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Does pregnancy management fee get charged by in-hospital private group practice (public or private H


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#1 Meli-melo

Posted 28 January 2019 - 09:32 AM

Hello,

I know lots of threads talk about going private or public, but I just want to know more aboiut pregnancy management fee (PMF). I live in Adelaide.
I'm aware that if we go to see a private obstetrician in their own private clinic throughout the pregnancy, PMF is payable at 20-28 weeks basically that's their on call and turning up to the birth fee, only a small portion gets reimbursed by Medicare and wont be covered by the private health insurance. I can't give them a call until tomorrow and curious to know other people's experiences please as this is my first time going private and this is my third pregnancy.
My questions :

1. If we're seeing obstetrician throughout the pregnancy in a public hospital o&g private group practice (i think they're seeing public patient too through the womens outpatient), do we still have to pay for PMF? Because basically PMF is an on call and booking right if we simplify it?! But if we get into admission as a private patient for the birth, they can't guarantee that DR of your choice (the one we're seeing at the private group practice) would be available at birth, there's a note says:
Note: Where your doctor of choice is unavailable, you can still elect a private admission in our hospital and be treated by the doctor on duty.
So I thought they shouldn't charge for PMF?? As there's no guarantee that the obs that we've been seeing in the private group practice would be the one that delivers the baby. Or private group practice in public hospital works normally like their own, out of hospital private obs clinic and the admission at childbirth as a private patient in the public hospital is completely unrelated??

2. Exactly the same question about the private practice group but in a private hospital, Ashford hospital  for example, PMF??  

Thank you for any help!!

Edited by Meli-melo, 30 January 2019 - 08:22 AM.


#2 taters

Posted 28 January 2019 - 10:07 AM

Im not sure about public hospitals and their process. But for Q2 if you are having an OB through a private clinic I think you will need to pay the fee. Because you are guaranteeing an OB from that practice turning up at the birth. I know my OB had a locum over christmas and of course the pmf was still payable even though it wouldnt be the OB whose practice it was that would be atrending the birth.

For what its worth our fee was $2550 and we got about $500 back from medicare.

#3 Veritas Vinum Arte

Posted 28 January 2019 - 11:47 AM

The Pregnancy Management Fee is not just about birth, but the fact you can call your OB anytime. I had an accident, the first person I called was my OB. I knocked my 35wk bump heavily on the bottom of my wrought iron bed. Or when I started having contractions at 34wks. Even to ask about taking some codeine medication. It was being able to call anytime without needing to go to a hospital.

No OB will guarantee they are at the birth.

If you are going Private in a Public hospital yes you still have to pay the PGMF.

#4 Mooples

Posted 28 January 2019 - 12:56 PM

My ob wasn’t present at my private hospital birth. One of his colleagues was there. I still paid my management fee to my ob and the ob that did attend charged my phi an attendance fee, which was a similar price to a management fee.

#5 elmo_mum

Posted 28 January 2019 - 02:02 PM

The fee is paid to your obstetrician
Regardless if you a private patient at public hospital or fully private

Your dr should advise you of holidays booked when you book in but they will tell you who will look after guy ou if they are not there
At a public it may be random on call junior dr


They will also have a clause saying you cant change drs once booked in or you will still be charged the full amount

#6 Soontobegran

Posted 28 January 2019 - 02:24 PM

The benefits to the patient of being private in a public hospital 'may' mean less OOP expenses, a slightly longer stay and a better chance at a private room than if you are a public patient ( if there is shared accommodation).
The other benefits are those of being in a tertiary public hospital ( if it is one of those) where there is 24 hour ICU, NICU, theatre, pathology and radiology.
You are still likely to have your chosen obstetrician at your delivery, it would only be if you deliver quickly or for some reason your doctor is otherwise busy or away when you will get another private obstetrician or a hospital doctor in an emergency.

You will still be paying anaesthetist, paediatricians etc but often at the scheduled fee meaning there is less or no gap payment involved dependent on your PHI.

The main beneficiary is in fact the public hospital and that is not a bad thing.

Edited by Soontobegran, 28 January 2019 - 02:26 PM.


#7 Luci

Posted 28 January 2019 - 02:29 PM

The Pregnancy Management Fee is not just to cover the actual delivery of your baby. It is partly associated with having an Obstetrician caring for your throughout your whole pregnancy, which can end up being large amounts of time if you end up with complications etc.

#8 Veritas Vinum Arte

Posted 28 January 2019 - 09:27 PM

Yes my sister ended up with HELLP Eclampsia and HELLP PE in her other 2 pregnancies so was seeing her OB sometimes twice a day from 30wks. In and out of hospital for 4-6wks. Her OB earned his money. With her third though her OB was on scheduled leave when they were born so his relief performed the emergency cs.



#9 Meli-melo

Posted 30 January 2019 - 10:43 AM

Thanks a lot for your response everyone!! I got a different answer for the public hospital, maybe their private outpatient work differently than other hospitals?!

I have called both public and private hospital.

With public hospital (i rang WCH Adelaide) o&g private practice group: they bulk billing all clinical appointments and PMF, so the only out of pocket expense is for imaging/ultrasound if it's done outside the hospital. They work the same way like other private clinic, the chosen obs would be the primary and if his unavailable, obs from the same practice. But in case of something happened, i have to call/see the hospital's women's assessment then they're the one who calls the private obs available. I think its a standard procedure??

With private hospital (i called Ashford private) private practice works exactly the same as private clinics out of hospital, price differ for every obstetrician as they're not hired by the hospital directly.

#10 Soontobegran

Posted 01 February 2019 - 10:55 AM

So you are not wanting to have your appointments with a private obstetrician?

#11 Meli-melo

Posted 25 February 2019 - 09:21 PM

Sorry must have missed this. Yes, we're seeing someone in the private group practice that's in conjunction with the public hospital, if you know what i mean . We gonna see someone who's only taking high risk patients, so hopefully we're happy with him. Otherwise, might need to see a fully private obs.




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