Patient Terms and Conditions – With effect from 21 February 2022

Part A – Insured Patients

This section will apply if you are covered by private medical insurance.

  1. You agree to pay for your Care.
  1. Whilst you will remain responsible for the payment of your Care, where you have private medical insurance:
  • You are to provide us with the authorisation code from your insurer at the time of booking your care. We will then where possible, process the insurance claim for your Care with your insurer, provided you have given us and your insurer all the information we and your insurer need to do so. If this information is incomplete or inaccurate, we may not be able to process your claim and you will need to pay for your Care, as set out in (c) below;
  • where we process your insurance claim and your insurer pays us direct, the rate agreed between HMT and your insurer (rather than the HMT Standard Rates) will apply to your Care;
  • if your insurer fails to settle our invoices (or any part of them within 30 days of the date of issue we will assume that the outstanding amount will not be paid by your insurer and we may invoice you direct or debit the relevant balance from your credit or debit cards in accordance with the process set out in paragraph 24 below (as relevant); and if we invoice you for your Care or an element of it you agree to pay us the amount invoiced within the time limits set out therein. If you do not think that we have invoiced you correctly, please let us know as soon as possible so we can deal with any mistake or misunderstanding.
  1. It is your responsibility to confirm with your insurer in advance that your Care is covered by your insurance policy and HMT will not obtain any such confirmation on your behalf. While you are in Hospital, if you want to check with your insurer whether any aspect of your Care is covered by your insurance policy, we will give you access to a telephone, so you can contact your insurer.
  1. Please note that some insurers use Care guidelines that may not match the professional medical opinion of the Consultants, nursing staff and other medical professionals providing your Care. In some cases, this can mean that your insurer may not pay for certain parts of the Care you receive, and you will be required to pay for that part of your Care.  In particular you should note that treatment for complications may in some cases not be covered by insurance and in such cases, you agree to cover the cost of your Care as set out in paragraph 2(c) above.
  1. Please note that your insurance policy may not cover the cost of Sundry Items or other items such as specialist equipment, like crutches, all types of braces, or it may only cover part of such costs. You will be required to pay for any such items not reimbursed by your insurers.
  1. If you pay for your treatment and subsequently seek reimbursement from your insurer, and if no other rate has been expressly agreed between you and HMT, the HMT Standard Rates will apply to your Care.
  1. If no rate has been agreed between HMT and your insurer in respect of your Care, the HMT Standard Rates will apply to your Care.

Part B – Self-Pay – Inclusive Care Package:

This section will apply if you are paying for your own Care, and your Treatment Letter states that we have offered you an inclusive care package. An inclusive care package can only be offered by the Hospital and there is no automatic entitlement that you will be offered such a price, it will be determined by clinical assessment.

You will be required to pay in full for your treatment before admission to the hospital and before receiving any procedure.

  1. You have been sent a Treatment Letter that will confirm your Treatment Package and inclusive care package and how you pay. You will pay the Hospital for all your Treatment, including the Consultants fee, and then the Hospital will pay the Consultant.  Please ensure you read this letter carefully.  As set out in Part F (Other Terms and Conditions: All Patients), your Treatment Letter is part of your Contract with HMT.

What is included in the inclusive care package?

  1. Your Treatment Letter will confirm the inclusive care package for your Care that you are to receive under your Treatment Package. Unless your Treatment Letter says otherwise, your inclusive care package in relation to your Treatment Package includes:
  • all Consultants’ fees while you are in Hospital;
  • your accommodation in the Hospital including your meals until you are clinically ready to be discharged, which may be a shorter period of time than previously stated;
  • your nursing Care, including while you are in Hospital and post- discharge (for example, for the removal of stitches, application/ removal of plaster case and/or changing of dressings);
  • operating theatre charges;
  • all tests to determine your fitness for surgery immediately to pre- admission;
  • all tests, treatments, drugs and dressings you may need during your stay in Hospital;
  • your essential medical or surgical equipment;
  • all prosthesis typically used for the procedure that you are having, selected from a standard range;
  • X-rays, scans and physiotherapy that you require during your stay in Hospital;
  • all take home drugs that you require on the advice of or as prescribed by your Consultant for up to 14 days following discharge (other than in relation to DVT prophylaxis where, if required, you will receive a full course of treatment);
  • all clinically necessary follow- up physiotherapy which your Consultant prescribes to support your rehabilitation (up to a maximum of 6);
  • any basic home aids, such as braces, crutches, sticks and reachers that you require;
  • one clinically necessary follow- up appointment with your Consultant;
  • all clinically necessary post- discharge radiology and pathology; and
  • treatment for any clinical complications, subject to paragraph 16 below.

