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    • 30
      Sep
    • (0)
    • By PeteCrutchley


    • Medical Billing News

    Don’t assume a patient’s insurance policy covers EVERYTHING!

    It is dangerous for an insured patient to assume his insurance covers everything.

    Often it does not. This will impact on how much you get paid.

    Short term issues

    Private medical insurance is designed for short-term issues. For example, an injury that suddenly happens and treated/cured relatively quickly.

    A broken hand can be treated quickly. A diabetic problem may not.

    Consider it this way.

    Private medical insurance is in place to cover elective non-urgent issues.

    If the condition was known before the policy was taken out, it may not, however, be covered.

    But it does NOT follow that if the injury is short-term and treatable under private medical insurance cover, all parts will be covered.

    It will depend on the type of policy held.

    Basically, the higher the costs of the cover, the more covered. The lower cover may set a financial limit on how much can be paid out.

    They may, for example, exclude consultations.

    How does this affect the consultant?

    Whilst it may impact on the consultant surgeon it will be a sad day if a consultant even stops to consider if he/ she will treat a patient based on an insurance policy. They would not remain an MHM client if they did.

    But what is the impact on the consultant?

    For one thing, a budget type policy could easily lead to shortfalls. It may also lead to excess. It may result in the refusal of consultation fees.

    This will lead to a requirement for the consultant to have such amounts collected from the patient.

    Therefore what is covered is indeed relevant to the private consultant.

    pete@medicalhealthcaremanagement.co.uk

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