I’m often asked who is actually responsible for paying an excess or a shortfall.
The patient is responsible.
Interestingly the question was asked recently by a consultant surgeon who had started his/her private practice two years earlier. He was of the opinion that such excess was the responsibility of the patient’s insurance company. They would be collecting excess or shortfall amounts from the patient on his behalf.
Sadly this is absolutely NOT the case at all.
The responsibility for collection of such items rests very squarely on the consultant himself. Consider excess and the cause of excess?
When the patient obtains private medical insurance there will be an amount – or excess – agreed on the policy. The exact amount of the excess will depend on how much the patient pays for his/her policy.
Generally speaking the higher the premium, the lower the excess.
It’s just like car insurance. If you agree a £500 excess, the premium will be lower than if you only agree £100.
That’s fine – until you come to make a claim on your insurance.
Private medical insurance carries the same principles.
So, when the patient claims the cost of your services from their insurance company there could well be excess for which the patient is liable. You, however, are responsible for collection.
The patient’s insurance company is not responsible.
The consultant who asked the question called a few days later.
To his horror, he had over £5,000 worth of uncollected excess in the previous two years unpaid which nobody was collecting.
The real question however is:
Why were the excess & shortfall amounts allowed to build up over two years without anybody noticing?
pete@medicalhealthcaremanagement.co.uk