Important notes for patients with private medical insurance
Mr Solan provides expert orthopaedic advice and specialist surgical services for patients with fractures, pain, deformity and for those who have sustained accidents or sports injuries, as well as conditions affecting the foot and ankle.
Since 2003 he has helped patients, working from Private Hospitals and clinics in London and Surrey.
All patients have been charged the same fees, irrespective of whether they pay themselves or have insurance to help meet the costs. There are many different insurance companies, each with a variety of levels of cover and reimbursement. Sometimes, the policy does not meet the full costs of treatment and then it is the responsibility of the patient to make up the difference. This point is made clear in the information that patients are sent prior to their treatment.
Although the fees that Mr Solan charges for operations have not risen for 10 years, some insurers have begun reimbursing much less to their customers. This means that there is a greater chance that you (the patient) will have to meet a proportion of the cost of treatment yourself. In some ways, this is like finding there is a bigger “excess” on your policy or that your insurer has reduced your level of cover. We would like to point out that this is not due to surgical fee increases. As such, it is very important that you contact your insurer before treatment to clarify how much they will help you with the costs.
Insurance company’s call centre staff try to divert them away from reputable surgeons, towards other providers. “Mr X does not stick to our fees”, is often the reason for offering an appointment with an alternative doctor. What the policy holder is not told, is the reason why there is a discrepancy between standard fees and what they will reimburse; namely, that they (some insurers) have radically reduced the reimbursement fees, in some cases by up to 50%, even though our prices have remained unchanged for the last 10 years. Furthermore, the alternative practitioner suggested by the insurance administrator often does not even have the right expertise.
Mr Solan is not signed up to any insurance company “loyalty scheme”, and believes that the cost of your treatment should be the same, irrespective of which insurance company you have a policy with or indeed, whether you are insured or not. Charges are not therefore set according to the amount that your insurer will cover, as this is unfair.
Medical insurance companies are in no way regulatory bodies but simply insurance companies. Being “fee-assured” by an insurance company or being a “partner” simply means a doctor has agreed to their financial terms. It is in no way a measure of qualification or capability. Some insurers are likely to say we are “unrecognised” and may warn of shortfalls in benefit if you continue under our care. As stated above, our fees remain unchanged.
If you are unhappy with the way your insurer is handling your claim, our suggestion would be that you complain directly to them or, if still unsatisfied, to the financial services ombudsman (who can be contacted on www.financial-ombudsman.org.uk/consumer/complaints.htm).
We enclose/attach a patient information letter which has been produced by the Federation of Independent Practitioner Organisations which gives further detail about insurance providers’ current activities. On request, we can provide you with a template letter which you may find useful if you wish to make a complaint to the Financial Services Authority (FSA). Finally, if you do make an official complaint, we (SFAC) would be grateful if you could copy us in to any such correspondence.
If you have further questions regarding your costs, please contact the Accounts Line at the Surrey Foot and Ankle Clinic.