Patients ripped-off for private consultations.

[jimh111]

This news has reminded me of one of my experiences expressandstar.com/news/uk-... . This is also reported in the BMJ but I don't have access to the full article.

This case was illegal because Spire Healthcare and the consultants colluded to increase prices for self-pay patients.

In my case I had seen a private consultant about sudden severe back pain using my health insurance. The authorisation was taking some time to go through but my appointment had been accepted. So to save time I booked my consultation and said I would pay the bill if authorisation hadn't come through and I would reclaim from the insurance company. I can't remember the figures so will make up an example. I received the bill for £200 and by chance recieved the authorisation on the same day which stated they pay the consultant up to £150. I sent this to the consultant and they were happy with the £150 (who wouldn't be!).

I don't think this is an isolated case. Many consultants charge a high fee but accept a lower fee from insurance companies so they get regular business. I don't think this is illegal.

I think it is worth being aware that consultants often rip-off self-pay patients. There's not a lot we can do about it but it helps to know what is going on. In a way insurance companies are doing a good job in keeping consultant fees reasonable, imagine paying USA fees. Consultants have got around this by dual pricing.

As an afterthought is might be an idea to ask a consultant 'my insurance company only pays up to £x for a consultation, is this OK?' before booking a self-pay consultation.

[Gingernut44]

I wish I had known that little ploy - I was well and truly ripped off at a Spire Hospital, a supposed 40 minute initial appt lasted a little over 10 minutes. On that reckoning, it cost me £22 per minute. That chap will soon be able to retire- the sooner the better if you ask me!

[helvella Administrator Thyroid UK]

In a way insurance companies are doing a good job in keeping consultant fees reasonable, imagine paying USA fees.

But in the USA one of the reasons for high fees is that the insurance companies make everything such a burden to the medics. The medics have to register with, potentially, numerous schemes, and do lots of paperwork, and the delays in payment, etc.

There are quite a number of medics who refuse insurance - which ends up letting the insurance companies off the hook in some circumstances.

[jgelliss in reply to helvella]

Helvella Thank You for your thoughtful post. Yes this is exactly how our system is working now. If you need to see a well respected Dr we need to pay out of pocket for their very high fees. Dr' don't want to bother with Insurance companies . Nor do they need to hire someone who takes care of insurance collections . Patients are losing out big times.

[jimh111 in reply to helvella]

I think our insurance companies exert a downward pressure on consultant fees, they often operate a cartel with 'recommended' fees. It's worse in the USA although I don't know why. The important point is to watch out for consultants who automatically charge self-pay patients over the odds.

I've dug out my receipts. I received a bill from the consultant on a self-pay basis for £250, the agreed fee with the insurance company was £130. Quite a difference. Quite simply he is exploiting patients.

My consultation took less than ten minutes. I presented a neat summary which he was able to scan and so saved him a lot of time. He was quite abrupt, only interested in efficient patient processing. Very skilled and made a correct diagnosis but I would expect the focus to be on optimal patient care rather than rapid processing of patients. As you would probably guess I was more assertive and persistent than the average patient. If I get a back problem again I will choose someone else.