Private Medical Insurance
CQC Report 2012
The CQC report on 'The Whiteley Clinic' was released February 2012.
The Whiteley Clinic has made its reputation introducing cutting edge technologies and treatments to the UK, researching and auditing them to ensure our patients get the best and most effective treatments.
It is with great pride that we offer our patients the very best that is available in the UK.
Our results speak for themselves - our success in doing so can be seen by our:
- research papers
- press coverage of our veins treatments
- press coverage of our LSA results
- patient satisfaction
The proof of our success is in our results - not one patient in 10 years has had to come back to have another operation on the veins that we have operated on previously.
Private medical insurance should cover most of these techniques and those medical insurers that come and talk to us and who understand our research and audit, and who want their clients to get the excellent care that we provide, cover our clinic. This cover should pay for consultations, tests and treatment of your veins (as well as the associated problems such as leg ulcers, phlebitis, venous eczema etc).
Of course private medical insurance does not cover cosmetic procedures and so thread vein treatments are not cover by medical insurance.
What to do if your insurance says "No"
There are several reasons that your private medical insurer might say no to your claim for veins.
If it is because your insurance doesn't cover you for veins, or there are other exclusions that are contractual, then you will need to check your insurance contract and see what you agreed to in your initial agreement when you took out the insurance.
On the other hand, if your claim is acceptable, but you directed elsewhere or are told that you can have treatment but not at The Whiteley Clinic, then you should not accept this without question.
In the UK, it is the Patient's Choice that is paramount. Your right as the patient to choose who treats you is more important than any commercial agreement or choice of doctor of facility that your insurance company might have made for you. Thus if you want to see an expert at The Whiteley Clinic and your insurance company tries to direct you elsewhere, you should check with the Insurance Ombudsman if they are allowed to do this when you have made your choice.
One of the major problems with insurance companies telling you where to have your treatment is the liability if something goes wrong. The Whiteley Clinic provides very specialised investigations and treatments based on our own experience, protocols, audit and research. If it is your choice to have us treat you, then your wishes should be agreed to.
However if your insurer (or anyone else for that matter) directs you elsewhere, then they are taking some responsibility towards your medical care by influencing your decisions. Provided you are happy with any subsequent treatment, then there would be no problem. However, if anything goes wrong with your subsequent treatment, then some of the responsibility and liability for any resulting problems will need to be shared by whoever influenced your decision.
Useful link: www.financial-ombudsman.org.uk
We have recently been contacted by patients insured with one or other of the insurance companies listed above to say that having been refused funding for treatment at The Whiteley Clinic, they contacted the Insurance Ombudsman.
In the cases we have been informed about, the Insurance Ombudsman contacted the inurance companies that had refused funding and a subsequent offer for some funding for treatment at The Whiteley Clinic was then made to the patients.
We have not been involved with these discussions directly as it is a matter soley between the patient, their insurance company and the Insurance Ombudsman.
However it does appear that patient choice is being given a higher priority than the choice of insurance companies as to where they wish to send people insured with them.
Recently there has been some debate between the insurers and Consultants where insurers are looking increasingly to recognise a reduced range of consultants. In principle we do not have an issue with this as long as the criteria for inclusion on the reduced list are made on the basis of quality as well as cost.
The Federation of Independent Practitioner Organisations (FIPO) is a medical organisation representing the majority of the medical professional's organisations in Britain that have private practice committees.
FIPO seeks to work constructively with all independent hospital providers and the private medical insurance industry and has this to say on the subject:
"You should note that just occasionally some insurance companies might make comments about the consultant to whom you have been referred, sometimes implying that they are expensive or that they are not on one or other of their "Partnership" lists.
You should not be deterred from your choice by any such comments and you should expect an explanation of whether or not your treatment will be paid."
For the full transcript, please read here.
With continuous dialogue, we are hopeful that in the future, we will be able to work with all medical insurers to enable all of our patients to have the chance of treatment at the Whiteley Clinic.
We keep our charges very competitive compared with anyone offering the same standard of treatment.
At The Whiteley Clinic, our prices include:
- Surgeons fees
- Anaesthetic fees
- Hospital fees
If you are not aware of this, then comparing our all inclusive fee with fees quoted by surgeon (who quote surgical fees only) or hospital (who often quote hospital fees and not professional fees for the surgeon and the anaesthetic) then we can appear expensive.
In addition, we do not charge any extra for recurrent varicose veins over primary varicose veins - we just charge for the procedures that are done.
We are always happy to explain our treatments and treatments plans, to go through our charges and results, to anyone who is interested.
Until such time we will continue providing the same excellence we have always done, will continue our research and development making sure our patients have the very best diagnosis and treatment that is available, for the best price that we are able to provide.