Position Summary
Information about treatment costs should ideally be provided to patients prior to their treatment. Patients are
responsible for contacting their private health insurer to confirm their cover and the benefits that the insurer will pay for the dental service. Dental Practitioners have an ethical obligation to ensure patients have access to information about future maintenance costs and the impact of non-traditional sources of funding.
1. Background
1.1. The Board has a Code of Conduct which has identified the requirements for obtaining patient financial consent to treatment.
1.2. Some Third Parties require health care practitioners to obtain informed financial consent from patients before proceeding with a course of care.
1.3. Provision of a written quotation of fees and recording its acceptance by the patient prior to treatment is good business practice and results in fewer disputes over accounts and fewer bad debts.
1.4. Due to the plethora of different private health insurance policies, there is inconsistency between rebates for a particular dental service.
1.5. In some instances, patients may have wrongly assumed that the fee for the dental service is fully or
mostly covered by their health fund.
1.6. Patients are responsible for contacting their private health insurer to confirm their cover and the benefits that the insurer will pay for the dental service.
1.7. Dental Practitioners cannot be expected to know the difference between their dental fees and the
benefits (gap) payable by private health funds for a dental service.
1.8. The amount of rebate for a service from a Third-Party funding agency is normally a contractual
arrangement between the patient and the agency.
1.9. It has been shown that professionally monitored and maintained dental work is longer lasting that which is not maintained, providing a better clinical outcome.
1.10. The ability of a patients to afford maintenance of dental restorations impacts the ability for the patient to professionally maintain those restorations.
1.11. Non-traditional sources of funding (e.g. Superannuation) are available for patients to utilise within the restrictions of those schemes.
1.12. Under the Australian Tax Office (ATO) rules, patients may seek access to their superannuation if
approved. This requires two medical reports finding that dental treatment is required to treat a life-threatening, illness, alleviate acute or chronic pain, or mental illness.
1.13. The access of non-traditional funding and credit schemes including Buy-Now-Pay-Later style arrangements increases the risk of patients accepting treatment plans that are unaffordable and/or maintenance is unachievable.
Definitions
1.14. BOARD is the Dental Board of Australia
1.15. DENTAL PRACTITIONER is a person registered by the Australian Health Practitioner Regulation
Agency via the Board to provide dental care.
1.16. FUNDING AGENCIES are third parties, which make contributions to the payment of the fees charged by Dental Practitioners.
1.17. INFORMED FINANCIAL CONSENT is consent given to the dentist by a patient to the fees to be charged for treatment agreed to be performed.
1.18. PATIENT is a person receiving health care or any substitute authorised decision maker for those who do not have the capacity to make their own decisions.
1.19. THIRD PARTY is an outside body that can influence the relationship between the dentist and the patient.
These include but are not limited to:
• funding agencies (e.g. government departments, agencies and statutory authorities, private
health insurance and private health organisations) which have responsibility for the entire fee for
service, or part thereof;
• owners of dental clinics who are not dentists, including health insurance funds, corporations and
the public sector (government departments);
• regulatory authorities;
• the dental industry;
• professional indemnity providers; and
• appointment and rating websites
2. Position
2.1. Informed financial consent should be part of sound ethical professional practice.
2.2. Informed financial consent may not be appropriate if it would delay and therefore compromise
emergency patient care.
2.3. The clinical relationship between a Dental Practitioner and a patient is independent of the source of
funding for the patient’s treatment. Nevertheless, an ethical approach to patient healthcare should
incorporate consideration by the provider of the ability of the patient to pay out-of-pocket expenses for a
dental service.
2.4. Dental fees may be based on either an itemised schedule of treatment or on the time taken to complete the dental procedure. Accordingly, the dentist may only be able to estimate a range of fees based on the expected time to undertake the procedure and the anticipated complexity of the procedure. Similarly, if the planned procedure is changed during the procedure due to unforeseen circumstances, this may also result in a change to the final fee charged by the Dental Practitioner. Any such change should be advised at an appropriate time.
2.5. Any information about expected charges provided to the patient prior to treatment should include advice that the estimate is not guaranteed and the cost to the patient may increase if the planned procedure takes longer than expected or other procedures are required.
2.6. Where charging is based on an itemised schedule of treatment, Dental Practitioners should provide the patient with the relevant item numbers from The Australian Schedule of Dental Services and Glossary or the appropriate government schedule item numbers for each of the proposed dental services to enable the patient to confirm the applicable private health insurance benefit or government rebate.
2.7. Patients should be encouraged to contact their health fund to better understand applicable benefits and be afforded the time to give due consideration to the out-of-pocket costs of treatment before treatment commences.
2.8. Where patients are concerned with the cost for a dental service, they should discuss their concerns
directly with their treating Dental Practitioner.
2.9. Dental Practitioners should ensure that a patient or the person responsible for the dental account has adequate capacity to give informed financial consent.
2.10. Dental Practitioners should take reasonable steps to confirm that patients have adequately understood the estimated cost of treatment.
2.11. Dental Practitioners have an ethical obligation to ensure that informed financial consent includes
reasonable information about future maintenance costs.
2.12. Where approval is given to access superannuation funds for the purpose of dental treatment, the ATO should be responsible for providing information to the person accessing funds to ensure they are aware that this will impact retirement funds.
2.13. Accessing superannuation for the purpose of dental treatment is not a preferred pathway for patients who are unable to finance dental treatment necessary for health. Governments should support patients with financial hardship through targeted schemes.
2.14. Dental Practitioners are not responsible for providing financial advice, however, should encourage
patients to seek independent financial advice where appropriate.
