Payment Information

payment-informationDeposits

MIOT Pacific Hospitals requests for deposits at admissions for patients who:-

  • Are self-funding
  • Do not have cover with a recognized insurance company
  • Have not had their insurance cover confirmed by their insurer
  • Do not have suitable guarantee documentation.
Self-pay patients

Patients without healthcare insurance, can be referred to MIOT Pacific Hospitals by their GP who will write a letter to a Specialist Consultant requesting an opinion.

Relevant tests may be carried out during the initial consultation or booked for a later date. If tests are carried out immediately, the patient is asked to settle all bills, including hospital and consultant charges, before a report is released from the Specialist Practitioner to the patients GP.

In some cases, the consultant may recommend in-patient or day-case treatment and those without insurance will be given a guide to the hospital’s and consultant’s charges. It is then up to the patient or the next of kin choice whether to go ahead with the treatment.

If the procedure is agreed to then the patient must settle all bills before admission. Once this is done, the patient is admitted to hospital for treatment. At this point, a summary of treatment undergone is sent to the patient’s GP by the hospital or consultant. The patient then attends a follow-up consultation with the consultant and after this the patient can contact the hospital for advice.

Patients with Medical Insurance

It is the patient’s or their representative’s responsibility to ensure that their health insurance cover is adequate to pay for treatment. We strongly recommend that patients contact their insurance company prior to treatment in order to check cover and the terms of the policy. We may process insurance claims directly with approved insurers on the patient’s behalf if the patient has provided sufficient claim details.

It is the patient’s or their representative’s responsibility to verify with the insurer that the condition to be treated is covered by insurance. We will not be responsible for this verification. Insufficient documentation may prevent direct settlement and will result in the account being treated as self-funded by the patient.

Any shortfalls in benefit are the patients or representatives responsibility. In all circumstances, responsibility for payment for our accounts rests ultimately with the patient. Should any guarantee fail or insurance claim be declined in whole or in part, the patient will be required to pay the outstanding balance in full.

While in the majority of cases, the patient’s insurer will pay for treatment, it is important to note that there may be certain treatments that the insurer may not pay for. By signing the Admission Form, the patient agrees that if their insurer does not pay for any part of the treatment, the patient will pay for these themselves.

Issues with insurance companies

The treatment that the insurer will cover will depend on a variety of factors such as the Insurance Company the patient is insured with, the type of policy held and the level of insurance obtained. If the patient has any of the following types of treatment, we strongly recommend that the patient contact the insurance company to clarify whether such overage is available and if so, the portion of costs which may be covered:

Chronic illnesses – these are generally excluded from certain insurance policies.
Diagnostics and screening – Screening and routine testing are excluded from some insurance policies and it is advised that you check with your insurance company on whether this covered.
Cosmetic surgery -these are generally excluded from insurance policies.

Most private medical insurance companies require claims to be authorized before a patient may be treated here. If confirmation of cover cannot be obtained by the time of admission/registration, we will treat the patient as a self-funding patient and ask for a deposit or require that the account be settled in full. Exclusions under the policy may also be relevant depending on the patient’s previous pre-existing medical conditions. The patient should always check general exclusions under the policy. It is always better to check for any exclusion or benefit limits before commencement of treatment.

The patient agrees to pay for any services not covered by the insurance company under the policy.

Offshore Insurance

Offshore insurance only cover INPATIENT treatment. The following offshore insurance companies hold approved credit accounts with MIOT Pacific Hospitals:-

  • TRICARE/International SOS Pty Ltd.
  • CIGNA.
  • Allianz Global Assistance.
  • Corporate Services Network (CSN).
  • Customer Care.
  • Cover More.
  • Sydney Euro.
  • First Assistance NZ.

A Guarantee of Payment is essential from the Insurer. Usually a refundable deposit is taken as co-payment between F$1,000-F$3,000 (depending on the condition of the patient) as a co-payment arrangement is usually made between the insurance and the insurer.

Sponsors/Grantors

If a company, employer or other third party agrees to settle the account, they will need to sign the guarantor section in the admission form and pay a deposit. We will only accept guarantees from third parties who have made prior arrangements. If such an agreement is not in place, the patient will be asked to settle their account and seek to recover the amount from their guarantor.

Treatment may be refused

We regret that in certain circumstances, patients arriving for treatment may not be admitted or registered if they arrive without satisfactory insurance, guarantee documents or acceptable methods of prepayment. On such occasions, the Admission staff will contact the doctor or consultant and the General Manager and Financial Controller to discuss the situation.

Payment Arrangements

Deposits

MIOT Pacific Hospitals requires upfront deposits at admissions as follows:

  • $750 for Medical Admission (Resident).
  • $1000 for Medical Admission (Non Resident).
  • $2000 for HDU Admission (Resident).
  • $3000 for HDU Admission (Non-Resident).
  • 100% upfront payment required for all surgical procedures.
  • For non-resident patients, MIOT Pacific Hospitals will have an additional 15% charge on the normal bill.

Upfront deposits at admission for patients who:

  • Are self-funding.
  • Do not have cover with a recognized insurance company.
  • Have not had their insurance cover confirmed by their insurer.

Invoices
We bill outpatients on the day of service. Short stay in-patients are normally billed for treatment or soon after discharge although there may be some delayed charges. Longer stay patients may be billed at the time of discharge.

Estimates
An estimate of the anticipated charges for services may be provided to the patient upon request from us. Estimates may vary significantly from the final charges based on a variety of factors, including but not limited to the course of treatment, the intensity of care, physician consultations and the necessity of providing additional goods and services.

Cost Estimates
You may request an estimate of the costs of your procedure. Please ask your Customer Service Officer about the expected cost (specialist and anaesthetist fees) and the length of your stay in hospital (e.g. day stay or overnight, 1 week).

We are only able to provide you with an estimate of your surgery costs at this time. The actual cost will not be known until after your surgery has been completed and your account is made up at the time of your discharge.
If you are paying for all of the costs of your procedure yourself, you will be asked to pay a deposit for the majority of the hospital fee, on or before your admission. We accept credit cards, cash and bank cheques on the day of your admission or direct credit to our nominated bank account.

The balance of your hospital account must be settled upon your discharge

Consent, Disclosure and Confidentiality
By signing the Admission Form, the patient confirms that he/she has read and understood Terms and Conditions as set out in this Guide. In particular the patient consents to their medical and personal information being provided to:

    • Their General Practitioner or referring doctor at the end of treatment.
    • Their Insurance Company on information regarding the settlement of expenses related to treatment.
    • MIOT Pacific Hospitals clinical audit teams (either appointed internally or through the use of external consultants) to monitor standards of care any relevant regulatory authority.

 

If a patient is too ill to give consent, information may need to be shared without consent in order for treatment to be provided. If the patient is a minor, then the parent or legal guardian consents to the disclosure of information.

Giving Birth at MIOT Pacific Hospitals
Please see a Customer Service Officer who will provide you with estimates for both normal and caesarean deliveries – he/she will be happy to fully explain the option you choose. Payments for these services are requested 2 weeks prior your delivery date.

You are welcome to contact us if you have any questions relating to hospital payment or other arrangements (e.g. FNPF).