For all your private medical practice needs

pete@medicalhealthcaremanagement.co.uk

01902 280 442

Hilton Hall, Hilton Lane, Wolverhampton, WV11 2BQ

Most consultants when they first start a private practice, consider how best they can set their fees.

Self- Funding Patients

In the case of self-funders, there is nothing to stop you charging any consultation fee you like.

Save of course if there are other consultants in your area then their fees will influence that which you charge.

Effectively it is up to the patient whether they chose to accept that fee or not.

Insured Patients

 

In reality, in the case of an insured patient, it is not the consultant who sets fees.

It is the patient’s insurance company.

Consideration of fees for an insured patient should be viewed from two distinct areas:

1: Consultation fees

2: Surgical Fees

Consultation Fees

Consultation fees (for both initial and follow up) will be agreed at the point of recognition by the respective insurance companies of the medical professional e.g. consultant surgeon, anesthetist, etc.

Surgical fees.

The insurance company with whom your patient is insured will always set surgical fees.

You may feel the fee is too low and therefore try to charge more.

Almost certainly your invoice WILL be rejected.

Keep sending invoices in for fees greater than that allowed by a particular insurance company and you run the risk of being de-recognised.

It’s not a good idea to be in such a position.

Whether it is right or wrong for insurance companies to hold such power over the setting of surgical fees is for another article.

I have very firm views on it but at this point, the stark reality is that the insurance companies do hold most of the cards.

pete@medicalhealthcaremanagement.co.uk