This statement contains the standard terms of our engagement with you as part of your care through Anodyne (trading under PMAP Australia Pty Ltd, ABN: 25 617 889 488).
For the purposes of this statement, “Us”, “Our”, and “We” refers to Anodyne and “You” and “Your” refers to you, the patient, visitor, and/or client who utilizes the services of Anodyne.
Please review this statement carefully. You accept and consent to these terms as part of signing the Patient Registration form prior to your first appointment. You have the option to not accept/consent to any one or more of these terms. If so, you will need to notify Anodyne in writing of the terms you do not accept/consent to. If you do not accept/consent to any one or more of these terms than it may result in your care not being able to be completed through Anodyne.
If you have any questions regarding these terms of engagement, please contact (08) 6166 3788 or via email at [email protected] with attention to the “Operations Manager”.
PROVIDING HEALTH-CARE DETAILS
As part of your health care through Anodyne you agree to provide us with a complete and accurate history of any requested personal and health care related details. The requested details are used to assist you with your healthcare requirements (see Anodyne Privacy Policy for further details on how your information is used and protected by us).
The provision of your personal and health care related details are usually in the form of secure online forms, checklists, and/or questionnaires. By completing these documents you are consenting to complying with the requirements stipulated in each of them. If you are unable to complete these documents you are agreeing that you will contact Anodyne, and or a support person, to assist in their completion. You will be required to do so in a timely fashion that meets the other Anodyne requirements stipulated herein.
You are free not to provide any one or more of the requested details, but this may mean that your healthcare cannot be completed via Anodyne.
Guardianship, Administrators, and Enduring Power of Attorney. If you are not directly responsible for your own health care and/or finances (e.g. if you have a guardian, administrator, enduring power of attorney, and/or public advocate), then you are authorizing us to manage any of your healthcare and/or financial requirements (as part of your health care) directly with the person responsible.
By consenting on the Patient Registration form, any Guardian, Administrator and/or Enduring Power of Attorney are confirming they have the legal authority to act on your behalf in the capacity that they sign the consent. This also means that Anodyne will communicate directly with the applicable signatory in respect of that authority with regard to any applicable health related and/or financial decisions that are required with respect to your health care via Anodyne. And the signatory is consenting to receive such communication.
Advanced Health Directives. If you have an Advanced Health Directive and/or Do Not Resuscitate (DNR) order in place, it is your responsibility to advise us of this. It is your responsibility to ensure Anodyne have a copy of any specific health care requirements so that these are followed.
My Health Record. My Health Record provides you and your health professionals secure access to your key healthcare information. Anodyne is able to view your My Health Record and upload any communications created during your care to your My Health Record. To enable Anodyne to complete this request, you will need to provide us with your unique 16-digit Individual Healthcare Identifier (IHI) number. Anodyne will not view or upload any communications to your My Health Record unless you have consented us to do this. You are able to restrict access to your My Health Record by logging in and adjusting the access settings. We will then need to obtain an access code from you to be able to view this information. To know more about My Health Record please visit https://www.myhealthrecord.gov.au/.
PRIVACY POLICY
As Anodyne is a provider of healthcare-related services it is important that you are aware of how any personal information we collect is used. Below is a summary of our privacy policy. For full details please see the Anodyne Privacy Policy that has been provided to you. By signing the Patient Registration form you are agreeing that you have read and understood the Anodyne Privacy Policy in its entirety.
The personal information collected by Anodyne is that deemed necessary to best attend to, and treat, the presenting health condition(s). Your personal information is primarily used within Anodyne, but sometimes it is used to ensure quality and continuity of health care for you. This means we may use the information you provide for your health condition, administrative and/or billing purposes. Depending on the circumstances your personal information may be partially or fully disclosed to others outside of Anodyne for the purpose of best managing your health condition. For example, when referring you to another medical practitioner or when requesting blood tests, scans, itemising accounts for Medicare, etc.
To assist us with the management of your health condition we may request your authorisation to gather information from other health care providers. You are free to consent/not consent to this in your Patient Registration form.
