Most consultants, and certainly when they first start a private practice consider how best they can set their fees. In reality, however, it is not the consultant who sets his or her own fees. It is the patient’s insurance company in all but one area.
Consideration of fee setting should be viewed from two distinct areas:
1: Consultation fees 2: Surgical Fees
Consultation fees first.
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. Clearly, if you have 20 years post qualification experience and are one of the few consultants within your geographic area in a particular specialism, then you can command a higher fee.
In reality, most likely you not be in such a position. You will be offered consultation fees at a level set by the insurance company you are dealing with. In return, the insurance company will refer patients to you.
In the case of self-funders, however, there is nothing to stop you charging any consultation fee you like. Save of course if there are other consultants in your area then the fee levels they charge will influence that which you yourself charge.
Surgical fees, if anything, are the easier one to deal with.
The insurance company with whom your patient is insured will always set surgical fees. You may feel the fee is too low and therefore charge more. Almost certainly your invoice WILL be rejected or at the very least shortfalled to the patient. Keep sending invoices in for fees greater than that allowed by a particular insurance company and you run the risk of being de-recognised.
Whether it is right or wrong for insurance companies to hold such power over the setting of surgical fees is for another article and I have very firm views on it but at this point, the stark reality is that the insurance companies do hold such power.
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