Fees and Insurance

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THE HARLEY STREET ENT CLINIC

INFORMATION FOR INSURED PATIENTS

Costs of consultation

The cost of an initial or new condition consultation is £250. Follow-up consultations for the same treatment episode are £160. Any diagnostic tests or procedures undertaken during your consultation e.g. hearing tests, blood tests, ear microsuction, nose or throat endoscopy etc will incur additional charges. Please ask if you require further information about the fees prior to any tests being carried out.

Our policy for major UK insurance companies

The Harley Street ENT Clinic agrees to invoice all the major UK-based insurance companies directly and has agreed contract prices with BUPA, AXA PPP, Aviva, Cigna, Medisure, Standard Life and WPA. Please note that any medication dispensed from our on-site ENT pharmacy must be paid for prior to leaving the Clinic as we do not invoice insurance companies for this.

Our policy for overseas & specialist UK insurance companies

If you have a medical insurance based overseas we require you to settle your account in full on the day of consultation and then reclaim. This will also be the case for those UK-based insurance companies who do not deal directly with providers, such as Benenden Health. We accept cash or credit/debit cards only so please ensure you have appropriate and adequate funds available. Please note we do not accept Diners cards. We do accept American Express but a surcharge of 1.5% is added to cover the additional charges imposed by them.

Contact your insurance company for authorisation

First, you should ensure that you contact your GP as soon as possible (NHS or private) for a referral, if you have not already done so, as we have found that insurance companies are requesting copies of GP referral letters. You must then contact your insurance company as soon as possible to tell them about your forthcoming visit to The Harley Street ENT Clinic. Many companies will issue an authorisation number which you should bring with you, together with your personal membership number and any group scheme membership number, if applicable. It is highly likely that you will require some diagnostic tests and/or procedures when you attend, depending on your symptoms, e.g. hearing tests, blood tests, ear microsuction, endoscopic examination etc so please mention this when you phone. Please note that we cannot guarantee your claim will be met if you do not contact your insurance company before your visit.

Check your outpatient benefit status with your insurers

As we are considered an outpatient facility it is also extremely important that you check whether you have a cap on your outpatient benefit and, if so, how much benefit remains available to you in this current year. If you do have limited benefit you should also check whether procedures will be allocated to your outpatient budget or not. It is vital that you tell us immediately of any benefit limitation so that you are made aware of any potential treatment shortfalls prior to any tests or procedures being undertaken.

Are you liable for any of the fees e.g. for policy excesses?

The insurance companies will reimburse The Harley Street ENT Clinic directly, usually with no requirement for patients to pay anything. However, some policies carry policy excesses which can either be a fixed amount per year or else a sum per claim. Some policies have a cost share arrangement attached instead, whereby the patient must pay a percentage of all invoices issued (this is generally around 10-25%). Again, please check with your insurers and let us know, although we will not require any payment from you until the insurance company have paid us. We will inform you by letter of any shortfalls you have to pay and the reason for this.

Check whether a claim form is necessary

The reimbursement procedure is generally very smooth but we do urge you to comply with any conditions your insurance company imposes as soon as possible, e.g. forwarding completed claim forms, so that our invoices are paid promptly. Please be aware that any outstanding invoices will remain entirely your responsibility, whether or not you thought you were fully covered by a third party.

Inform your insurers of any upcoming operations

If you need to proceed to an operation you must inform your insurance company as soon as possible of the hospital you are being booked into and the procedure codes. You will be given these codes, along with the proposed consultant's fee by the consultant's secretary. It is extremely important that you check your coverage as any shortfall due for any reason will be your responsibility.

If in doubt about anything above please feel free to contact us.

A useful check list for you:

 Contact your GP for a referral letter

 Contact your insurance company for authorisation

 Check your outpatient benefit status

 Check if you are required to pay fees e.g for policy excess

 Check whether a claim form is necessary

 Inform your insurers of any upcoming operations