All patient records that include your personal information are the property of Anodyne. However, should you choose to visit another Doctor at any time, copies of the appropriate files can be forwarded on receipt of your written request. Under no circumstance will this practice divulge personal information without your prior written consent or unless required to by law.
Release of information to you. If at any time you would like a copy of your patient file, you will need to make the request in writing (email is accepted). The contact for said request is to Anodyne, Attention Operations Manager, on [email protected]. Any request for release of information will be in accordance with the respective Australian Federal and State laws and legislation.
Release of information to others. Under no circumstances will Anodyne divulge any personal information and/or your medical records to another person/agency without your prior written consent or unless required by law.
In all instances of legal requirement to release your information (e.g. court ordered subpoena) we will notify you, but we are obliged by law to release this information even if you decline the release.
In all other non-legal instances we will request that you sign an authority to release information form before releasing any part of your personal information and/or medical record.
COMMUNICATIONS POLICY
Anodyne is a paperless practice and therefore all communications to/from the practice will be via non-postal means. Our preference is to communicate via email, but we are also able to communicate via our website, telephone and/or SMS. You will have the option to provide us with your preferred method of communications on the Patient Registration form. If at any time your preference changes, it is your responsibility to notify us in writing so it can be updated. If you do not have access to any of these communication channels, then you will need to inform us in writing and you may need to present to our clinic in person.
Telehealth. Some Anodyne related services may be completed via telehealth (phone or video call). All new patient, DVA and bulk billed consultations MUST be via video or face-to-face (phone consultations are not possible). If you have a preference for either telehealth or face-to-face consultation, it is your responsibility to advise us at the time of booking. If conducted via video, you consent to be provided with a Zoom (or equivalent) link to enable the appointment.
Reminder system. Anodyne uses a reminder system to help you maintain your health. The practice sends reminders by email, telephone, voicemail and/or SMS for appointments and other health reviews. You are free to consent/not consent to this as part of your Patient Registration form.
FEES POLICY
It is important that you approach your appointment (for any outpatient, consultation, procedure, hospital admission and/or treatment-related service) informed of the financial requirements. Prior to any appointment or treatment-related service, all patients need to read, consent to and sign the Anodyne Financial Consent and Payment Details form(s) (inpatient and outpatient versions). These forms provide details on the likely medical costs you will be required to pay as part of your healthcare with Anodyne and any affiliated service.
Outpatient consultation & treatment related services. Fees for outpatient-related services depend on the category of patient you represent.
– Private patients: If your health care is being funded by you, Anodyne requires payment prior to, or on the day of, your appointment. The medical fee estimate will indicate if there is any applicable Medicare and/or health fund rebate. A receipt will be issued to you on the day of your appointment to claim any applicable rebate. Alternatively, Anodyne can electronically submit this on your behalf and you will receive any associated rebate payment directly from Medicare and/or your health fund.
– Third party patients: For third party (e.g. motor vehicle accident, Worker’s Compensation, etc.) insurer accounts we require written confirmation from the third party that they will cover your fee prior to booking your appointment. Once received, there is no fee to pay and Anodyne will direct bill your insurer. If an approval is not provided, or if the third party does not approve your appointment, then no booking will be made. We will inform you if we have not received approval from your third-party insurer. You will then have the option to become a private patient or close the referral.
– Department of Veteran Affairs (DVA): There is no fee for DVA Gold card and pre-approved White card holders. In an approved DVA arrangement, Anodyne accepts the DVA benefit as full payment (i.e. no cost to you). Anodyne will direct bill, and receive payment from, DVA with any DVA-related invoices.
– Bulk-billing patients: Bulk-billing is when your health professional directly bills Medicare for your medical or allied health service. In a bulk billing arrangement, Anodyne accepts the Medicare benefit as full payment (i.e. no cost to you). Anodyne will direct bill, and receive payment from, Medicare with any bulk billed invoices. Anodyne will offer bulk-billing on a case-by-case basis.
Inpatient, hospital admissions and day procedure related services. Fees for inpatient hospital admission and day procedure related services depend on the category of patient you represent.
