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Paying through private medical insurance

Consultations

If you have private medical insurance, you will need to obtain pre-authorisation for the consultation from your insurance company before your clinic appointment.

Important: Your Private Insurance Company may not fully cover your out-patient consultation fees and there may be an excess for you to pay.

Mrs Caroline Overton’s consultation charges

Consultation or procedure Cost
New consultation (30 minutes) £180
Follow-up consultation (20 minutes) £120
Ultrasound scan £200
Post-operation consultation fee £200

Other charges

Any procedures or treatments may incur an additional charge.  Any other tests/investigations e.g. blood tests, swabs, smear, xrays, pathology tests etc will be charged by the Nuffield Chesterfield Hospital.  Please ask at the time of your consultation if you have any queries about fees.

Payment information for Nuffield Health Chesterfield Hospital

Spire Bristol Hospital payment page

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. 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.

What happens before your operation.

Operations: what your insurance covers

Hospital fees

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-operative 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, except BUPA.

Excess or fee shortfall

In our experience, there may be a shortfall with our consultant fees. For example, with a typical insurance company and taking the example of an: abdominal hysterectomy:

Item Cost Insurance pays You pay
Staying in hospital In the region of £5,000 All costs £0
Mrs Overton's surgical fee £1,030 £520 £510
Consultant Anaesthetist £325 £275 £50

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 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 abdominal hysterectomy is £Q0740

Dr Scrutton 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.