anaesthesiologist will assume that the rules as set out in the source documents (SASA and SAMA) are the correct and ethical interpretation.
B. Tariff Determination
The Anaesthesiologists’ Standard Tariff is determined by taking the value of the service, the cost to the anaesthesiologist to deliver the service and local economic factors into account. The Standard Tariff is charged to all patients irrespective of age, economic circumstances or funder involved as required by the Consumer Protection Act.
The patient and/or guarantor, are encouraged to contact the relevant anaesthesia practice prior to your procedure, in order to request a cost estimate.
The patient and/or guarantor’s Medical Aid Tariff will likely be less than the Standard Tariff, meaning that a co-payment is likely.
| tariffs for 2026 | Estimated Time | Practice standard fee | estimated 100% scheme rate | shortfall on 100% scheme rate |
|---|---|---|---|---|
| Please Note | Procedure Units will vary due to the complexity of the procedure (a procedure unit value of 5 is presumed for this estimate) | |||
| Basic anaesthetic less than 30 min | 30 min | R 3617.80 | R 1559.80 | R 2058.00 |
| Basic anaesthetic 30 to 60 mins | 60 min | R 4763.00 | R 2023.20 | R 2739.80 |
| Basic anaesthetic 60 to 90 min | 90 min | R 6480.90 | R 2718.30 | R 3762.60 |
| Basic anaesthetic 90 min to 2 hrs | 2 hours | R 8198.70 | R 3413.40 | R 4785.30 |
| Every additional 15 mins (after 2 hrs) | per 15 min | R 858.90 | R 347.60 | R 511.30 |
| Modifiers | ||||
| Body mass index > 35kg/m2 | add per 15 mins | R 429.50 | R 173.80 | R 255.70 |
| Children < 1 year or Elderly > 70 yrs | add | R 858.90 | R 347.60 | R 511.30 |
| After Hours Consultation | add | R 911.00 | R 452.50 | R 458.50 |
| After Hours Anaesthetic Time | add per 30 min | R 483.90 | R 221.40 | R 262.50 |
C. Account Administration
- The administration of an account remains the responsibility of the patient and/or guarantor.
- In cases where a funder’s administration is substandard, the anaesthesiologist will not submit the account to the funder but to the patient/guarantor.
- The Anesthesiologist DOES NOT HANDLE THE ADMINISTRATION FOR THE FOLLOWING MEDICAL AIDS AND ENTITIES: Patients that belong to these entities must submit their accounts independently (see ‘Conditions’ below)
a. ICPS
b. The Road Accident Fund
c. GAP Cover entities
d. WCA/Injury on duty cases (IOD)
e. Momentum, Qantum, Cape Medical Sheme
D. Conditions
- The patient and/or guarantor and/or employer (IOD cases) remains responsible for the full amount of the account.
- Terms of full payment is strictly thirty (30) days after service delivery.
- After the 30 day period has expired, the account will be handed to a lawyer for debt recovery.
- The Anaesthesiologist may only accept payment from the patient and/or the patient’s guarantor and/or a medical funder registered as such with the Council of Medical Schemes. The Practice does not accept any direct payment from another doctor, hospital, insurance company or any other entity that acts on behalf of funders or the patient .
E. Medical Aid payments and Motivations
The Anaesthesiologist does NOT supply motivations to Medical Aids and/or Hospitals for the use of any medication and/or procedures and/or equipment that may be required during the course of the anaesthetic.
Examples of medication and/or procedures and/or equipment where the Medical Aid may refuse payment or require motivation include (but not limited to):
- Gastroscopy/Colonoscopy/Radiological/Cosmetic/Sterilisation procedures
- Bridion (Sugammadex)
- Dexmedetomidine (Precedex)
- Emergency medication (Noradrenaline/Protamine/Isosorbide-dinitrate/Esmolol/Iloprost/Vasopressin)
- INVOS
- Use of Ultrasound (Code 5103)
- Procedures for pain relief (Codes 2800, 2801, 2802, 2804)
- Pain Control Devices/PCA (Codes 1221,0201)
- Codes 0011, 0018, 0019, 0032, 0034, 0039, 0040, 0043, 0146, 0147, 1780
In case the Medical Aid refuses to pay for clinically accepted treatments, you are advised to contact the Council of Medical Schemes at www.medicalschemes.com
GENERAL INFORMATION
- You need to be starved for all anaesthetics and sedation for your safety. No food or liquids (excluding clear fluids) may be taken by mouth for at least six (6) hours before the anaesthetic or sedation.