What is not included in the inclusive care package?

  1. The following items are not included in your inclusive care package. If you have not paid for these already, you will be asked to pay for these separately at the HMT Standard Rates (unless otherwise stated in your Treatment Letter).  The items not included in your inclusive care package are:
  • your initial consultation and any tests carried out at the time of that consultation;
  • Care not listed in paragraph 9 above or Care listed in your Treatment Letter as being excluded from your Treatment Package;
  • chemotherapy drugs or IVF drugs not listed in your Treatment Letter as being included in the inclusive care package;
  • Sundry Items;
  • Care that you receive anywhere other than at the Hospital where you have booked your Treatment Package;
  • Care you receive that is not related to your Treatment Package, including treatment of complications and any condition associated with, or arising as a result of, pregnancies resulting from IVF treatment; and
  • Large home aids, such as commodes or stair lifts.

What happens if I decide not to go ahead?

  1. If you decide not to go ahead with your Treatment Package, you will need to pay for the Care that you have received up until the point of cancellation. This will be charged at HMT Standard Rates, but you will not have to pay more than the inclusive care package in relation to items which are included in the inclusive care package.

We reserve the right to charge a cancellation fee in accordance with paragraph 25 below if you cancel your treatment within 7 days of a scheduled appointment or admission date.

  1. If you have already paid for your Treatment Package, we will refund your payment, less any amount that you owe to the Hospital and/or the Consultant (as relevant, see Paragraph 22 below). Please note that we will pay any refund electronic transfer only to the cardholder or person who made the original payment.  We do not pay cash refunds.
  1. Note that if your Consultant cancels your Treatment Package because they consider it is not in your best interests for medical reasons, and you have already paid for your Treatment Package, we will refund your payment. Note that you will not be required to pay for any Care included in your Treatment Package that you have received up until the point of such cancellation.

What happens if my stay is shorter than expected?

  1. If your stay in Hospital is shorter than anticipated, because you have been deemed clinical fit for discharge, you will not be entitled to receive a refund of any portion of your inclusive care package.

What happens if I suffer complications? (Note time limits applying to cosmetic Treatment Packages)

  1. While the Hospital and your Consultants will do their best to ensure a satisfactory outcome, no clinical procedure is entirely risk-free, and the results of any particular treatment cannot be guaranteed with complete certainty. You can find treatment summaries containing information on a range of treatments, including common complications, on the HMT website at HMT-uk.org.
  1. Your inclusive care package includes the cost of treating, at a Hospital, any clinical complications identified by your Consultant as arising directly out of the treatment you received as part of your Treatment Package, provided that you have followed the advice of your Consultants and any other medical professionals involved in your Care (and that for all cosmetic  Treatment Packages, the date any clinical complication is identified by your Consultant must be within 12 months of your original treatment date).

What happens if I’m unhappy with the outcome of my cosmetic Treatment Package?

  1. If your Consultant agrees that the aesthetic outcome of your cosmetic treatment was not in line with the expected outcome that was discussed and documented with your Consultant, before your treatment, then your inclusive care package will include the cost of one episode of aesthetic revision treatment so long as you notify the Hospital, in writing, within 12 months of your original treatment date. If you are unhappy with the outcome of any episode of aesthetic revision treatment, then any further treatment will be not be included in your inclusive care package.
  1. Treatment for clinical complications and aesthetic revisions includes any consultations, out-patient, day care and in-patient treatment which your Consultant says you need and which the Hospital is able to provide.

If we are unable to re-admit you to the same Hospital we will make the most appropriate alternative arrangements at another HMT Hospital at no additional cost to you.  Where we are unable to treat your clinical complications, you agree that appropriate follow-up care may be provided by your GP or the NHS.  HMT shall not provide replacement prosthesis required for reasons of normal wear and tear or any non- medical, at home, domiciliary or other long-term care that may be required.

