MEDICLINIC FIXED FEES GLOSSARY

 

What are Fixed Fees?

Private fixed fee: Mediclinic’s private fixed fee refers to a quoted amount for a planned procedure that includes the hospital costs related to the clinical treatment received for the duration of stay in hospital, regardless of the level of care required. The private fixed fee excludes:

  • Doctor fees such as treating provider and anaesthetist
  • Associated provider fees rendered during the stay (e.g. radiology scans and pathology tests)
  • Prosthetic devices
  • Mobility Aids such as crutches, wheelchairs and similar items
  • Take home medication

Note that the quotation will specify a potential additional daily fixed fee charge, should the patient’s admission extend beyond the expected duration (length of stay cap).

Privately paying patients: Private fixed fees are available to patients who will be paying upfront for their surgery. This may include those without medical insurance, those whose insurance does not cover specific procedures or where benefits have been exhausted in that financial year.

Self-funding patient: Patient will be financing the surgery rather than claiming through medical aid or other insurance, otherwise referred to as privately paying patients.

Hospital cost: This refers to the actual costs of care including all nursing, theatre time, accommodation in hospital, medicine as well as other consumables. This cost does not include the doctor account/s or any radiology (x-rays or scans) and pathology (blood tests etc.) costs and may exclude certain prosthetic devices and take home medicine.

Length of stay cap: Through the statistics available to the hospital, the average standard duration of treatment for any particular procedure has been calculated. This average number of days has been allocated per fixed fee procedure as the ‘length of stay cap’, and reflects the timeframe that a patient’s admission will be covered by the fixed fee. Should a patient need to stay longer a daily fixed charge will be levied. This charge is stipulated on the quote, to ensure transparency for the patient. (Length of stay is calculated and charged per calendar day, and not per nights slept. See: days in hospital.)

Days in hospital: This refers to the number of calendar days a patient stays in hospital e.g. If you have been admitted on the Monday and discharged on Tuesday the same week, you have spent two days in hospital.

Per diem fee: Once the length of stay cap has been reached, a daily fee will be billed for each additional day the patient is admitted. This is a specified and set fee per day, regardless of the level of care being received (e.g. ICU, surgical unit etc.) or the cost of medicine required. The fee is stipulated on the quotation to ensure that the patient understands all hospital cost implications in the event of staying longer than the length of stay cap.

Level of care: This refers to the type or intensity of care being delivered in the hospital. This may vary from the intensive care unit (or ICU) to admission in a traditional unit such as the surgical or day ward that may require less nursing supervision.

Complications: This refers to any deviation from the expected planned treatment outcome as a result of clinical complications arising directly out of the treatment received for the duration of the hospital stay, provided that the patient followed the advice of the medical professionals involved.

Patient Benefits: Advantages of the private fixed fee offering such as certainty around costs and transparency around pricing.

Maternity patients: Patients preparing for the birth of a baby either by way of vaginal or caesar delivery.

Procedure groups: Groups of procedures covered by the fixed fee offering.

Surcharge: A daily fixed charge levied for each additional day a patient stays longer than the specified length of stay cap for the procedure.

Provider: Many times a physiotherapist, dietician or other medical specialist will be referred to as a service provider. In this case, it refers to a service that is delivered to the patient from a clinician not directly employed by the hospital. These individuals would be delivering a service that is not included in the hospital costs.