claiming on PHI, how does it all work??

[Olive]

there is a chance DD2 may need to get grommets, we have basic hospital cover..... so what does that cover the surgeon?? i assume it covers the hospital part

[feeb]

Will it be done private in a public hospital? or private in a private?

When I had boys my PHI covered my hospital stay (I had an excess to pay) and I then got sent bill for anethatist and pead which I paid and then claimed at PHI and medicare.

Dont know if that helps.

[Olive]

will be done private in private

[melbel]

It should cover the hospital costs minus any excess you may have. Plus it will cover any medical expenses up to the schedule fee....i.e. medicare pays 75% of the schedule fee and then the PHI should cover the gap up to the schedule fee....if the actual fee the surgeon or anaethetist charges is more than the schedule fee then you will have a gap to pay out of pocket.

It will also cover any drugs, dressings, meal etc whilst in the hospital.

Hope that helps

[AnyDream]

Get the surgeon and the hospital to list their charges (with the item numbers) on a quote and then contact your PHI to find out exactly how much of that they will pay.

Prepare to be unimpressed.

[Trillian]

I'm guessing the appt today went well then?

[Spring Angel]

We ended up about $600 in total out of pocket for DS to get his tonsils and adenoids removed. Our PHI covered the entire cost of surgeon, about $400 was for the anethitist (sp?) and $200 for the room. The rest was covered by PHI.

A little boy in the room next to us had grommets was only in for day stay and was allowed home as soon as he'd eaten so didn't have to pay for the overnight stay.

This was in a private hospital in Brisbane.

HTH
Spring xx