PATIENT INFO

PAYMENT

Payment responsibilities

The company policy is to require payment in full in advance, or at the time of treatment on all accounts not guaranteed by an approved third party. Interest may be charged at the rate of 12% per annum, calculated from the date of discharge or the date of the invoice if an invoice is presented prior to discharge, on all accounts where credit has not been granted and there are delays in payment. Where fixed price, contractual or any other policy discounts have been applied to an account and subsequently the hospital experiences difficulties in collecting the account, the hospital management reserves the right to reverse the discount and to re-bill the account in full. The amount shown as payable on the invoice is net of discounts. Any further collection costs incurred by the hospital (including fees billed by collection agencies, credit reference agencies and solicitors) will be added to the final amount payable.

Patients with medical insurance

It is the patient or their representative's responsibility to ensure cover is adequate to pay for treatment. We strongly recommend that patients/representative contact their insurance company prior to treatment in order to check cover and the terms of the policy.

The hospital will process insurance claims directly with approved insurers on the patient's behalf, if the patient has provided claim details. It is the patient's / representative's responsibility to verify with the insurer that the condition to be treated is covered by the insurance. The hospital is not responsible for this verification.

Insufficient documentation will prevent direct settlement and will result in the account being treated as self funding. Any shortfalls in benefit are the patient's or their representative's responsibility.

In all circumstances, responsibility for payment of hospital accounts rests ultimately with the patient. Should any sponsorship or guarantee fail, or insurance claim be declined in whole or in part, the patient will be required to pay the outstanding balance in full.

Who pays for my treatment?

While, in the majority of cases, your medical insurer will pay for all your treatment at our hospitals, it is important to note that there are certain treatments that your medical insurer may not pay for. By signing the Admission and Registration Form, you agree that, if your insurer does not pay for any part of your treatment, you will pay this yourself.

When might my insurance company refuse to pay for treatment?

The treatment which your medical insurer will cover will depend on a number of factors, such as which insurance company you are insured with, what policy you hold and what level of insurance you have. However, if you are having any of the following types of treatment, we strongly recommend that you contact your insurance company and ask them to clarify what portion of the costs they will cover. These are the treatments where patients most commonly face difficulties with their insurance cover:

Treatment for chronic illnesses
Treatment for chronic conditions is generally excluded from UK insurance policies. Chronic conditions are explained in the Association of British Insurers Private Medical Insurance Common Definitions guidance document this can be found here. For example, you may not be covered for treatment of digestive conditions such as Crohn's disease or irritable bowel syndrome.
Screening
Screening and routine testing is generally excluded from UK insurance policies. This includes, for example, scanning to detect early indications of heart disease and also testing to ensure that you are not carrying MRSA.
Experimental treatment
Some treatments are considered experimental by particular insurance companies and are therefore not covered by insurance policies. This applies most typically to newly licensed cancer drugs and certain prostheses.
Treatment not deemed to be medically necessary
Some insurance companies use care guidelines that may not match the professional medical opinion of nursing staff, your consultant and other medical professionals providing your treatment. In some cases this can result in certain parts of the care we have provided not being funded by your insurer.
Cosmetic surgery and treatments
Cosmetic surgery is not generally undertaken for the treatment of a medical condition and is therefore excluded from most UK insurance policies. If you are unsure about your insurance coverage, please speak to our staff who can help you to contact your insurance company.
Pre-Authorisation
Most private medical insurance companies now require claims to be authorised before a patient may be treated at a private hospital. If confirmation of cover cannot be obtained by the time of admission/registration, you will be treated as self funding and asked to pay a deposit or settle the account in full and claim back from your insurer. Exclusions may be due to your previous medical condition or to a general exclusion within your policy, for example: pregnancies following assisted conception treatment. It is always wise to check for any exclusion or benefit limits before commencement of treatment.
Six-Week Clause
Some insurance policies contain a six-week clause, which permits private medical attention only if you cannot be admitted to an NHS hospital within six weeks; it is imperative that the patient discusses this with their Consultant and insurance company before the planned treatment date.
Direct Settlement, Shortfalls and Exclusions
The claim form must be completed by the patient or their representative and forwarded to the consultant or GP arranging treatment.

International policies

HCA has agreements with a limited number of insurances that offer international cover. If no agreement is in place, the patient is required to pay in full and claim back monies from their insurer at a later date.

Self-funding patients

We require payment in full or a deposit on or before the time of treatment for self-funding patients. The hospital may require further payments on account, with payment of the balance in full on discharge. The value of the deposit will vary with treatment and is at the discretion of the hospital providing treatment. Organising payment in advance or your treatment will save considerable time admitting you into the hospital particularly at times when activity is high. Quotations or estimates given by a physician, consultant or their staff are not valid unless confirmed in writing by the hospital. Hospital prices are normally subject to annual review.

Packaged accounts

Packaged accounts are billed as a one line bill, are normally discounted, and assume a routine stay without medical complications. They are offered on the basis that full payment is made before, or on admission, and payment for any additional items is settled before discharge. Package prices do not usually include:

Ambulance charges
Telephone or personal expenses, guest meals etc
Outpatient drugs and dressings
Specialist medication
Physiotherapy aids, crutches, neck braces etc.
Companion fees
Special nursing
Histology tests
Additional night(s)
Additional procedure(s)
Consultant fees
Prosthesis

If in doubt please ask a member of the Patient Administration Department.

Please read the details of your particular agreement. Ensure you understand what's not included in the package price. If there are any unexpected complications, the hospital management reserves the right to re-bill on an item of service basis. Accounts not settled on departure may not qualify for discount and will be rendered in full. Your agreement may involve separate charges, as these items are individual to each patient and are specified by your doctor.

Any charges not included in the package price will attract additional costs that you will be required to settle. We do not want you to have any unpleasant surprises in relation to the account.

Outpatient services

Payment for outpatient services must be made in full on the day of treatment, except where a direct settlement agreement exists.

If payment is delayed or refused in whole or part, we will invoice patients for immediate settlement.

Deposits

We ask for deposits at admission for patients who;

Are self-funding
Do not have cover with a recognised insurance company
Have not had their cover confirmed by their insurer
Do not have suitable guarantor or sponsor documentation

We try, wherever timing and available information permits, to inform patients in advance and in writing of payment required on registration / admission.

Refunds

If a refund is due from your deposit, it must be refunded via the same manner in which it was paid. We require this data to enable a swift refund, if applicable.

Please note cash cannot be refunded on site. Arrangements can be made via Patient Administration.

Occasions when a patient may be refused treatment

HCA regrets that patients arriving for treatment will not be admitted or registered if they arrive without satisfactory insurance or sponsorship documentation or any acceptable method of pre-payment. On such an occasion, Admission and Registration staff will contact the Admitting Consultant to discuss the situation.