Frequently Asked Questions
FAQ
Read more about all aspects of our services.
General
FAQs
Your anaesthetist is a trained specialist medical doctor who has completed a primary medical degree, completed two years of residency, followed by at least another five years of anaesthetic specialization, and in some cases, even further subspecialty training. Selection for anaesthetic training is competitive and it typically it takes 12-15 years to become a consultant specialist anaesthetist. Your anaesthetist is with you throughout your surgery or procedure, ensuring your safety. They control your vital signs (heart rate, blood pressure, oxygen levels, temperature) throughout the surgery, and manage your level of consciousness and sleep during the procedure. If there is a problem during surgery, your anaesthetist will act to rectify the situation. Prior to your operation, they will develop the best and safest anaesthetic approach to your specific surgery or procedure.
With advancements in monitoring equipment and drugs, as well as the high level of anaesthetist training in Australia, safety in anaesthesia continues to improve.With its extensive specialist medical training, and examinations , Australia is one of the safest places in the world to undergo anaesthesia. For most, the risks associated with general anaesthesia are very low, however this is dependent on your medical history, weight, and the type of surgery or procedure. If you have specific concerns, your anaesthetist will be happy to discuss these with you and help to put your mind at ease. For a detailed list of Anaesthetic risks click here
Common minor side effects include headache, pain and bruising at the injection site, nausea and vomiting, a sore throat, and drowsiness. Your anaesthetist will endeavour to mitigate these side effects with a suitable anaesthetic approach that is tailored to you and your surgery.
Major side effects are rare, and include allergic reactions, heart and lung problems, dental or mouth injury, deep vein thrombosis and stroke . Further more detailed information on the risks of general anaesthesia can be found here.
Common minor risks and side effects of spinal or epidural anaesthesia include nausea, vomiting, and low blood pressure. Major side effects are rare, and include bleeding, infection, headache, and nerve injury.
Further more detailed information on the risks of spinal and epidural anaesthesia can be found here
Yes, this can usually be arranged without too much difficulty. As soon as you are admitted to hospital you will need to let the nursing staff know and they will contact your Anaesthetist to arrange this over the phone.
Many women who are breastfeeding undergo elective surgery. Breastfeeding has many established benefits for both mothers and children and should be encouraged and supported perioperatively.
Importantly, there is typically no need to discard breastmilk after anaesthesia. Modern drugs commonly used for general anaesthesia and sedation are safe for use in breastfeeding mothers.
Once a mother is awake and alert and safely able to hold her baby after her anaesthetic, the concentration of anaesthetic medications in her breast milk will be very low, and it is safe for her to continue breastfeeding.
Further information regarding breastfeeding after anaesthesia is available from the Australian Society of Anaesthetists here.
It is exceptionably rare to wake up or be aware under general anaesthesia. This has unfortunately been dramatised in films.
Your anaesthetist will be with you during the entire procedure, ensuring that a precise and safe amount of anaesthetic drug is administered throughout.
Some people may remember waking up in the operating room after the surgery, and this is sometimes confused with waking up during surgery, which is extremely rare. For procedures under sedation, you are not under a general anaesthetic, and you may be aware of your surroundings.
The ASA has very useful downloadable information sheets about specific surgical procedures which can be found here
Pre-operative
FAQs
In most cases, the first time you will meet your anaesthetist will be on the day of your surgery. Some patients may require a consultation prior, and we will contact you directly if this is thought to be necessary.
No, you do not need to call us prior to your procedure. Your surgeon will send our rooms the theatre list and we will contact you via email and/or sms a week or two prior to the procedure. The email and/or sms will contain a link with all the required pre-anaesthetic information, and an important survey to fill in with your personal and general medical information.
A quote for your anaesthetic fee together with a link to pay online by Visa or MasterCard will also be included. We will contact you if a pre-anaesthetic consultation is required prior to the procedure and advise of any associated fees.
It is vital you adhere strictly to the fasting instructions. To ensure an empty stomach before the operation you will need to follow the specific fasting instructions from your surgeon or the hospital. If you haven’t received specific instructions, then you can follow the below recommendations.
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Withhold solids and milk for six hours before admission.
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You may drink small amounts of water (Max 200 ml per hour) up to two hours before admission.
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PRESCRIBED MEDICATIONS may be taken with a sip of water up to two hours before admission.
