Quotation For Surgery

quotation for surgery (dr. jason brockwell) mr paul carr

date of surgery: (to be confirm)

diagnosis: impingement right ankle planned surgery:

ankle arthroscopic + debridement

prices are in hk$ (hk$7.8=us$1) procedure: ankle arthroscopy & debridement (limited) (100%) cpt code:29897 surgeon’s fee anaesthetist’s fee

class i (private) $25095 $8365

class ii (shared) $19001 $6334

class iii (ward) $12548 $4183

day case room $17567 $5856

if more than one procedure is performed, they are charged as follows: for procedures on the same site, the largest procedure is billed at 100% of the figure above; the next largest at 50% and any subsequent procedures at 25% each. additional procedures on different sites will be charged at 75% of the figure as calculated above. charges based on one night hospital stay and inpatient care charge applies for extra stay in hospital: ward round charge: class 1 class ii class iii day case (private) (shared) (ward) $2900/day $1800/day $1100/day na hospital charges: the matilda international hospital has been contacted for a quotation of the hospital charges and they will fax it to you when it is ready. should you have questions about the hospital charges or if your insurance company needs to make any arrangements regarding payment with the hospital, please contact mr. carlos ma on +852 2849 0375 or the admission office on +852 28490708. please visit www.matilda.org to pre-register on line, this will save time on arrival at the hospital. feel free to contact me at any time if you have any other questions regarding your surgery. linda fung, nurse manager [email protected] direct line: +852 3420 6606