– Private health insurance funded patients: If your procedure is being funded by your private health insurance, Anodyne does not usually charge a gap. We will direct bill your insurer for the doctor’s procedure fee and any relevant consultation(s). It is your responsibility to check if you are covered with your health insurance provider prior to any procedure and/or hospital admission or if you have any concerns regarding costs. We recommend you contact your private health fund prior to any procedure/hospital admission and ask the following: Does my policy cover me for this procedure/hospital admission? Do I have an “excess” payment on my insurance policy? How much is it? Are there any co-payments required? Have I served all relevant waiting periods? Does my policy exclude any of the suggested treatments? Are there any items used in the procedure not covered by my insurance?
– Uninsured patients: If you are uninsured, the Anodyne procedure and/or doctor consultation related fees are set in accordance with the latest AMA List of Medical Services and Fees Schedule. Your fee must be paid prior to booking. A receipt will be issued to you to claim any applicable Medicare rebate. Alternatively, Anodyne can electronically submit this on your behalf.
– Third party patients: For third party (e.g. motor vehicle accident, Worker’s Compensation, etc.) insurer accounts we require written confirmation from the third party that they will cover your fee prior to booking your procedure/hospital admission. Once received, there is no fee to pay and Anodyne will direct bill your insurer. If an approval is not provided, or if the third party does not approve your procedure/ hospital admission, then no booking will be made. We will inform you if we have not received approval from your third-party insurer. You will then have the option to become a private/self-funded patient or close the referral.
– Department of Veteran Affairs (DVA): There is no fee for DVA Gold card and pre-approved White card holders. In an approved DVA arrangement, Anodyne accepts the DVA benefit as full payment (i.e. no cost to you). Anodyne will direct bill, and receive payment from, DVA with any DVA related invoices.
– Bulk-billing patients: Bulk-billing is when your health professional directly bill’s Medicare for your medical or allied health service. In a bulk billing arrangement, Anodyne accepts the Medicare benefit as full payment (i.e. no cost to you). Anodyne will direct bill, and receive payment from, Medicare with any bulk billed invoices. Anodyne will offer bulk-billing on a case-by-case basis.
Other costs that are not covered. Not all services attract a Medicare or health fund rebate. This can include medicolegal reports and certain treatments (e.g. ketamine infusion therapy). Such costs are provided as a POA and depend on the invoiced service. Anodyne may require pre-payment of these services before booking and/or completion. If you are a privately insured patient and you are having a procedure that requires a radiographer present, there may be a radiographer fee detailed in the medical estimate. This is not a claimable amount and relates to the fee Anodyne pays the radiographer to operate the imaging machine during your procedure. Your procedure will only be booked once the radiographer fee has been paid. Anodyne is not responsible for any out-of-pocket costs incurred from the hospital, other doctors (e.g. anaesthetist), or any hospital excess arrangement you may have with your Health Insurer. Anodyne will be able to provide you with item numbers to check with your Health Insurer, and the Hospital and anaesthetist’s details if you wish to contact them. You will be liable for any costs not covered by Medicare, DVA, Health fund, and/or third-party insurers. This can include a ‘gap’ payment for private patients. If fees charged by the Hospital are higher than the reimbursement paid by your health fund / Medicare / Third party / DVA insurer, you are responsible for paying the balance of the hospital’s rates. We will advise you if your procedure and/or inpatient service does not attract a Medicare rebate and/or there are any out-of-pocket expenses. Anodyne may require pre-payment of these services before booking and/or completion.
Assigning your billing rights to Anodyne (if applicable). For bulk billing, DVA, third party and/or health fund-related payments that are required to be made directly to Anodyne, you are assigning your right for benefits to the relevant health professional. Private and uninsured full fee-paying patients will have any related benefit paid directly to them.
