We Are
Here to Help.

Here is a helpful guide to common questions our patients ask us. If you can't find an answer here, please get in touch and we'll get back to you.

You can also refer to the patient information section of the Australian Society of Anaesthesia.

  • In general, your anaesthetist or the hospital will give you a plan to help manage your medications at the time of anaesthesia and surgery.

    If you are taking medicine to help with diabetes or your blood pressure, then you will need particular instructions. Each anaesthetist has their own preferences for these medicines and the hospital will tell you what to do.

    Some medication must be adjusted days or weeks before surgery, so complete your admission paperwork or contact your anaesthetist as early as possible.

    Some medications, especially medicines that affect the way your blood clots, need particular care. These drugs include aspirin, clopidogrel, ticagrelor, prasugrel, warfarin, apixaban, dabigatran, and rivaroxaban. Sometimes you can keep taking them as usual, sometimes you need to make adjustments to either the dose or type of drug. If you are taking one of these medicines and have not been given specific instructions already, contact the hospital or you anaesthetist.

    If you are uncertain, have any concerns, or need special advice, contact your anaesthetist via NAPS or your hospital.

  • Breastfeeding your child as close to the time of the procedure as practicable will reduce the disruption to their usual routine.

    Once you are awake and alert after anaesthesia (or sedation) and able to safely hold your child, it is safe to breastfeed again.

    Watch your child for any behavioural changes or increased sleepiness during breastfeeding while you are still taking strong pain relief medications.

    Most agents used in anaesthesia for adults are the same as those used for infants and children and we know they are safe.

    Carers and health professionals can check medications and other substances for safety in breastfeeding using the US National Institute of Health LactMed Database

  • Your anaesthetist monitors your blood oxygen level with a probe that goes on your finger or toe.

    The probe measures the colour of the light that comes through your finger. Acrylic nails and nail polish can interfere with this reading.

    If possible leave one nail on each hand bare when you come to surgery.

  • We ask patients to fast because of the higher risk of regurgitation and aspiration of stomach contents into the airway and lungs. This can make you very ill.


    What do I fast from?
    There can be specific fasting instructions for specific procedures. The hospital, or your anaesthetist or surgeon will let you know. The following are the general guidelines for patients having an elective procedure.


    For adults and children over the age of 2 years

    • Solid food is allowed up to 6 hours before surgery

    • Clear fluids allowed up until 2 hours before surgery

    • Cloudy or milk containing fluids to be stopped at least 6 hours before surgery


    For infants and children over 6 months and under 2 years

    • Breast milk, formula milk and solid food is allowed up 6 hours before surgery

    • Clear fluids allowed and encouraged up to 2 hours before surgery


    For infants under 6 months of age

    • Formula milk is allowed up to 4 hours before surgery

    • Breast milk is allowed up to 3 hours before surgery

    • Clear fluids are allowed up to 2 hours before surgery


    Medications that are needed can be taken as required with a small amount of water.


    What is a clear fluid?

    • Clear apple juice

    • Water

    • Black tea or coffee (no milk)


    What is not clear fluid?

    • Cola drinks, red coloured energy or electrolyte drinks

    • Milk, including flavoured milk drinks, milk shakes, milk in drinks

    • All alcoholic drinks

    • Orange juice or pulp filled juice including fruit smoothies


    Additional information can be found at:

  • There is not one simple answer for children with runny noses and other respiratory infections at the time of surgery.

    The decision to go ahead or wait will depend on the severity of the infection, the need and nature of the surgery and your child’s general health.

    Be sure to let the hospital and your anaesthetist know as early as possible before surgery.

  • If you are worried about any trouble that might have occurred because of your anaesthetic, contact your anaesthetist via NAPS as soon as possible for advice.

    If you need further scripts for pain relief or other medications, you should see your general practitioner.

    If there are any out-of-pocket costs, NAPS will send you an invoice for payment, otherwise NAPS will deal with your health fund and Medicare directly. If you have concerns, please contact NAPS as soon as possible.

  • An Anaesthetist's fee is calculated based on the number of units (RVG units) which are calculated from: 

    • Type of surgery

    • Duration of the procedure

    • The addition of specialised monitoring devices

    • The use of specialised pain management techniques

    • The level of a patients underlying health status

    • The age of the patient, <12 months or >70 years of age

    • Whether the case is occurring as an emergency or out of hours

    Each Anaesthetist sets their own RVG unit price from which the total invoice is then calculated. At times, they will choose to utilise the amount that is offered by the private insurance funds (the no-gap or known gap rate) and as such the patient will have no out of pocket costs. At other times, they will have reasons where they feel it is appropriate to charge above the insurance fund fees and this will create an out of pocket cost to the patient.

