AIBU in disputing this charge following a consult at a private hospital?

[worriedmum100]

I genuinely don't know if IABU as I am new to private healthcare. Would really welcome some views.

Quick back story: we have been trying to conceive dc2 for 2 years. Had all the tests the NHS offers but they can't do anything else for us.

I recently went for a private consult with a gynaecologist at a private hospital. As part of the consult he examined me very briefly. He used some equipment. A nurse came in to chaperone (I did not request this).

Following consult I got the £200 bill I was expecting from the consultant and paid it straight away. Some time later I got another bill from the hospital charging me a smallish amount for the examination. I was genuinely confused as assumed this was all covered by consult fee.

No-one at the hospital mentioned additional fees. I wasn't given a price list. I spent a fair while with an admin person going through all my details etc and it wasn't mentioned I might be charged extra for any examination. It wasn't mentioned when the consultant said he wanted to examine me.

I queried it and have been told that there are notices around the hospital warning of extra charges but I don't recall seeing any and I'm usually pretty observant.

So AIBU to dispute this charge? I feel really cross about it but am also aware that this may be projected anger at what feels like 18 months of disappointment, sadness and feeling like no-one in the medical profession is listening to me. :(

Thanks

Well, from my experience of private treatment (those were the days - can't afford the health insurance any more), you get charged not just for the consultant, but also use of the private hospital, lab fees (for blood tests etc), and any thing else. If you see the consultant in his private practice (say, Harley St. place), then you pay for consultation only.

Was it a straightforward speculum examination or did he do anything else? It sounds outrageous to me but I don't know how private healthcare works.

That sounds right to me OP. You pay for every single thing and invoices quite often come separately.

Sounds a bit odd and usually this sort of exam should be part if the initial consultation fee. I always get treatment costs up front (where possible) and in writing so everyone knows where they're at.

LC is also right

Thank you for the replies.

It wasn't a speculum but some kind of small plastic thing which he inserted then seemed to look through with a bright light. He said he was checking my cervix. Not sure why as my issue is with c-section scarring in my uterus.

Even if its normal to charge separately would it not be normal to set this out up front? Or was it my responsibility to check?

Sorry bellavita! There may be a total cost of treatment broken into separate invoices.

I've always had to ask

What is a consult?

This is pretty standard practice in the UK - the doctor will bill you for his services and the hospital will bill you for theirs. Unless you are on an all-in-one package but they tend to be for things like hernia repairs, joint replacements that sort of thing. It is also standard to have a nurse chaperone - in fact it would be wrong if they didn't provide one. Every single thing will be billed to you - however it is never wrong to challenge the bill, they must be able to justify the fee. The doctor is just renting the room in which to see you, he is not responsible for anything else, tissues, speculum, bloods - that's down to you. Tests can be very expensive so I would check before you incur any more costs - the doctor's private secretary should be able to help.
Hope you get the support and answers you need.

I see a gynae surgeon privately and if it is just a standard internal examination, all I get charged for is his consultation fee. There is no additional fee payable to the hospital for any of my outpatient appointments. I get charged an extra fee by my consultant if he does a more specialist examination that involves a specialise piece of kit - e.g. ultrasound. I don't get charged a separate hospital fee for this.

I DO get charged a separate hospital fee for daycase procedures or inpatient procedures.

In your situation, if it was a bog standard examination (and it sounds like it was, otherwise the consultant would have charged you an additional sum for doing it), I would expect to only pay his fee and not to owe anything to the hospital. Unfortunately, I have had to have a lot of medical treatment in recent years - what I am explaining is the norm, as far as my experience goes, and what you are outlining is not.

However, they are within their rights to charge as they see fit. I would ask his secretary to explain his fee structure in detail, including how charges are likely to be made by the hospital that he consults at. I'd also talk to their accounts department, so you are clear about their billing practices - different private hospitals may have different policies.

I'm sorry this happened - I can see that it could have been quite unsettling, especially given the nature of what it is that you went to him about.

Thank you all.

Seems as if this is standard. I think I just expected any examination to be included in the consultation fee and no-one suggested otherwise.

My only other experience of private care is at our fertility clinic where all the prices are set out in advance so no bill comes as a shock.

