Fees for Procedures and Tests
Please ring the Chiltern Hospital and ask to speak to the ‘self-pay department’
An Explanation about Medical Fees in the Private Sector
FIPO, The Federation of Independent Practitioner Organisations, is a medical organisation of professional bodies whose objective is to maintain the highest possible standards of care in the private medical sector, and the independence and freedom of choice for patient and doctor. It defends the right of consultants to treat patients according to their clinical needs and to the best professional standards without external interference.
FIPO does not set medical fees nor does it support or defend unreasonable or high charges. Any specific questions on fee levels should be directed to your consultant. Patients should note that FIPO does not accept responsibility for any of the actions of individual consultants. However, there are certain principles that govern your fee arrangements and this document explains how patients and your consultants interact. FIPO has also published a Charter which lays down the principles of independent practice and this has been endorsed by the major Royal Colleges, the various Surgical Specialty Associations, the GMC and the Patients Association (http://www.fipo.org.uk/docs/patientcharter.htm).
Medical Fees – is there a contract between the patient and consultant?
Any patient who consults or is treated by a consultant in the private medical sector will be personally responsible for the payment of all their consultant’s fees and a financial contract exists between them. In many instances patients have private medical insurance that will fully reimburse them for their medical fees. However there are often exclusions within these policies (i.e. specific medical conditions, outpatient allowances or payment by the patients of an initial excess amount). Sometimes there may be shortfalls in the insurance reimbursement that the patient receives for the consultant’s fees. In the event that there is a shortfall it is borne by the patient who is personally liable to the consultant for his/her fees. Many consultants are not prepared to enter into direct billing arrangements with insurance companies, as they are concerned that this will eventually affect their independence and will not be in the best clinical interests of their patients and thus they may bill the patient directly and ask the patient to claim the reimbursement from the insurer.
How to choose a consultant and get preauthorisation by an insurance company
Most patients are referred to a consultant on the recommendation of their General Practitioner (GP). This is the traditional route. The GP will know the specialist interests and abilities of all the consultants to whom he/she refers patients. Some patients will have knowledge of a particular consultant and are entitled to ask to see that specialist. A GP referral letter is usual and at this stage most insurance companies ask patients to contact them for pre-authorisation. At this stage the patient may be given a specific authorisation number for this clinical event and this is usually a straightforward process.
Sometimes at pre-authorisation the insurance company raises queries about the expected level of fees or may even suggest referral to another (cheaper) consultant. In such circumstances we strongly suggest that the patient should always contact the consultant recommended by their GP. This recommendation and referral was made on the basis of the medical judgement of the medical practitioner who knows the patient best and was not influenced by any financial motives or dictated by an insurer.
Can I get an estimate of fees before treatment?
It is perfectly reasonable and desirable to ask your consultant to give you an estimate of his/her fees prior to treatment. This can often be furnished for a standard operation (i.e. hernia, hip replacement, hysterectomy etc.). In these cases the consultant should do his/her best to tell you about other potential professional charges, such as the anaesthetist’s likely fee. It is possible that you will also have professional care from other consultants who are entitled to submit accounts. Your consultant may not be able to state exactly what these colleagues will charge but might assist you in obtaining some information on what these are likely to be.
In some instances, however, a very precise fee estimate is difficult to make because your diagnosis and treatment is unclear. Frequently, other consultants may be called to see you and these doctors are usually chosen by your primary consultant with your agreement. Sometimes, in an acute clinical emergency neither you nor your relatives may be able to exercise influence over these decisions. In these circumstances patients should realise that all doctors work in specialist teams and that this reflects best clinical practice.