Failure to fast adequately may result in a delay or cancellation of your surgery/procedure. More importantly, it may lead to aspiration, which can be a life-threatening condition due to regurgitation of food or stomach fluid into your lungs that can result in respiratory distress or pneumonia.
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For children over 12 months of age having an elective procedure, breast milk or formula and limited solid food may be given up to six hours before admission. Clear fluids (water, apple juice, lemonade, or pulp-free [completely clear] drinks) may be given up to one hour prior to admission (no more than 3ml/kg/hr may be given).
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For infants under 12 months of age having an elective procedure, formula may be given up to four hours, breast milk up to three hours, and clear fluids (no more than 3ml/kg/hr) up to one hour prior to admission.
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As a general rule, you may take your usual morning prescribed medications with a sip of water 1-2 hours prior to your surgery, unless otherwise directed by your surgeon or Anaesthetist.
There are some specific exceptions;
Certain diabetic and Heart medications
All injectable insulins, gliclazide (Diamicron) and oral SGLT inhibitors, which include:
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dapagliflozin (Forxiga, Qtern or Xigduo XR)
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empagliflozin (Jardiance, Jardiamet or Glyxambi)
Anticoagulants / ‘blood-thinning’ medications
These include:
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clopidigrel (Plavix, Iscover), warfarin, Eliquis® (apixaban), Pradaxa® (dabigatran), Xarelto® (rivaroxaban), and Savaysa® (edoxaban)
Ozempic (semaglutide)
Ozempic should ideally stopped 4 weeks prior to surgery. It is essential you inform your Anaesthetist as soon as possible if you are on Ozempic.
Herbal medications and fish oil
These should be discontinued 1–2 weeks before surgery, unless otherwise directed. The ingredients of some of these are unknown, and some, for example, garlic, ginkgo, ginseng and fish oil, can inhibit platelet function and cause bleeding if in high doses.
The Surgical rooms will usually give you specific instructions about the above medications and are the first port of call. If you have not received instructions from the surgical rooms. Please contact us about the above exceptions.
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You will need to call the hospital to find out your admission time - this is not determined by your anaesthetist.
You can leave your acrylic nails intact unless you are having hand surgery, or your surgeon requests that they are to be removed.
Having a gastric band poses a potential aspiration risk. It is important that you advise your anaesthetist that you have a gastric band.
The ASA has very useful downloadable information sheets about specific surgical procedures which can be found here
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Contact Us
admin@precisionanaesthesia.com.au
7 Stuart Street
Mosman Park, WA 6012
Please note our rooms are not always staffed. It is essential you have an appointment before attending.
Experienced & well-credentialed anaesthetists delivering exceptional service with professionalism and skill, with particular attention to your safety well-being and comfort.
Precision Group
© 2023 by Smith Social for Precision Group
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FAQs
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Billing & Insurance
FAQs
Health Insurance can be complex and confusing. Please see the link below to PDF Document where we give an overview .
How does Anaesthetic billing work?
The way in which insurance companies work can be complex and confusing. Anaesthetists function independently from insurance companies and their fees are not determined by health funds. Sometimes confusing, unclear wording and terminology is used by health funds which we feel is unfair. When they say you are 100% covered, what is correct is that you are “fully covered” to the amount that they will pay.
There is often a shortfall that your insurance company does not pay. You should be aware that most health funds only rebate approximately 30-40% of the AMA (Australian Medical Association) schedule (this amount includes the Medicare rebate). Some pay even less and will only pay the Medicare schedule plus 25%. The ASA has more information about billing here should you wish to read further. Should you have specific questions about your cover we would encourage you to contact your insurance company. Insurance company contact details can be found at this link .
There are several reasons for this. Over decades Insurance companies and Medicare have not indexed rebates anything close to inflation and medical costs. Thus, unfortunately the discrepancy between the rebate from Medicare and your Insurance company and the anaesthetic fee has increased to the point where an out-of-pocket is incurred.
In addition, many anaesthetists have in recent times now contracted out of one WA largest insurers. Under these circumstances the insurer only pays the Medicare rebate plus 25%. This may significantly exacerbate the out-of-pocket shortfall. Unfortunately, we do not determine insurance company policy and are unable to answer questions as to why they have adopted this policy. Further information from the ASA may be found here. Should you have specific questions about your cover we would encourage you to contact your insurance company. Insurance company contact details can be found here.
See the below link for an interesting summary by the AMA. showing that in the 4 years (ending June 2023) the MBS rebate has increased by 4%, Hospital treatment rebates have increased by 8% and net profits of insurance companies have increased by 50 % !