When a bulk-billed, DVA, health fund and/or third party related invoice is raised, you are assigning your right to those benefits to the health professional who rendered the service(s) (i.e. Anodyne is paid the benefit directly to the health professional). Patients who are bulk-billed, funded by DVA, private health insurance and/or a third party, and who sign the Patient Registration form are consenting to assign their right to benefits to the health professional who rendered the service(s). In addition to this form, bulk billed patients are also consenting to assign their rights to benefits to the health professional when OK/YES is pressed on the EFTPOS terminal at Anodyne as part of the Medicare Easyclaim payment system used.
Claims enquiries. In order for patients to be able to access any applicable Medicare, DVA, third party and/or health fund related rebates, Anodyne staff may be required to make queries with the relevant departments. Any such investigations are for claiming purposes only and we agree to maintain the confidentiality of the information that is obtained. By signing the consent on your Patient Registration form, you are confirming that you are consenting for Anodyne to search for, or confirm, your Medicare / DVA / Health fund /3rd party details for claiming purposes only.
Outstanding invoices. All outstanding invoices need to be paid before any appointments and/or treatment services (including procedures) can be made.
For approved third party, motor vehicle and Worker’s Compensation insurer accounts two outstanding invoices will be allowed. If there are three or more outstanding invoices then these will need to be paid before any appointments and/or treatment services are booked.
Refunds. Once any service has been provided to you by Anodyne, we are unable to provide any form of refund.
Payments. Anodyne accepts payment via cash, EFTPOS, Visa, Amex or MasterCard. Amex does incur a 2% credit card fee.
Payment may be made online (link provided in Anodyne Financial Consent and Payment Details form), over the phone or in person. A receipt will be issued to you.
For any service that incurs an out-of-pocket fee, you will be required to pay Anodyne prior to the associated service being booked.
APPOINTMENTS & BOOKINGS POLICY
Any bookings, appointments or procedures will not be actioned until confirmed in writing by us.
Consultations and outpatient services are booked an allotted timeframe that can vary. Fees can therefore vary according to the appointment time. If your appointment time exceeds the allotted time, you will be charged in accordance with the higher rate.
For third party, motor vehicle and Worker’s Compensation insurer accounts, we require written confirmation from the third party that they will cover the costs prior to booking any appointment. If this is not provided, or if the third party does not provide approval, no appointment will be made unless advised in writing by you that you will accept responsibility for payment. We will inform you if we have not received approval from your third-party insurer. You will then have the option to take on responsibility for the payment of your account or to close the referral. We will need to have your acceptance in writing that you will pay your account before an appointment is made.
CANCELLATIONS & LATE ATTENDANCE POLICY
It is important that you are aware of your obligation if you miss, cancel and/or are late attending to an appointed service. When you make an appointment, you are making a commitment to attend. As such an account will be prepared in accordance with the established fee structure.
Without sufficient notice, these are costs borne by Anodyne and it prevents other patients from accessing these services in a timely, fair and effective manner. As a result, there may be a cancellation fee. Cancellation fees are not claimable with Medicare, DVA or your health fund.
Your obligations. If you need to cancel your appointment (outpatient, inpatient, treatment and/or procedure-related services), we request a minimum of 2 working days prior notice. You are required to call Anodyne to make a cancellation.If you are running late for an appointment, you are required to phone Anodyne to advise us of the likely time of attendance.
Late cancellations and missed appointments. If you do not attend, or if you cancel within 2 business days of the appointment, you will be charged a cancellation fee as follows:
– Outpatient consultation and treatment-related services: the full cost of the missed appointment. Any associated pre-paid fees and/or deposits for the appointment will be forfeited.
– Inpatient and procedure-related services: $200.00. Any associated pre-paid fees, deposits and/or associated appointment fees (e.g. radiographer fee for procedures) will be forfeited.
Late attendance to appointments. Depending on the nature of your appointment and how late your attendance is will determine the course of action.
– Outpatient: If you are late attending an outpatient-related appointment you may be seen only for the remaining period of your allotted appointment. If your arrival at an appointment is later than 20 minutes of the appointed time, then the appointment may be cancelled and will be treated as a missed appointment and cancellation fees will apply.
