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Informed Financial Agreement

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Informed Financial Agreement

Understanding your procedure costs

As a service to our patients, we provide an estimate of the expected medical fees for your in-hospital or day case procedure, covering Dr Sørensen’s fees only. To ensure you are fully informed, we recommend discussing these fees with the FNQ Plastic Surgery team before your procedure, as out-of-pocket expenses will apply. You will also be responsible for any fees not covered by Medicare or your Private Health Fund.

This estimate does not include hospital fees, excesses, or co-payments for pathology (such as breast tissue samples), scans, or x-rays that may be required during your stay. Additionally, unforeseen circumstances may arise during your procedure, requiring extra medical services or the use of a prosthesis, which could result in additional costs beyond those outlined in this quote.

Please note that you will receive your quote via email after your initial consultation with Dr Sorensen, along with other relevant information regarding the surgery discussed. Please note that the quote is valid for six months from the date it is issued.

Informed Financial Agreement

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Dr. Sorensen's fees include

  • Surgeon fee
  • Second assistant (if required)
  • Assistant fee (nurse)
  • All follow-up appointments for up to 12 months for cosmetic procedures
  • Post-operative garments & implantable devices as required
  • Scar treatments as required

Private Health Insurance

If you have Private Health Insurance, it is your responsibility to confirm your coverage for the procedure. If it is not covered, you will be responsible for any hospital fees. To avoid any unexpected costs, please ensure you are aware of these fees before your surgery date. Below are listed questions you should ask your Health Fund:

  1. Am I covered for the Cairns Private Hospital or Ramsay Surgical Centre Cairns?
  2. Am I covered for the 5 digit item number/s listed on my quote?
  3. Will I be covered if this surgery is combined with a cosmetic component that does not have an item number?
  4. Do I have an excess to pay when I go to hospital? if so, how much is it?

Please note: We do not participate in the "Gap Scheme" often mentioned by private insurance companies.

Anaesthetist

  • Anaesthetist payment - usually 1 week prior to surgery
  • Please ensure you contact the Cairns Anaesthetic Group - 07 4044 6900

Hospital Payment

  • A payment, including insurance excess, is usually on the day of admission
  • Please ensure you contact the hospital – 07 4052 5109

Payment Terms - Costmetic Surgery

For cosmetic surgery, the final payment is due 3 weeks prior to your scheduled surgery date.

Please use your Surname as the reference and contact us once payment is complete. We can reconcile your payment to your account.

Payment Terms - Skin-related Surgery

For skin-related surgery, the final payment is due 2 weeks prior to your scheduled surgery date.

Please use your Surname as the reference and contact us once payment is complete. We can reconcile your payment to your account.

Payment Methods:

  • Direct Bank Transfer
  • Credit card (all types)– Over the phone or in the clinic ($2.99 transaction fee applies)
  • Cash
Deposit amount agreement(Required)

Refund Policy

At FNQ Plastic Surgery, we understand that circumstances may arise requiring you to cancel or reschedule your procedure. However, due to the significant preparation involved, the following refund and rescheduling policies apply:

Deposit Policy:

  • A 20% deposit is required to secure your procedure date.
  • This deposit is non-refundable, except in cases of illness or medical emergency, at the clinic’s discretion. A valid medical certificate must be provided.

Date Change Policy:

  • A $500 re-arrangement fee will apply if you choose to change your surgery date within 6 weeks of the booked surgery. This fee covers administrative costs associated with rescheduling the surgeon and any prosthesis, anaesthetist, and hospital booking.
  • This deposit is non-refundable, except in cases of illness or medical emergency, at the clinic’s discretion. A valid medical certificate must be provided.

Cancellation Fees:

  • If you cancel your surgery within 21 days of your surgery date, you will be responsible for 50% of the total procedure cost. This amount is non-refundable and cannot be applied to a future procedure.
  • If you cancel your surgery within 7 days of your surgery date, you will forfeit the total procedure cost. This amount is non-refundable and cannot be applied to a future procedure, except in cases of illness or medical emergency, at the clinic’s discretion. A valid medical certificate must be provided.
Refund Policy Agreement(Required)
Medicare & Health Fund Rebates(Required)
Assignment of Medicare Benefits (AoB)(Required)
Complication Care Policy(Required)
Unsatisfactory Cosmetic Results Policy(Required)
Your name(Required)
Please enter your name
By signing your name, you acknowledge and agree that this electronic signature is the legal equivalent of your handwritten signature, and you confirm that you have read, understood, and accept all the terms and conditions outlined in this Informed Financial Agreement. If you have any questions regarding this policy, please contact our office.
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