HealthAgenda

Treatments & procedures

Tools to help you prepare for hospital

Follow one patient’s journey to learn how the private hospital process works.

1. Meet Jeanette

Jeanette is 54 years old and has worked as an office manager for a big construction company for over 20 years. She loves her job, but in the last few months she’s been feeling numbness and pain in her hands, which is starting to affect her work.

2. Getting a specialist referral

Jeanette goes to see her GP, who believes she may have carpal tunnel syndrome (CTS) – a painful disorder of the hand caused by pressure on the nerves that run through the wrist.

She’s at risk of this because her job involves repetitive activities like typing. The GP recommends she rest her hands and book in a few sessions with a physio – luckily Jeanette’s HCF extras cover pays benefits towards this treatment.

Two months later, Jeanette goes back to her GP because the pain is getting worse. Her GP suggests she sees an orthopaedic surgeon. 

3. Doing your research

Jeanette tells her GP she’s an HCF member and they use the Dr Gap tool to find a no-gap or known-gap specialist.

This free online tool helps you understand what you’re likely to pay in specialist costs. You can find a specialist who’s more likely to charge no-gap or known-gap (capped at $500 per specialist) when you’re admitted to a private hospital. 

It’s also important for you to ask if your specialist will take part in our no-gap arrangement before you go to hospital to understand any out-of-pocket costs. 

“We appreciate that asking about fees can be difficult, but it’s your right to be fully informed,” says HCF’s Chief Medical Officer, Dr Andrew Cottrill. “We genuinely want to help you keep money in your pocket and avoid bill shock when it comes to your healthcare.”

4. Understanding your bills

Jeanette decides to see the surgeon recommended by her GP. Thankfully, the surgeon participates in HCF’s no-gap arrangement.

We have arrangements with specialists across Australia who provide more than 95% of their services with no-gap or known-gap (capped at $500). Doctors who participate send their bill directly to us, so you don’t have to worry about managing the paperwork.

5. Getting a diagnosis

Jeanette’s surgeon confirms it’s CTS and recommends surgery, which will relieve the symptoms by cutting the ligament pressing on the nerve.

Jeanette hasn’t had surgery before and she’s nervous, so she decides to use HCF’s free, confidential Second Opinion service (available for eligible members).

The Second Opinion service identifies an expert in CTS. They write a report on Jeanette’s diagnosis and treatment plan, which is sent to her surgeon. It confirms the original recommendation for surgery. Jeanette feels reassured and ready to move ahead.

6. Finding a hospital

Now that Jeanette has chosen her specialist, she wants to know which private hospitals they operate in and whether they’re part of our participating hospital arrangement.

Members can get no-gap treatment (for services covered by their policies) at HCF participating hospitals. Jeanette uses this online tool to look up her private hospital.

7. Preparing for surgery

Jeanette uses our Preparing for Hospital online guide to understand more about the surgery. She learns about pre-operative tests, anaesthetic options, pain relief after surgery, what happens on the day and the recovery process.

She also watches videos where members share their experiences of surgery for carpal tunnel syndrome.

“To provide peace of mind, we created our Preparing for Hospital tool with information and explainer videos on 47 common procedures, like knee and hip replacements, IVF and cataracts,” explains Dr Cottrill.

“This growing resource helps members make informed decisions, ask the right questions and find out what they need to know and do before they head to hospital.”

8. On the road to recovery

After preparing so well for her hospital journey, including knowing the costs and choosing her doctor, Jeanette recovers successfully after the surgery with the help of our at-home rehab.  

After six weeks of recovery Jeanette is ready to return to work – pain-free and delighted to see her colleagues.

Taking charge of your health

Are you planning to see a specialist or have elective surgery? Understanding your health journey puts you in charge of your care and helps you to avoid out-of-pocket costs.

Find out more about the Dr Gap tool, the Second Opinion service and the Preparing for Hospital guide.
 

This article first appeared in the March 2021 edition of Health Agenda magazine.

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