Shock specialist bills and hidden fees: patients silently bear the burden

Patients Australia (formerly the Australian Patients Association) is today calling on all major parties and independents to support a shake-up of medical billing practices after troubling survey findings that Aussies are facing unfair bills and poor transparency when receiving specialist medical care.

The latest Patient View Report released today reveals that over a third of Australians surveyed (37%) experienced psychological distress from out-of-pocket medical costs, with one in five patients skipping specialist appointments or declining treatment due to cost.

A staggering 60% of patients admitted to private hospitals reported out of pocket fees, 70% of whom paid in excess of $500, a finding in sharp contrast to government reported figures of only 35%, suggesting that the practice of “split billing” is widespread in Australia.

“Split billing happens when a doctor gives a patient one bill that is visible to the government and the private insurer, while another bill—labelled as a ‘booking fee’ or an ‘administration fee’—is sent directly to the patient,” said Patients Australia CEO Lisa Robins. “These fees can reach thousands of dollars but remain invisible to the government as part of the patient’s total cost of treatment.”

“As a psychologist, I find the emotional toll of shock out-of-pocket costs especially concerning. The last thing anyone needs while focusing on post-intervention recovery is the added stress of an unexpected bill they have little to no way of paying.”

Patients felt disempowered and unable to question unexpected bills, with fewer than one in ten patients (7%) complaining to their specialist.  Nearly half felt there was no point in complaining and one in five were concerned that complaining might affect their care.

“We have a serious deficiency in consumer protections when Australians consult their medical specialists” said Dr Nick Coatsworth, PA’s Ambassador for Health Reform.  “Whilst not all doctors practice in this way, this survey shows that there it is of a scale that warrants intervention by government to protect healthcare consumers.”

“Billing practices that are invisible to government need to be banned, and we need to do that because it’s impossible to assess impact of tax-payer funded Medicare rebate increases unless every doctor is transparent about their out-of-pocket fees.”

The Patient’s View survey had 5451 respondents and was jointly analysed with partners from La Trobe University’s Care Economy Research Institute in Victoria.

ENDS

For more information, contact:

Lisa Robins

CEO, Patients Australia

media@patients.org.au

About Patients Australia

Patients Australia is a leading independent not-for-profit organisation championing the rights of patients across Australia. We’re here to ensure that patients’ voices are amplified and their needs prioritised within the healthcare system. Our organisation drives significant improvements in patient care, advocating for greater transparency, accessibility, and quality within Australia’s healthcare landscape. By actively engaging with health consumers, policymakers, and industry stakeholders, we empower patients to create a more responsive and equitable healthcare system for all Australians.