- Water or apple juice may be taken up to two (2) hours before the anaesthetic.
- It is against the law to drive a motor vehicle or operate heavy machinery for 24 hours after the anaesthetic.
- It is recommended that no alcohol be taken, and no important decisions made within 24 hours after the anaesthetic.
- Medical history -You will be required to complete a medical questionnaire before your procedure. Please bring information on any medical conditions you may have when you are admitted for your procedure.
- Medication
- Bring your current medication to the hospital if there is any chance that you will be staying overnight or need to take this medication while in the hospital.
- Bring a list of any medication that you are currently on or have taken in the past 3 months (including homeopathic and natural products).
- Take your routine medication as normal. (If you are taking Warfarin, Aspirin, Plavix or any other blood thinners please ask your doctor when you should stop these before the operation).
- Timing of your procedure
- Your procedure may be hours after the scheduled start time due to various circumstance.
- If you are admitted later than the start time of a list, you may only see the anaesthesiologist in the theatre waiting area.
- If you have a medical condition or want to discuss anything with the anaesthesiologist please either make contact before the day of surgery or ensure you are admitted to the ward at least one hour before the start of the list.
- Complications during anaesthesia
- Anaesthesia is not without risk.
- Adverse events can occur during any anaesthetic, which can range from trivial to brain damage or death.
- These events may occur due to: Reactions to anaesthetic drugs, underlying medical diseases, complications with procedures that have to be performed or due to surgery.
- Anaesthetists have been trained to manage these complications.
- If a complication persists for more than 48-hours please inform your anaesthesiologist
The following list covers some of the complications that may occure under anaesthesia, post operatively or due to side effects or interactions of post-operative medication
| Common Complications (1 to 10% of cases) Minimal treatment usually |
Rare complications (Less than 1 in 1000 cases) May require further treatment |
Very rare complications (1 in 10,000 to 1 in 200,000 cases)Often serious with long-term damage |
Brain damage or Death (Less than 1 in 250,000 cases) |
|---|---|---|---|
|
Nausea and vomiting Sore throat Shivering or feeling cold Headache Dizziness Itching Pain during injection of drugs Swelling or bruising at the infusion site. Confusion or memory loss (common if elderly) |
Injuries to teeth, crowns, lips, tongue and mouth Painful muscles Difficulty in urinating Difficulty breathing Visual disturbances Worsening of underlying medical conditions like diabetes, asthma or heart disease Hoarse voice, vocal cord injuries. Pressure related injuries |
Eye injuries Nerve injuries causing paralysis Lung infection Awareness of the operation Bleeding Stroke Allergic reactions/ anaphylaxis Unexpected reactions to anaesthetic drugs Inherited reactions to drugs (Malignant hyperthermia, Scoline apnoea, porphyria) |
Due to any other complication getting more severe Heart attacks Emboli (clots) Lack of oxygen |
Complications arising due to procedures that may be performed during your anaesthetic
| Procedure | Complication |
|---|---|
| Intravenous line | Pain, swelling, bleeding, inflammation, infection, clots, repeated insertions. |
| Central line for monitoring or therapy | Pain, swelling, bleeding, inflammation, infection, repeated insertions, puncture of lung, artery or nerve, clots. |
| Arterial line for specialised monitoring | Pain, swelling, bleeding, inflammation, infection, repeated insertions, loss of blood flow to the hand leading to death of fingers. |
| Airway management | Damage to lips, teeth, tongue, palate, throat, vocal cords, hoarseness, inhalation of stomach contents (aspiration), pneumonia, obstruction of breathing, failure to maintain the airway requiring an operative procedure. |
| Nerve blocks, spinal or epidural injection | Back pain, Non-resolving headache, nerve damage, paralysis, headache, nausea, vomiting, infection, dizziness, shortness of breath, chest pain, pneumothorax, seizures, drug toxicity, failure of technique with conversion to general anaesthetic. |
Should you wish to complain or comment on your anaesthesiologist, anaesthetic or billing experience, the following procedure is in place: Complete a complaint form at https://haumannvennote.co.za/enquiries or request one from the practice which will be comprehensively addressed and responded to
Should your complaint not be resolved to your satisfaction, complaints can be forwarded to the South African Society of Anaesthesiologists (SASA) at sasa@sasaweb.co.za
