Using your private health insurance

Processing claims

Claims processes differ from insurer to insurer. Yours will guide you through their specific process. If your employer provides your insurance, you should follow the claims process specific to your scheme.

Sometimes your insurer needs a claim form for your GP to fill out. If your insurer needs a claim form you should:

• Bring it with you when you attend your first outpatient appointment
• Let the Spire patient administrator know if you have a claim form and it is already with your consultant, GP or insurance company
• If you're being admitted for in-patient or day-case treatment, please hand your claim form to the patient administrator so that we can arrange for the medical section to be completed by your consultant
• Make sure you've completed and signed the "patient/member" section on the claim form

Before you come into hospital

Gather the insurance details you’ll need to bring to your outpatient appointment:

• Your policy documentation even if you have attended a Spire hospital before
• Your insurance company name and scheme details
• Your membership or policy number
• Any confirmation of eligibility such as a pre-authorisation or claim reference number

If you can't provide full insurance details or if your insurance doesn't cover the full cost of your outpatient treatment, we may ask you to pay up front for any hospital charges.

Payment process

For most patients, treatment costs are based on agreements with your insurer and payment will be made direct by your insurance company.

We charge for our hospital services such as nursing, use of our facilities, medical consumables etc. Our consultants - surgeons, anaesthetists and physicians - charge independently for their time and expertise.

To make things easier for you, we have direct settlement arrangements with the major UK insurance companies. Your insurer will normally settle your bills from your consultants and us directly. In order to do this we’ll need to know:

• Your insurer
• Your registration number
• Your scale/level of cover
• Your scheme details if you are insured under a company scheme
• Your pre-authorisation number for your treatment

You'll be asked to provide your credit or debit card details; this is only to verify your card and no funds will be taken at this stage. This is to cover any insurance excess or shortfall your insurer is not liable to pay such as for sundry items. Your details will be kept securely for up to six months and we will notify you in advance if it’s necessary to use them.

In addition to any insurance excess or co-pay, sundry items may include:

• Specialist equipment to aid recovery eg a wrist brace, crutches
• Drugs to take home if they are not already included in your overall treatment arrangements
• Personal expenses such as telephone calls, meals for visitors, newspapers.

Excesses and balances not covered by private health insurance

If you do not have sufficient cover or if there is an excess on your policy, your insurer will advise you of the outstanding payment due to the hospital. They will also notify us of your excess/out of cover charges and we will send an invoice to you advising of the balance to be processed against your debit or credit card.

Consultants may invoice to your home address and it may be necessary for you to forward bills to your insurer.

Billing queries

Our Customer Service team can help with any queries you have about your bill once you've had treatment. Find out more about understanding your bill.