The Federal Government is investigating ways to crack down on doctors who are not transparent about fees, including another new watchdog or expanded powers for the Professional Services Review.

Its public consultation on improving informed financial consent, published last week, says medical groups have strong policies that most doctors follow.

However, it says patients are still facing bill shock. Citing a report commissioned by health insurance lobby group Private Healthcare Australia, it says 44% of patients were unaware what their non-GP specialist would charge until the appointment and 38% received bills they did not expect at all.

It acknowledges that costs under Medicare can be hard to understand and may change during treatment based on what is clinically needed.