7 steps to arranging insured treatment
The prospect of arranging surgery may seem a little daunting, especially if you are feeling anxious or worried. We have put together a guide to explain what you can expect when choosing to have your surgery with us.
1. Contact your insurance provider
Cosmetic surgery is not generally covered by medical insurance, however if your procedure is classed as “medically necessary” e.g. skin cancer / cyst removal, hooded eyelids affecting vision etc., then we ask that you first of all contact your insurer for authorisation.
Your insurer will ask that you see your GP in the first instance so they can confirm whether the treatment will be classed as “medically necessary”. Your GP will arrange a referral for you to see us.
Before arranging your initial appointment, please check;
*that you have a GP referral
*if there is an excess / cap on your policy?
*whether there are any restrictions on your policy e.g. only cover at certain hospitals, will not cover in-patient stays etc.
*you have an authorisation code - we will need this along with your membership no. in order to book your initial consultation
2. Contact us to arrange your consultation
A booking for a consultation can be made by contacting my secretary directly (0113 2185971) or contacting the relevant hospital bookings team (see below for contact details). We can normally arrange an appointment for you within a couple of days; however, this may be longer depending on which hospital you choose to proceed at.
The fee for an initial consultation is £150. Please check with your insurers whether the full amount will be covered by your policy. If this fee is not covered by your policy you can pay this fee over the phone by card by calling my secretary 0113 2185971.
Out-patient clinics available at:
Spire Leeds Hospital – 0113 218 5967
Alternate Mondays 5.30-8pm, Thursday 9am-12noon, Saturday 9-10am
Nuffield Leeds Hospital – 0113 388 2111
Alternate Mondays 6-8pm, alternate Saturdays 11am-1pm
Nuffield York Hospital – 01904 891 762
Wednesday 2-5pm, alternate Friday 1-3pm
Or e-mail us at info@cosmeticsurgeryleeds.com / claire.bartle-coates@spirehealthcare.com
3. Initial consultation
What happens at an initial consultation?
Appointments last approx. half an hour, or as long as you need. Here you will be examined and advised on any recommended treatment or surgery. The nature of the treatment/surgery will be explained to you, along with any associated risks and complications and also what results you can expect.
We may ask one of our nurse specialists to be present for your examination.
4. Tests or scans which may be required
At the time of your consultation, we may advise that you have diagnostic tests or scans (e.g. mammogram, ultrasound etc.) carried out. These may help determine what treatment, if any, is required. You should contact your insurers to confirm you are authorised to proceed with the recommended tests.
5. Booking your treatment / Surgery
Now you’re ready to book your recommended treatment / surgery. Please contact my secretary by email or phone to discuss potential dates for surgery, allowing for time to recover and allow time off work. We would recommend no long distance travel/flying for 4-6weeks before or after any general anaesthetic surgery.
You do not need to make a payment for your procedure in order to secure a treatment date. If you are booking in for surgery, the hospital will invoice you separately with your “package price” – payment of this is required approx. seven days prior to your surgery date.
If you are booking in to clinic for a treatment i.e. dermal fillers or Botox, this will be billed to you by the hospital following your appointment.
Once booked in, the hospital will send you an information pack about the admission, process and payment. Please contact my secretary if any advice is required or queries arise.
6. Pre-assessment
If you require surgery under a general anaesthetic, you will be asked to attend a pre-operative assessment beforehand. This will be carried out by one of our pre-assessment nurses approx. 3-14 days prior to your surgery and involves a number of tests which assess your health before you have an anaesthetic.
Procedures which are carried out under a local anaesthetic do not generally require a pre-assessment. This is something which can be confirmed to you at the time of your initial consultation.
Again, you should contact your insurers to confirm you are authorised to proceed with a pre-assessment.
7. Treatment / Surgery
Once you are ready to proceed with any recommended treatment / surgery, we will provide you with a procedure code to give to your insurers. It can sometimes take a couple of days for your insurance company to assess the claim and they may ask for a medical report outlining what treatment is required and why, along with associated reports of any diagnostic tests carried out. This is something we can provide. Once you have received authorisation from your insurers, your treatment or surgery can then be arranged.
Billing and Fees (please read carefully)
We will directly invoice your insurance company following any consultation. If there is an excess or shortfall on the policy, your insurers will issue both parties with a statement advising of the amount outstanding to Mr Fenn. We will also issue you with a request for payment, which is required within 30 days of the appointment.
**Please note that Mr Fenn is not “fee assured”. Following your consultation we will provide you with a procedure code, along with the “surgeon fee” amount for carrying the procedure out. When obtaining authorisation from your insurance company, please ensure to ask what contribution will be made by them. Quite often the fee that an insurer will pay out for a procedure code does not meet the standard fee charged by the surgeon. This is when a shortfall is then charged to the patient. Prior to the surgery taking place, you will be asked for payment of the outstanding balance (shortfall amount).
Following the surgery or treatment, fees will be billed directly to your insurers by the hospital, surgeon and anaesthetist (where applicable).