Unfortunately, the health fund industry can be complex. One area that can be difficult to explain and is not always made clear is a policy of ‘benefit reduction’. Broadly speaking there are two ways in which benefit reduction can be applied by insurers.
Some insurers significantly reduce their rebate if a doctor/service provider is not ‘contracted in’ or ‘opts out’ (i.e., the doctor does not agree to be a ‘preferred provider’ and accept the rebate the insurance company stipulates. HBF and NIB are examples.
Other insurers Will only implement a benefit reduction if the shortfall (out of pocket expense) charged by the Doctor is over a specific amount (usually around $400- $500). Many insurers have this policy.
It is important to appreciate that health funds do not pay or employ doctors for medical services. Heath insurer’s role is to reimburse their customers for medical expenses. The anaesthetist’s fee is entirely independent of insurers.
Due to the very poor indexing of rebates by both Medicare and insurance companies over the last two decades, opting out, and not being a preferred provider, has become increasingly common. This may result in significant short fall payments required. The shortfall payments required can be exacerbated significantly if the insurers have ‘benefit reduction’ policies.
Private health insurance is complex – there are more than 70,000 variations in policies. Below is a general and transparent explanation of benefit reduction. It is of a general nature and will not cover every situation or every insurance company.
Scenario one
Here the insurer will apply a reduction to their usual rebate if a doctor charges any amount (even one dollar) over the insurance company’s fee schedule. This will result in a reduced rebate to approximately 25% of the MBS by the insurer (plus the portion Medicare pays). This will affect all operations. There are only one or two insurers who have this policy in WA, but it is common and may result in significant shortfall payments to you. HBF and NIB are examples.
Scenario Two
Here the insurer will apply a reduction to their usual rebate only if a doctor charges a shortfall over a certain value. This value is usually around $500. The insurer will pay their normal rebate if the shortfall is not more than $500. If the shortfall is more than $500, the insurer reduces the total rebate to approximately 25% of the MBS. This usually only affects longer or more complex operations. Many insurers in WA have this type of benefit reduction.
Let’s try explaining these in more detail. using unit values (see previous FAQ “How Billing works “if unit values need explanation)
Scenario 1 (HBF and NIB have variants of this policy)
The AMA schedule is $100 /unit.
The Medicare rebate is $16.85 /unit (this has been very poorly indexed for decades).
Most insurers rebate approximately $30-40/unit. This is inclusive of the Medicare rebate of $16.95
If the ‘benefit reduction’ policy is applied, the insurer will drop their rebate to $ 22.55 a unit (inclusive of the Medicare rebate of $16.95). In this setting the insurer is paying approximately $5.60 a unit. This may contribute significantly to any shortfall you are asked to pay.
Scenario 2 (MBP, AHSA funds and BUPA) have policies that are similar to this)
The insurer will pay their usual rebate (approximately $30-40/unit). This rebate is unchanged until the shortfall (out of pocket fee) exceeds a specific amount (usually around $500).
The insurer then applies a benefit reduction to the entire account and reduces the rebate down to approximately 25% of the Medicare rebate: i.e., the rebate paid on your behalf comprises the rebate paid by Medicare $16.95 /unit plus the 25% (paid by your insurer). This is now the same as scenario 1 and the insurer is paying approximately $5.60 a unit.
Scenario 2 is more likely to affect you if you are having longer, more complex surgery, partially cosmetic or reconstructive surgery. As the benefit reduction is applied to the entire account it may result in a significant shortfall.
Please note we are not allowed and cannot give any specific advice or opinion on insurance companies policy or preference.
So, we respectfully ask you not ask the secretaries about Insurance company recommendations. You can however ask your health care provider about your rebate and if they operate a ‘benefit reduction’ policy, and how it works.
The Medicare Safety Net is only applicable for outpatient consultations and is not relevant to your inpatient anaesthetic procedure account.
If your anaesthetist requires you to have a telehealth consultation, or face to face consultation, prior to procedure, and you have reached the Medicare safety net, your Medicare rebate will increase. Please note this does not change the consultation fee in any way. It simply potentially increases your Medicare rebate.
For further information please visit: https://www.servicesaustralia.gov.au/medicare-safety-nets
Detailed information for specific surgical procedures
The Australian Society of Anaesthetists has put together detailed information for specific surgical procedures, including joint replacement, oral, eye, labour epidurals, breastfeeding, bariatric and more.
