somnia specialist anaesthesia

Billing Policy

At Somnia Specialist Anaesthesia, our top priority is providing exceptional medical care to our patients. We believe in being transparent about our billing policies to ensure that our patients have a clear understanding of our fees and any potential out-of-pocket expenses.
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Our fees may occasionally exceed those set by medical aid schemes due to factors such as the complexity and duration of the procedure, as well as the expertise required from our anaesthesiologists. If your medical aid scheme does not cover the full cost of our fees, you will be responsible for the balance, which we accept payment for by EFT (Electronic Funds Transfer). If you have GAP cover, please inform us.

We have contracts with selected medical schemes and exceptions, which include patients over the age of 65 who are pensioners, patients with PMB conditions, Joint care/Major joints for Life patients having a hip or knee replacement, and all Discovery plans when the procedure is done at a day hospital. If you have concerns about your ability to pay for our services, please contact our billing department at admin@somnia.co.za. We comply with all relevant laws and regulations governing medical billing and coding, including fee transparency and disclosure. We will provide you with an itemised bill that outlines the services we provided and the fees we charged.
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Please note that all private patients will receive a quote before the service, and full settlement is required before the procedure. This is a quote, and the final amount invoiced may be more, in which case you will be invoiced, or less, in which case you will be refunded.
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We do not claim directly from health insurance companies, as they differ from medical aid schemes and are underwritten by insurance providers not regulated by the Council for Medical Schemes. These patients will be managed as private patients, and we will provide the necessary invoices to claim back from your insurance. If you have any questions or concerns about our billing policies, please do not hesitate to contact us. We are always happy to assist our patients in any way possible.

All plans are charged at Discovery Classic rates, except for the plans listed below, where the applicable scheme rates or contracted rates will be charged. If your medical aid is not listed below, you will have a shortfall between the fees we levy and what your medical aid will pay. The total account balance remains the responsibility of the main member.
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