All the consultation, investigations and procedures undertaken at 108 Harley Street are routinely covered in full by medical insurers subject to policy terms and conditions, exclusions and excesses.
For surgery requiring an inpatient stay at our partner hospital the patient is provided with a written estimate of both the surgical and anaesthetic fees. Medical insurers do not all pay the same towards medical fees and not all publish their fee schedules. We use as a guide the WPA fee schedule as they are one of the only insurers to publish their fee schedule on their website, however we guarantee no shortfall for breast surgery subject to policy excesses and exclusions.. The patient is advised to contact their insurer prior to admission to check that your policy covers the hospital and medical fees.
A referral from a Doctor or other Specialist is essential if you are expecting your medical insurer to contribute towards the cost of your treatment. If this is the case, we recommend that you contact them, in advance of the initial visit, to check what your policy covers and ensure that they will authorise your claim. If they raise any objection to the referral please contact Clair Linnane Practice Manager at 108 Harley Street, (0207 563 1234), as it is always easier to resolve any issues with them in advance of any treatment.
Subsequent visits can usually be made by self-referral as this constitutes on-going management, however you should check that this is acceptable to your medical insurers. Please advise whether your policy excludes outpatient treatment eg consultations and/or investigations. Patients paying for their own treatment can, of course, self refer at any time.
An indication of consultation and investigation fees can be given in advance of any appointment based upon standard outcomes and the information provided by the patient but these are for guidance only and are not binding.
Most medical insurers have moved away from issuing paper claim forms and will authorise all claims over the telephone and issue a pre-authorisation number for the claim. Where we have pre-authorisation and membership details, invoices can be submitted directly to medical insurers, on your behalf, for treatment received. Should your insurer still require a claim form, it will be completed and signed by the consultant and sent directly to the insurer, unless you advise us otherwise. When no insurance information is available, invoices will be sent to the patient to be forwarded to their insurer.
Patients with non UK based insurance companies will be asked to settle their accounts at the time of treatment, receipts will be provided to enable the claim to be submitted to their insurer.
Patients are responsible for any shortfalls arising for exceeding their annual outpatient benefit limit, there should be no shortfall on in-patient surgcial fees. Patients are, of course, personally responsible for settlement of any non payment arising from exclusions to their policy, or charges not covered by their insurer, such as excesses. Payment is required immediately upon notification of liability.
All patients remain responsible for the settlement of their account until full payment is received from their medical insurer. We allow the insurer time to settle the claim but patients will be asked to pay anything not settled after 3 months of the treatment date.
Please note that surgical procedures, performed in The London Breast Clinic treatment rooms are subject to a hospital charge, in addition to the consultants fees. These charges have been agreed with all the major UK medical insurance companies and do not usually affect the out-patient allowance.
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