Informed Financial Consent

1.            PURPOSE AND SCOPE   

a)            The purpose of this policy is to ensure that all patients are fully informed of potential costs and provide their informed financial consent before admission, and to reduce the risk of loss of income due to patients not paying their expenses.

2.            POLICY

The Healthe Care policy on Financial Consent – Estimation of Expenses is:

a)            All patients must be provided an estimate of all expenses prior to admission to hospital

b)            In the event of an emergency admission or where a patient has presented without a prior estimation communicated, the front office/administration clerk will notify the Chief Executive Officer and provide the estimation to the next of kin/carer/guardian.

c)            In the event that the next of kin/carer/guardian is not available the estimation of expenses will be discussed with the patient at the earliest opportunity in consultation with the attending VMO and Chief Executive Officer.

3.            PROCEDURE

1.            Staff responsible for providing estimates of patient expenses must be trained to do so and must have access to the relevant rate information.


2.            For insured patients, a health fund eligibility check must be performed to confirm a patient’s level of cover before estimating their expenses.  An estimate is based on the information obtained from the health fund check with a patient’s health fund.


3.            For self-insured patients, estimates must be based on the item numbers, prosthetics, disposables, accommodation type and estimated length of stay nominated by the doctor.


4.            Estimates must be provided to patients in writing using Healthe Care’s standard Patient Estimate of Expense form.


5.            Estimates must comprise enough information to comply with Informed Financial Consent requirements.  Refer to Government Circular HBF627/PH379 – Informed Financial Consent.


6.            The standard Patient Estimate of Expense form must be explained to patients, including the ‘Terms and Conditions’ on the rear of the form, prior to obtaining a signature.


7.            Patients must sign the Patient Estimate of Expense form before admission to provide their informed financial consent.


8.            For Day Unit patients, staff must ensure that day and overnight out-of-pocket expenses are quoted in the event that a patient must stay overnight.


9.            Where patients who do not have a booking request an estimate, they must be notified that the estimate provided may change when their doctor makes the booking and that they must request another estimate at that time.


10.          Patients with overseas health funds are treated as self-insured (unless the hospital has an arrangement with the fund).


11.          Patients from overseas who are not insured by a contracted overseas health fund must be quoted the standard self-insured rate. They must pay up-front and recover the cost from their health fund later.  On discharge, they must pay any outstanding expenses in full and must be provided with a completed claim form and hospital receipted invoice.