Recently a family member decided an appointment with a private consultant was necessary.
As the family member had private medical insurance, a phone call was made to the consultant suggested by the GP. It turned out although not an MHM client, the consultant practice manager and I are old friends. So I made the call myself and booked the appointment.
Open Referral
Came as a surprise the next day, for my family member to announce the insurance company had called. They wanted her to see a different consultant. My family members quizzed them why. Eventually, she was told the second consultant didn’t charge as much as the one she wanted to see. Not a good thing to say. My family member insisted on seeing the consultation of her choice. I quickly found out how much the second consultant charged. It was indeed less.
The Consultant’s fee
Nonetheless, the appointment with the first choice consultant happened.
Two weeks later a letter arrived from my family member’s insurance company stating the consultant had been paid. However, there was a shortfall as the 1st consultant’s fee was higher than that of the second consultant. My family member was required to pay the difference.
The fact that my practice manager friend is pulling her hair out with the increases in shortfalls she’s seen this year whilst relevant, is not the point.
Fee levels
The stark reality is that the insurance company was using finance as criteria upon which to base the decision which consultant one of their policyholders went to see.
And that, I’m sorry, is NOT right.
pete@medicalhealthcaremanagement.co.uk