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Surgeon's $1500 'Informed Financial Consent Fee' exposes need for specialist billing reform

Australian Health Funds Council

The Australian Health Funds Council (AHFC) is calling for stronger protections against excessive and confusing specialists fees after receiving evidence that some doctors are charging patients $1500 to obtain informed financial consent before surgery.

 

The charge is highlighted in the AHFC’s submission to the House of Representatives Standing Committee on Health, Aged Care and Disability inquiry into access to and affordability of medical specialists.

 

The bill, provided to an AHFC health fund by a member, includes a $1500 surgeon’s fee in addition to a $500 surgical co-payment. Both are listed to be paid prior to surgery. These charges were billed on top of what the surgeon would receive by Medicare and the patient’s health insurer.

 

AHFC CEO Dr Rachel David said the bill raised serious questions about specialist billing practices and whether patients were being charged for activities that form part of routine clinical care.

 

“This bill describes a range of clinical and administrative tasks under the heading of ‘informed financial consent’. Explaining fees to patients is a basic professional responsibility, while preparing patients for surgery and coordinating care are core part of delivering treatment.

 

“Patients should not need a medical degree or insider knowledge to understand the fees being charged by their medical specialists, and they certainly shouldn’t have to pay $1500 just to find out what their surgery is going to cost,” Dr David said.

 

The example is not an isolated concern. Consumer research conducted in 2025 found 38% of respondents had received an unexpected medical bill, while 29% reported being charged an administration or booking fee unrelated to their treatment.

 

The AHFC is calling for a ban on hidden fees, stronger action against split billing arrangements, and legally enforceable requirements for informed financial consent.

 

The submission also recommends patients should not be liable for out-of-pocket costs that were not disclosed before non-emergency treatment is provided.

 

“Specialists’ fees have been rising at around three times the rate of inflation, leading more Australians to delay or forego care because of cost concerns,” Dr David said. 

 

“Patients deserve clear, upfront information about what they will be charged and stronger protections when providers fail to disclose costs properly.

 

“We need more consumer protections for patients in the private health system, backed by effective enforcement and penalties for providers who do the wrong thing.”

 

Dr David encouraged private patients to contact their health fund if they did not understand a specialist’s fees or were concerned they may have been charged inappropriately.

 

The AHFC submission also outlines a range of practical reforms to help patients make more informed choices and reduce out-of-pocket costs. These include:

 

• integrating specialist fee information into GP referral software so patients can compare costs before booking;
• improving patient choice through open referrals, easier access to second opinions and longer referral validity periods; and
• considering Medicare bulk-billing incentives for initial specialist consultations to reduce financial barriers to care.

About us:

The Australian Health Funds Council is the national peak body representating 99% of health insurance funds, which provide cover for more than 15 million Australians.

Contact details:

Julia Medew 0402 011 438 [email protected]

Andrea Petrie 0412 655 264 [email protected]