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Dr Kym Anderson

YOUR TELEHEALTH APPOINTMENT

As a service to you, we provide the following estimates of the possible costs you might incur for your telehealth consultation/s. You can discuss these costs with your doctor or doctor’s staff to be sure you understand. You will be liable for any costs not covered by Medicare (out-of-pocket). Please note that this is an estimate only of the fees charged by Dr Kym Anderson.

Possible Item Numbers Claimable:

OUT OF POCKET COSTS “GAP PAYMENT” OR FULL PAYMENTS can be made by card over the phone – please call the rooms on 5222 2222 after your Telehealth to make payments and to book your next appointment (if required).

  • If you require any further information regarding your appointment or guidance on how to access the Telehealth system, please call our friendly reception staff on the above phone number.

Terms

  1. Payment of an account in full is required within 14 Days of the appointments.
  2. The Account Holder accepts full liability for Medicare claims which are rejected.
  3. Monthly account keeping fees may be imposed on overdue accounts at the prevailing rate.
  4. In the event of the Account Holder being in default of their obligation to pay and the overdue account is then referred to a debt collection agency, and/or law firm for collection.
  5. Reference to the Account Holder includes reference to his heirs’ executors and permitted assigns and where there is more than one, shall include reference to each of them jointly and severally.
  6. The Account Holder accepts liability for payment of all accounts incurred by them for the period until the Account Holder advises in writing to the contrary.

Agreement and Consent:

I agree to the appointment being undertaken by telehealth and have read the information above and understand that there could be out-of-pocket costs. If the telehealth appointment is Bulk Billed, I understand and agree to assign the Medicare Benefit Directly to Dr Kym Anderson. I understand that I can phone/email the practice for further information and assistance and request a copy of this information at any time.

I have read the above information and possible fee outcomes and wish to continue with the appointment.