    It is important to remember that there are over 30 individual Anaesthetists within the NAPS cooperative, and the individual decides how they will approach their billing and which cases will attract an out of pocket cost.

    Across the entire practice however, close to 60% of our accounts are billed so as to leave no out of pocket costs. And the majority of the others are billed within the known gap levels.

    At NAPS, we take every possible step to ensure patients undergoing procedures that will attract an out of pocket cost are notified with an Informed Financial Agreement.

    We attempt to obtain lists from the Surgeon’s rooms with your contact information as soon as they are placed on a list. We find that we need this information at least 72 hours before the day of surgery. Surgeons are not always aware of all of their cases on any particular list until inside that time, however we have staff dedicated to coordinating this process and attempt to send an email within 48 hours of receiving a patient's name/email address, or to post the information when no email address is provided.

  • As doctors, we have no control over what proportion of our fees are covered or not covered by the various insurance bodies responsible for the reimbursement of money to patients.

    Anaesthetists decide what our time and experience is worth, while we care for our patients with our surgical and procedural medical colleagues. We base this decision on the fact that we are working in a first world medical environment and that we have studied and trained for between 5 - 6 years beyond our undergraduate medical degree, to provide some of the safest and technologically advanced anaesthetic care in the world. 

    Any invoice is partly covered by the Medicare rebate, at a rate defined by the Federal Government in its Medical Benefits Schedule (MBS) of fees. Between 2013 - 2018 there was a freeze placed on these MBS rebates and even now some services have not been released from this freeze. These Medicare rebates are currently under review, but they are often set based more on what is possible for Governments to gain Parliamentary support for rather than the real costs of medical care.

    Private insurance funds then pay for an amount above this Medicare rebate as defined by their own benefit scheme, and each fund, while often being aligned, gives differing amounts for each item attracting a rebate. Furthermore, there are some procedures which are not included in the MBS and these may or may not be available for reimbursement by a fund. Finally, it can depend on the level of insurance (gold, silver or bronze) a client chooses to hold, and which fund a client chooses to insure with.

    Some funds keep their premiums to clients low, but then have a different lower rebate system should the doctor choose to charge above the fee that the fund has set, this will force the client to pay a larger out of pocket cost. It should be taken in to consideration that it is to the benefit of shareholders within a for-profit health insurance fund to keep outgoing payments low.

    Consequently, given there is a benefit to government and insurance companies to undervalue and limit payment for the services of doctors, and more specifically, Anaesthetists, then there will be an amount of our invoices that remains uncovered and will need to be met by the patient themselves.

    What is the gap cover scheme and does my anaesthetist charge with it in mind?

    Private Health Insurers (PHI) have their own schedules, they define what level of cost they are prepared to reimburse the patient for and these schedules fall in to the general definition of being either:

    No Gap: No out-of-pocket cost

    The insurer sets an upper limit for how much they will pay over the MBS fee. If your doctor charges above the MBS but under, or up to, the insurer's 'no gap' threshold, you will be covered and have no out-of-pocket cost. If they charge more than the 'no gap' threshold, you may be able to take advantage of your insurer's 'known gap' scheme (see next point).

    (PHI's that have no 'known gap' scheme may reduce the amount reimbursed to the patient back to the MBS amount if a doctor charges above their no gap amount.)

    Known Gap: Known out-of-pocket cost

    This gives you a bit of leeway if your doctor charges above the 'no gap' threshold, but not all health funds offer a known gap option in their scheme. The insurer sets a known gap amount, which is often exactly the same amount as the no gap amount. Usually, if the doctor charges up to $500 more than the known gap amount, you pay the difference between the known gap amount and the doctor's charge. The health fund and Medicare pay the rest. This usually limits your out-of-pocket costs to a maximum of $500.

    But be aware, if your doctor charges only a few dollars above the known gap amount, you will no longer be eligible to claim anything under the gap scheme, and you will be back to paying the difference between the MBS-set fee and what the anaesthetist or surgeon charges.

    Health funds have agreements with particular doctors who have agreed to charge up to the threshold for some or all of their patients. But even if a doctor has a gap agreement with your health fund, it is up to them if they choose to use it for you.

    For further information, please refer to choice.com.au, the leading consumer advocacy group in Australia

    Or, you can always
    contact us directly:

    +61 2 4935 9300

    info@naps.com.au

    Suite 3, 25 Morehead Street,
    Lambton, NSW 2299