Thanks dpotter. I hope so too but it feels like an uphill struggle to get anyone to listen to me. The clinic are nice but not really concerned with why I can't conceive just how to "get round" it with IUI or IVF. That's fine but when the money runs out and those treaments haven't worked (and I appreciate how lucky we are to have some money to do any of this) I'll be left back at square one. Was hoping the independent gynaecologist would look more at treating the cause.

I was surprised with the different fees charged by our local hospital but they are covered by the insurance so I have never queried them.

An example would be ENT consultation for 2-3 mins with consultant, then separate charge for audiologist for hearing test, then separate fee for use of hospital equipment (I.e. Hearing test room). It took the total for a 20min visit to just under £500!! When the insurance stopped paying I insisted DS went back to the NHS as frankly £500 for hearing to be checked when we thought it was ok to be checked seemed ridiculous.

When I had a mole removed privately I was also charged separately for the consultation and use of hospital even though it was just the consultant in a usual room but he did use scalpel and needle for stitches etc. Perhaps they were worth £150 extra?!?! The consultant fee was fine.

The way I've been invoiced is one invoice per visit. The invoice will then list whatever has happened during said visit to include any procedures undergone during that consultation.

I do try and get a general idea if how much treatment will be though as I said.

I remember looking at an invoice once and being charged for x amount of swabs (amongst other miscellaneous bits and pieces) which I found a little amusing for some reason.

They will charge for whatever they can in my experience. I work in the NHS and our consultants do private work. One patient told me that she saw a consultant privately and went over her appointment time by 5 minutes and he charged her £20. Disgraceful in my opinion. BTW, I definitely don't think you are being unreasonable OP.

They will charge for whatever they can in my experience. I work in the NHS and our consultants do private work. One patient told me that she saw a consultant privately and went over her appointment time by 5 minutes and he charged her £20. Disgraceful in my opinion.

Blimey I just wouldn't be paying that extra bill. It would cost him so much to try to recover the money it wouldn't be worth it.

OP, I don't know about private healthcare in the UK but here in the US it's pretty standard to be billed separately for the facilities, the doctor, the various tests, etc.

I had to pay separately for the consultant, anaesthetist and the hospital. It soon mounts up.

I hope you get the answers you are looking for.

I had a private gynae appt for infertility £150 for 30 mins, examination like you said with chaperone but no extra charge x

I used to work for a private hospital.

You get screwed if you are not insured. The hospitals charge for everything, each cotton swab or tissue.

The insurance companies have rates they pay and the hospital swallow the difference.

I would call their bluff, say that you will be going elsewhere for any fertility treatment you decide to have if they don't remove the charge and tell them you will also be writing to the consultant to tell him/her of the additional charge.

And also ask their accounts department what they would charge BUPA.

Thank you everyone.

I've decided to write to the CEO of the hospital setting out my views! If you're a self-payer I really do think they need to be much clearer about the fees. I will probably end up paying as in the great scheme of things it's a small amount - its more the principle. As if because you're self-paying you have money to burn. We've made sacrifices and scraped together every penny because we so want our second child. It just feels like they don't bother to explain fees because usually the insurance pays and if you're not insured you're a target.

Thanks again everyone

The consultant will charge for his professional services, so for the consultation and also possibly a fee for undertaking a procedure no matter how small. Some consultants charge for doing a vaginal examination in addition to the consultation fee. On top of this the hospital will make a charge for any procedures undertaken as it is them who are providing any equipment, testing facilities, consumables used. This is standard practice and will apply to insured and self funding patients - however hospital fees will differ depending on the insurer.
But you definitely should have been told that the hospital makes an additional fee. The hospital I work in sends out a financial information leaflet with the appointment card which explains that an additional fees are payable.

In the US if you are paying cash then it's always worth calling the hospital and asking for a discount. They'll often drop the fee to whatever a typical insurance company would pay. Maybe worth a try for you, although not sure if UK private hospitals will negotiate in the same way.

I don't think it's really that you are a target as such, but that the existence of the NHS completely masks the cost of healthcare. That cost then comes as a big shock when you actually see it.

I'm a HCP although not a gynaecologist so no expert, but I don't think there is much infertility that is truly reversible. A lot of it does come down to circumventing it.

Thanks all.

Had a scan yesterday which confirmed moderate to severe endometriosis. Bit of a shock as I have no symptoms other than infertility. Quite upset. Not sure where to go from here.

Have written to the hospital but will probably pay the bill. There are only so many fronts I can fight on!

Thank you all again.