– Procedure: If you are late attending a procedure, it may not be able to be completed if it affects the procedure times for other patients and staff availability. This can only be determined on the day of the procedure. If the procedure is not able to be completed because of late attendance, then it will be treated as a missed appointment.
If your appointment is partially completed because of late attendance, you may require another appointment for completion. This will be invoiced as a new account.
If your appointment is partially completed because of late attendance, you will be charged for the entire booking time. Any applicable Medicare, DVA and/or health fund rebate may be reduced according to the time you were seen.
Rescheduling cancelled appointments. Anodyne will offer to reschedule any missed or cancelled appointments, services and/or procedures. These will be invoiced as a new account and will only be appointed once any associated cancellation fee has been paid.
If there are 3 consecutive missed and/or cancelled appointments/procedures, without medical or emergency reason, then your care will be discharged from Anodyne. You may be required to provide a medical certificate to substantiate any claims.
Anodyne cancelled and delayed appointments. Please be aware that on occasion due to unforeseen circumstances your appointment may be cancelled and/or delayed. We will endeavour to contact you to advise of this situation at the earliest convenience, however, this may not always be possible.
If your appointment is delayed and/or cancelled by Anodyne, no cancellation fee will be payable. If there has been any pre-payment of an appointment and/or procedure that has been cancelled by us, you will receive a refund in full with no deductions or fees applicable. You will have the option to use any pre-payments credited towards a future appointment and/or service.
Procedure, treatment service and inpatient related instructions. In preparation for certain treatment services there may be specific medical requirements that you need to complete. For example, fasting from food before a procedure. Anodyne will provide you with all instructions for such services. Such instructions are typically to ensure the safe and effective management of the related treatment service. When you are booking a treatment related service you are also agreeing to follow these medical instructions.
If you do not follow any required instruction(s) than the related treatment service may need to be cancelled. If the relevant treatment service needs to be cancelled because medical instruction was not followed than it will be treated as a missed appointment and cancellation fees will apply.
Medical emergencies and/or unforeseen circumstances. If there are medical reasons or unforeseen emergency circumstances for cancelling, you need to notify Anodyne via phone call as soon as possible. Any late cancellation fees will be waived, and any pre-payment or associated procedure fees credited, for medical or unforeseen emergency situations. You may be required to provide medical certification to substantiate any claims.
You will have the option to use any pre-payments credited towards a future appointment and/or service.
REFERRAL POLICY
Referrals to specialist medical doctors and allied health practitioners have an expiry date. Referrals from another specialist expire after three months. GP referrals expire after twelve months unless they are marked “indefinite” in which case it expires after 5 years.
To access any applicable Medicare, DVA and/or private health insurance funding for your appointment (including procedures), you will need to have an unexpired referral. It is your responsibility to ensure your referral is up to date. Our staff can provide you with the details of your referral expiry date.
If your referral is not up to date at the time of your appointment then you will be responsible for payment of the associated fee. You will not be able to claim a Medicare, DVA and/or health fund rebate.
In some instances Anodyne will not book any appointment or treatment service unless there is an unexpired referral in place for the proposed date of service.
PRESCRIPTION POLICY
Prescriptions must be requested during your allocated appointment time. Some prescriptions can be requested outside of appointments under special circumstances. For Schedule 8 medications, you may be required to see the doctor for your prescription.
There will be a $50.00 fee for prescriptions requested outside of appointment times and must be paid for at the time of collection. Alternatively, you can request your prescriptions at the time of your consultation or consult your General Practitioner for repeat prescriptions.
Please note that some prescriptions (e.g. Schedule 8 medications) need to have the originals provided to the nominated pharmacy (i.e. cannot be faxed or emailed). You will be required to pick up the original prescription to provide to the pharmacy.
OPIOID & ‘DRUGS OF ABUSE’ MEDICATION POLICY
Both you and your doctor are subject to strict regulations when specific medicines classified as potential ‘drugs of abuse’ are prescribed. These medications include but are not limited to opioids (morphine-like substances), stimulants (e.g. dexamfetamine, methylphenidate) and certain benzodiazepines (e.g. alprazolam and other ‘-pam’ drugs). Your doctor may need to obtain special approval from the Department of Health to provide ongoing prescriptions.
