Fees in your health care
The government does not regulate fees charged for health care services by private health providers (for example, doctors, dentists, denture makers, optometrists, physiotherapists and podiatrists, etc). Private practitioners, private hospitals, day surgeries and nursing homes can decide what they will charge for their services in the same way as any other business.
If you are asked to pay for something you were not expecting, or your bill is substantially higher than what had been discussed, the first thing you should do is discuss the situation with your health care provider. Sometimes there might have been a misunderstanding or error in the bill.
If, after speaking with your health service provider, you still feel that the charge is unfair or unreasonable, you need to communicate this to them, preferably in writing. It is better to deal with the matter rather than withholding payment, as the health service provider may decide to put unpaid bills in the hands of a debt collection agency. It may be possible to negotiate an agreement on how to pay the account, for example, by instalments.
The Health Care Complaints Commission is unable to assist with complaints about fees in health care and can’t assist people to get refunds, compensation or to have their bills changed. The following organisations may be able to assist if you have questions about your medical bills or you are seeking a refund.
Private Health Insurance Ombudsman
If you are a member of a health fund, contact the Private Health Insurance Ombudsman (PHIO) on 1800 640 695. PHIO provides more detailed information on the topic of medical bills.
Office of Fair Trading
If you are seeking a refund for goods (for example dentures, glasses, orthotics), which are faulty or for a service you feel you did not get what you paid for, contact the Office of Fair Trading on 13 32 20.
Department of Health
If you are concerned about health practitioners claiming for services or products that weren't provided, contact the Provider Benefits Integrity Hotline on 1800 314 808.
Still need more information
If you would like to speak to someone at the Commission for more information before you lodge a written complaint you can contact the Inquiry Line during business hours, Monday to Friday from 9am – 5pm on 1800 043 159 or submit an online inquiry.
Ready to lodge your complaint
All complaints must be made in writing and we aim to assess complaints within 60 days. Your complaint will be allocated to an assessment officer and we will write to you to explain the outcome of your complaint.
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You can track the progress of your complaint online.
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