Paying through private medical insurance
If you have private medical insurance, it is essential that you contact your insurer before long consultation, to obtain pre?authorization. You will need to check the terms of your policy, particularly the level and type of outpatient cover you have, including any reimbursement limits on Mrs Overton?s consultation fees.
Mrs Overton will submit claims relating to your treatment direct to your private medical insurer. Mrs Overton?s charges are generally met by the private medical insurance. However, there are many different policies and it is essential that you know what your health insurance provides in terms of cover. Please note that you are responsible for any fees not covered by your insurer.
We will provide quotations for any treatment upon request.
Mrs Overton is recognised by the private medical insurers listed:
- Aviva UK health
- AXA-PPP International
- BUPA International
- CIGNA Healthcare
- CIGNA international
- National friendly
- PMI health group
- Simply health
- Western Provident Association WPA
Important: your private insurance company may not fully cover your outpatient consultation fees and there may be an excess for you to pay.
Mrs Caroline Overton’s consultation charges
|Consultation or procedure||Mrs Overton?s fee||Hospital fee|
|New consultation (30 minutes)||?225 (includes the hospital fee)||?0|
|Follow-up consultation (20 minutes)||?150 (includes the hospital fee)||?0|
|Post-operation consultation fee (20 minutes)||?200 (includes the hospital fee)||?0|
|Ultrasound scan||?200 (includes the hospital fee)||?0|
|Telephone private prescription||?30||?0|
|Cervical smear (cytology & HPV testing)||Included within the appointment fee||?88|
|Combined chlamydia & gonorrhoea testing||Included within the appointment fee||?99|
|Hormone blood test (FSH, LH, prolactin & estradiol)||?0||?99
|Endometrial biopsy Q2020||?180||?340|
|Removal of cervical polyp||?180||?135|
|Fitting of a Mirena IUS in the Outpatient clinic||?300||?255|
|Fitting of a pessary for prolapse||Included within the appointment fee||?45 for the pessary|
Any other tests carried out, for example, blood tests, x-rays, MRI, CT scan, items dispensed from the Hospital pharmacy, will be charged separately to you or your private health insurer. The fees are determined by the hospital. If the cost is not covered by your private health insurer, it becomes your responsibility to pay.
Please ask at the time, so that you are not faced with an unexpected charge.
Excess charges you may have to pay
Your Private Insurance Company may not fully cover your out-patient consultation fees and there may be an excess for you to pay.
Your Private Medical Insurance Company will notify you if there is an excess to pay, and this excess will be payable to Mrs Caroline Overton. Please note that this is separate to any bill(s) from the Nuffield Chesterfield Hospital and Mrs Overton's bill will not have been paid by the credit card swipe taken by the receptionist as part of the Nuffield booking process.
Your Private Medical Insurance Company does not typically cover the following items:
- Phone consultations £120
- Failure to attend/last minute cancellation with less than 24 hours’ notice £180 for 30 minutes or £120 for a 20 minute appointment
- Meals for friends and family while you are staying in hospital
If you need an operation under private medical insurance
If you have private medical insurance cover and have decided to proceed with an operation, you will need to pre-authorisation from your insurance company. Mrs Overton will provide you with the relevant information required by your insurance company, including the operation details, operation codes (OPCS), and Mrs Overton’s fees.
Operations: what your insurance covers
Hospital fees are invoiced directly to the private medical insurance company by the hospital. These fees are usually covered in full and include your pre-operation assessment, your stay in hospital, operating theatre fees, consumables, drugs and dressings, nursing care, inpatient physiotherapy, xrays, scans, blood tests, hospital accommodation and meals.
Consultant fees are charged separately and consist of Mrs Overton's and the Consultant Anaesthetist's fee. Mrs Overton will charge her surgical fee and your consultant Anaesthetist will charge a separate Anaesthetist's fee. The contract for your clinical care as a private patient is between yourself and Mrs Overton/Consultant anaesthetist. Mrs Overton is not under contract with the hospital or any private medical insurance company.
Excess or fee shortfall
In our experience, there may be a shortfall with Mrs Overton?s surgical fees. For example, for laparoscopic treatment of endometriosis (code Q3800) and a typical insurance company.
Example: Laparoscopic treatment of endometriosis Q3800
|Item||Cost||Insurance pays||You pay|
|Staying in hospital||In the region of ?2,627||All costs||?0|
|Mrs Overton?s surgical fee||?770||?548||?222|
|Consultant anaesthetist fee||?265||?220||?45|
Example: Hysteroscopic removal of submucous fibroid Q1802
|Item||Cost||Insurance pays||You pay|
|Staying in hospital||In the region of ?1,688||All costs||?0|
|Mrs Overton?s surgical fee||?865||?452||?413|
|Consultant anaesthetist fee||?265||?195||?70|
Mrs Overton’s surgical fee includes the operation, her surgical assistant, pre- and post-operative visits in Hospital and the clinic follow-up appointment.
The level of reimbursement of your care will largely depend on your insurance company and type of policy. Most companies have not increased consultant fees since 1995 and over the past five years have introduced reductions. During the same period, the cost of private medical practice has increased by over 35%.
How to check what you might pay
If you are unsure about your fees, please contact Maxine Taylor or Sharon Barnett at the Nuffield Hospital, so that you can be informed of the extent of your cover and how much you have to pay.
You can find out how much your Private Medical Insurance company will pay towards the Surgeon's and Anaesthetist's fees by searching the internet and typing the name of your insurance company and 'fee schedule'. By putting in the operation code, you can see how much your Private Medical Insurance Company will re-imburse the surgeon (Mrs Overton) and your anaesthetist.
For example the code for laparoscopic treatment of endometriosis is Q3800 and Bristol Anaesthetists in general charge WPA rates. To find out how much the Anaesthetist will charge you can search the internet for WPA and 'fee schedule' and put in the code provided.