Opioid related medications. Anodyne follows evidence-based practice when it comes to the use of opioids in the management of chronic non-cancer pain. This means that there are very few instances that Anodyne will use opioids in the management of chronic non-cancer pain.
In the instances that opioids are indicated, Anodyne will usually only use atypical slow-release opioids (e.g. tapentadol, buprenorphine) and for a defined time period (i.e. not indefinitely). Please note that some Anodyne doctors do not support or prescribe any of the typical morphine-like opioids (e.g. codeine, oxycodone, morphine, hydromorphone, methadone and fentanyl) under any circumstances.
Anodyne will not routinely provide ongoing prescriptions of opioid-related medications. If an opioid prescription is commenced by an Anodyne doctor, your referring doctor may be given authority to provide the opioid-related prescription. It is your responsibility to ensure your referring doctor is willing to provide any opioid-related or other recommended prescriptions.
Stimulant medications. In the case of stimulant medications, patients must adhere to further specific local regulations. Your referring doctor may be authorised to prescribe stimulants in extenuating circumstances. For further information, please refer to the Healthy WA website.
Department of Health contact. Please be aware that at times we may need to discuss with the Department of Health your medication prescribing history as part of any prescription of Schedule 8 medications (opioids, stimulants, alprazolam). This is in keeping with legislation requirements and this clause has been provided for your information.
Prescribing agreement. When signing your agreement to these Standard Terms of Engagement, and you have also been provided with an opioid-related or other ‘drugs of abuse’ prescription and/or authorisation by an Anodyne health professional, you are agreeing to the following requirements:
– You will not use the medicine other than at the dose prescribed
– You agree to take the medicine only as prescribed for the relevant condition and not to change the dose
– You will discuss any changes in your dose with your medical practitioner
– You are responsible for the security of your medicine. Lost, misplaced or stolen medicines or prescriptions for opioid and other drugs of abuse medicines will not be replaced
– You will only obtain the medicine from the authorised medical practitioner to provide the prescription, or other doctors in the same practice authorised to prescribe to you
– You understand that no early prescriptions will be provided
– You should fill all your prescriptions at the same pharmacy
– You will tell your doctor of any problems you may be having with your treatment
– You are aware that your medical practitioner is required to gain authorisation from the Department of Health for continued prescription of a restricted medicine.
– You are aware that your medical practitioner may need to contact the Department of Health to gain access to your prescription history before any prescription or authority is provided
– If you are travelling away from home for long periods of time, you will need to discuss your opioid medicine requirements with your doctor so arrangements can be made if ongoing supply is required
– You have informed your medical practitioner of any present or past dependence on alcohol or drugs that you may have had, and of any illegal activity related to any drugs (including prescription medicines) that you may have been involved in
– You are aware that providing your medicine to other people is illegal and could be dangerous to them
– You will work together with your medical practitioner to improve your level of functioning and reduce your pain or other symptoms relevant to the condition being treated
– You understand that your medical practitioner may stop prescribing your medicine or change the treatment plan if your level of function has not improved, if you do not show an improvement in your symptoms, and/or if you fail to comply with any of the conditions listed above
OTHER IMPORTANT PRACTICE INFORMATION
Anodyne is a private outpatient health specialist service. Therefore, Anodyne will be able to assist you with your health care during normal hours of operation only.
Emergency care. We are unable to provide treatment and/or consultations outside of our working hours. If you require urgent medical assistance, it is your responsibility to contact emergency services (dial 000) or attend your local hospital Emergency Department.
Events out of our control. There may be circumstances out of our control that mean consultations, services and/or procedures may not occur as expected. If these events occur it is usually (but not always) related to a Government, Hospital, Medicare, DVA, third party insurer and/or Health fund related directive(s). Sometimes this can occur suddenly and unexpectedly. We will endeavour to contact you to advise of any such situations as soon as we are made aware and at the earliest convenience.