What are clinics expected to tell patients about fees?
The Medical Board of Australia's code of conduct asks doctors to make sure patients are told about fees and charges in time to decide whether to go ahead with consultations and treatment, and to tell patients when a referral may bring additional costs. The Board's telehealth guidelines also expect billing arrangements to be explained before a telehealth consultation. The Australian Government's Medical Costs Finder describes informed financial consent as knowing what treatment you will receive and roughly what it will cost, and suggests patients ask specialists for a written estimate of fees. Other National Boards publish their own codes, so check the one that applies to your profession.
Which fee questions can reception answer on the spot?
Reception can answer questions that have one correct answer for every caller, provided the answer is written in the fee script. Standard appointment fees, the bulk billing policy, when payment is taken and whether the rebate is processed at the counter all fit. So do fees for forms and reports, and the practice's cancellation and non-attendance policy. The script should give the wording as well as the figure, so that two staff members describe the same fee the same way. Anything that depends on the patient's clinical situation, insurance or eligibility belongs in the next category.
- Standard appointment fees by appointment type and length
- Bulk billing policy, worded exactly as approved
- Payment methods and when payment is taken
- Whether Medicare rebates are claimed at the counter
- Fees for forms, reports and certificates
- Cancellation and non-attendance policy
Which questions need a written estimate?
Questions about procedures, treatment plans, surgery, anaesthesia or hospital stays depend on what the practitioner finds and recommends, so reception should not estimate them. The Medical Costs Finder suggests patients ask the specialist for a written estimate of fees, whether they will have out-of-pocket costs, whether Medicare will cover the treatment and how much it would pay, and whether the specialist has a gap arrangement with their health insurer. Reception's job is to explain how to request that estimate, record the request and pass it to the person who prepares estimates. Telling a caller a figure 'should be about' a certain amount is the answer that leads to disputes later.
How do you build an approved fee script?
Keep one fee script, owned by the practice manager and approved by the principal. List each fee item with its effective date, the exact wording staff should use and the questions that must be referred. Include plain wording for how rebates work, such as explaining that the out-of-pocket cost is what remains after Medicare and any insurer contribute, without promising an amount to the caller. Add a short list of phrases to avoid. Update the script whenever your fee schedule changes and keep earlier versions, so you can see what a caller was told on a given date if a dispute arises.
- Fee item, amount and effective date
- Approved wording for each answer
- Questions that must be referred, and to whom
- Phrases staff should not use
- Version number and approval date
What happens when the script does not cover the question?
Record the caller's name, contact details, the question in their words and any appointment it relates to, then send it to the person who handles billing questions with a callback time set by the practice. Tell the caller who will call back and roughly when, using your practice standard, and avoid guessing in the meantime. Review the log each month. A question that appears several times belongs in the script, and repeated questions about one practitioner's fees may mean their estimates need to be clearer. Disputed invoices go to the practice manager through your complaints process.
Can an AI receptionist answer fee questions?
An AI receptionist can answer scripted fee questions if it reads from the same approved fee script your staff use and nothing else. It should decline to estimate procedure or treatment costs, take the request and hand it to staff, using the same referral wording as reception. Test it before launch with a list of real fee questions from your call log, including awkward ones such as concession eligibility and gap payments, and check every answer against the script. After launch, review a sample of fee-related transcripts each month and update the script and the system together.