Dr Denise Sproul Inc is a private specialist practice. Our fees are based on recognised medical billing codes and the practice's own rates, which reflect specialist training, professional time and the cost of running a fully equipped rooms.

Every charge falls into one of four clear categories, so you always know what you are paying for:

We follow the HPCSA's ethical billing guidelines (Booklet 19), which require that fees are transparent, disclosed in advance, and never exploitative. We charge to remain sustainable — never to profit from your care.

The following are our current private consultation and in-rooms procedure fees. Where a medical scheme applies, these may be billed per the relevant tariff code. We will always confirm the fee with you when you book.

Fees are reviewed periodically and were current at the last page update. Additional charges may apply for longer or more complex consultations, procedures, consumables or after-hours services, as set out below. You are always welcome to ask for a written quotation before any planned procedure.

Our practice holds a payment arrangement with Discovery Health Medical Scheme (Classic plans). This is good news for Discovery Classic members:

• Where Discovery has a payment arrangement with a specialist, approved consultations and procedures are covered at the agreed rate, which helps limit or avoid co-payments for you.
• For specialists without an arrangement, Discovery typically reimburses out-of-hospital specialist claims up to 300% of the Discovery Health Rate, and any shortfall becomes the member's responsibility.

Your medical aid is a contract between you and your scheme. We will always bill correctly and provide a fully detailed invoice, but we cannot control what your specific plan chooses to reimburse.

For all in-rooms consultations and services (other than direct Discovery Classic claims that we submit on your behalf), we operate on a cash-on-service basis — payment is settled at the time of your visit by card or EFT.

You will receive a detailed, coded invoice that you can submit to your medical aid for reimbursement directly into your account. This keeps our costs down and, in turn, helps us keep your fees fair.

If you ever anticipate difficulty settling an account, please speak to us in advance. We would always rather arrange a sensible, agreed payment plan than have anyone avoid necessary care.

A co-payment (or shortfall) is the portion of an account your medical aid does not cover. It arises for reasons set by your scheme, not by us — for example:

• Your plan reimburses specialists at a rate lower than the actual fee.
• Your day-to-day or savings funds are depleted.
• The service falls outside your plan's benefits or network.
• Scheme-specific rules apply to certain procedures.

We strongly encourage every patient to know your plan and, where relevant, to consider gap cover — a short-term insurance product designed specifically to cover the shortfall between scheme tariffs and actual specialist rates. You are always entitled to ask us, up front, what a service will cost and whether a co-payment is likely.

Our consulting hours

During these hours our team is here to help with bookings, queries and accounts. For anything life-threatening or a genuine emergency, please go directly to your nearest emergency unit or labour ward — never wait for a message reply.

Contacting the doctor outside of practice hours

Dr Sproul is committed to your care — but like any professional, her time outside of practice hours is her personal and family time. When a patient asks the doctor to engage clinically outside of consulting hours (for example a non-emergency call, WhatsApp or email that requires her clinical attention), she is being asked to step away from her own rest and family to focus on your matter.

For that reason, the doctor reserves the right, at her sole discretion, to charge for after-hours clinical communication. Depending on the time, complexity and nature of the interaction, this fee may be as much as R2 690, billed under the appropriate consultation code (for example a telephone/electronic consultation, or an after-hours consultation loading).

Wherever possible, please direct clinical questions to a booked consultation during practice hours, where the doctor can give your concern her full and proper attention.

Every appointment reserves dedicated specialist time set aside just for you. When an appointment is missed or cancelled at short notice, that time usually cannot be offered to another patient who may have needed it. To be fair to everyone, the following applies:

A short-notice or no-show fee will only be applied where the reserved slot could not reasonably be filled by another patient.

By booking an appointment with the practice, you acknowledge that you have been made aware of this policy.

In addition to the consultation fees above, the following nursing and consumable items are modest cost-recovery charges — they cover the real cost of the materials and time involved.

Some things are simply part of caring for you, and we do not charge for them:

• The first two (2) printed ultrasound images with any scan.
• Discussion of your results during your consultation.
• Your routine first post-operative check — the standard wound review and recovery discussion after a procedure.
• Standard repeat prescriptions generated during a consultation.

A new problem after surgery — such as an infection, unexpected bleeding or a complication — is a new clinical matter and is charged as a normal consultation.

We know how precious your scan images are, and we love sharing them with you. Every scan includes two printed images at no charge.

Additional printed images are charged at a small R20 media-recovery fee each, and a full set of images can be supplied digitally (email or USB) for R100. This simply covers the cost of the specialised thermal print media, the printer and the time involved — it is never a charge for the images themselves.

Procedures performed in hospital (such as a caesarean section or gynaecological surgery) are billed using the standardised South African coding system, based on SAMA / CPT-derived codes and modifiers. This is the same system used by every specialist practice in the country.

Your hospital account, anaesthetist's account and surgeon's account are separate accounts from separate providers. In addition to the main procedure, standardised modifiers may be added where they clinically apply, for example:

• Assistant fee — where a surgical assistant is required.
• Emergency modifier — for unscheduled emergency procedures (e.g. an emergency caesarean).
• High-BMI modifier — explained in detail below.

These are not optional or discretionary "extras" chosen by the practice — they are defined, industry-standard codes that reflect the additional complexity, time and risk of a case, and they are applied consistently to all patients.

We want to explain this one openly and kindly, because it is often misunderstood and can feel personal — when in fact it is nothing of the sort.

What it is

The high-BMI modifier (code 0018) is a standardised, industry-wide billing modifier that adds a set percentage to the fee for certain incisional surgical procedures where a patient's Body Mass Index (BMI) is 35 or greater. It applies to both surgeons and anaesthetists.

Why it exists

A higher BMI is clinically associated with greater surgical and anaesthetic complexity and risk — including more difficult access, longer operating time, more challenging anaesthesia, and a higher likelihood of complications. The modifier recognises this additional clinical work and risk. It is a recognised part of the South African coding system and is not unique to our practice.

Will my medical aid cover it?

Whether the modifier is reimbursed depends entirely on your medical scheme and plan. Some schemes fund it in full; others may not, which can leave a co-payment. This is a matter between you and your scheme — but we will always disclose it in advance and are happy to provide a written quotation before any planned procedure so there are no surprises.

If you have questions about the modifier, please talk to us. We would far rather explain it calmly beforehand than have you feel it was unexpected or personal. It never is.

Completing detailed reports and forms is professional work that takes time away from patient care, and is therefore charged for. Your records are handled in line with the National Health Act and POPIA.

Fees shown on this page are the amounts charged by the practice. Please note that VAT status and fees may change; the practice will update this page and its invoices accordingly. Where VAT applies, it will be reflected on your invoice.

We would always rather have a friendly conversation about fees up front than leave you uncertain. If you have any questions about your account, a co-payment, a quotation for a procedure, or how your medical aid works with our practice, please contact our reception team.