Advice sought re medical invoice/charge

[SoftDay]

Hello, kind MN legal experts. I am looking for some advice, if anyone has a minute to respond. It is a little convoluted, but I will try to be as clear as possible.

I am hoping to have surgery in the new year as a private patient (health insurance). There is a pre-surgical process to go through, which involves several appointments with members of a multidiscplinary team. In documentation provided, I was given a fixed price for what these appointments would cost, separate to the surgery itself (which is covered by insurance). The documentation further stated that a separate appointment with a respiratory specialist might be required.

I began the process in July and had an initial consultation, payment for which was clearly set out as part-payment of the agreed fixed-sum price. Some weeks later, I received a text message from a health practitioner (psychiatrist) indicating that she wished to arrange a telephone conversation with me as part of the assessment process. We arranged a time and the telephone consultation took place, lasting some 40 minutes.

There was no mention at any time of payment, certainly no specific sum mentioned. No invoice was issued; I was not asked for an address. Some weeks later, I received a voice message requesting payment of GB £250 for this consultation. It is even more in my currency as I am not in the UK. I found this distressing and wasn't sure what to do. A week later, I received another voice message requesting payment. I e-mailed the hospital, explaining the situation, and they called me back and apologised, characterising it as "poor communication" on their part.

I failed to clarify with them whether I was, in fact, liable for this charge. I should have done that. Instead, I blocked the number from which the telephone calls were coming demanding money, hoping it would all go away! Today I received a letter to my home address containing an invoice for the £250.

Could anyone tell me where I stand legally? I absolutely hate confrontation, would usually rather lose money than make a fuss, and find the whole thing quite distressing. However, I really think this was sharp practice or, alternatively, remarkable incompetence. As I said, there was no mention of a charge, so I (perhaps stupidly) assumed this consultation was part of the fixed-price pre-assessment process. I feel that I was somewhat taken advantage of, but perhaps I am wrong in this? I am also in very straitened circumstances financially, so this is a major cost for me.

Any advice would be greatly appreciated. My feeling right now is that I might send them a cheque for €120 as a gesture of goodwill on my part. Sadly, though, I think I'm going to have pay the full amount, aren't I?

1. Have you passed this on to your insurance company?
2. What was your understanding of who would pay for the "several appointments"?
3. What did their initial letter say about these additional charges?

Hi, Collaborate. Thanks for taking the time to reply and for your questions. Sorry if it is clear as mud!

1. My insurance company will cover the actual surgery upfront. Any related pre-surgery appointments I pay myself and can then make a claim for part-refund. Using the £250 as an example, I would have to pay it and thereafter submit a claim. I usually get 40% back.

2 and 3. I was told the pre-surgery process would cost a fixed amount, namely, €600. This, as set out in the documentation, would comprise an appointment with the multidisciplinary team and, second, an appointment with the surgeon. There was a note that a respiratory assessment appointment might, additionally, be required, at further cost.
I had my initial appointment with the multidisciplinary team, for which I paid €320, this being the first part of the stated €600. It was some weeks later that I received the text message from the psychiatrist seeking to arrange the telephone consultation. I guess I assumed this was part of the first consultation, a sort of follow-up. It was a fairly rudimentary conversation, which I would consider the very minimum psychiatric evaluation required for what is a life-changing surgery! As I said, no mention of payment during the text message exchange or the telephone call itself, certainly no specific sum.

I feel that the private hospital should bear at least some responsibility here. They gave my telephone number and medical details to the psychiatrist (who is affiliated with their multidisciplinary team) and asked her to initiate contact. I feel like one of the two actors - the hospital or the affiliated psychiatrist - should have told me that this 40-minute conversation was a separate, not previously mentioned component of the assessment process which would be separately chargeable in the amount of nearly €300.

Thanks in advance if you have time to respond!

Did they set out in their initial letter that you may need a psychiatric evaluation?

Sounds to me like they said that you would pay €600 for the consultations, and the psychiatrist was part of that process.

Thank you so much for your help, Collaborate. I really appreciate it.