What happens if I decide to stay in Hospital longer?

  1. If, with the agreement of the Hospital, you decide to stay in Hospital beyond the date your Consultant considers it is appropriate for you to be discharged, or if you require further Care that is not covered by your Treatment Package, you will be charged at HMT Standard Rates.

Part C – Self-Pay – Other

This section will apply if you are paying for your own Care other than as part of a Treatment Package.

  1. If your Care is not paid for by an insurer or other funder (individual, employer or medico-legal company) directly, is not covered by an inclusive care package or is to be paid by you in accordance with these Terms, you will be charged at HMT Standard Rates and your Treatment Letter (if relevant and in so far as possible) will confirm this. As noted in paragraph 22 below, unless otherwise indicated, your Consultant will invoice you separately for the treatment he or she provides.  Note that this includes treatment for clinical or other complications, which, if needed, will also be charged to you at HMT Standard Rates.
  1. The Hospital will give you an estimate of costs for your Care. Please note that it is not always possible to give an exact estimate for the Care you receive at the Hospital and the total cost may depend on a number of factors, including any other conditions you may have.  The Hospital will always try to provide an accurate estimate and if the cost of your Care is likely to exceed this estimate the Hospital will try to notify you as soon as possible.  You are responsible for the payment of all Care you receive at the Hospital, including any Sundry Items.
  1. If you are an out-patient, you will need to pay for your Care prior to the day you attend the Hospital. If you are admitted to Hospital, you will need to pay the full value of your treatment package 21 days before you are admitted.  If, however, your treatments date is less than 21 days ahead you will need to pay the full value of your treatment package immediately in order to secure the appointment date.  Your Treatment Letter will set out what payment is required in relation to your Care.  If you have not paid for Sundry Items before you leave the Hospital, you agree that we can debit the outstanding balance from your credit/debit card upon at least 7 days of notice to you.

Payment should ideally by on a debit/credit card.  Cheques will be accepted if the treatment date is more than 7 working days in advance.  Cash will not be accepted.

Part D – NHS Patients

This section will apply to you if you are an NHS Patient and HMT is treating you on behalf of the NHS.

  1. If you are an NHS patient, the costs of your Care and all Consultant fees are paid by the NHS. However, the NHS does not pay for Sundry Items.  We will ask you for your credit or debit card details when you come into the Hospital and you understand that we will keep these details until all Sundry Items have been paid in full.  If you have not paid before you leave the Hospital, you agree that we can debit the outstanding balance from your card upon 7 days of notice to you.

Part E – Other Terms and Conditions – Private Patients

This section applies to all Private Patients.

  1. Consultants (your attention is particularly drawn to this paragraph):
  • While at the Hospital, you will be under the Care of the Consultant you have been referred to, who may also involve other Consultants in your Care, if appropriate. HMT staff, including nurses, will provide your Care under your Consultant’s instructions.
  • Consultants involved in your Care are independent practitioners and are not employees of HMT. The Consultant will be responsible for the Care he/she gives you.
  • If you have private health insurance, any Consultant’s fees relating to your Care will be charged to you by your Consultant, for Treatment Packages or for any care that you pay for yourself, HMT will act as collection agent on behalf of the Consultant. This means that if we issue invoices on the Consultant’s behalf and/or collect then pass on the fees due to the Consultant, this is merely for the administrative convenience of all parties.  Your Treatment Letter will make this clear but if you are unsure please ask your Hospital.
  1. Cancellations: We reserve the right to charge a cancellation fee if you cancel any appointment with HMT within 7 days of your scheduled appointment or admission date. A cancellation fee may be based on any Care that you have received up to the point of cancellation and/or any other reasonable costs that the Hospital has incurred.  Your Treatment Letter may also set out any specific cancellation fee that applies to your Treatment Package or Care.
  1. Credit/Debit Card: You are responsible for settling the cost of your Care before you are admitted or shortly after leaving the Hospital. We will ask you for your credit or debit card details when you come into the Hospital or when you make your appointment.  You understand that we will keep these details for up to six months after the last date of your Care or other appointment with your Consultant.  If you have not paid before you leave the Hospital, you agree that we can debit the outstanding balance and any cancellation fees from your card upon at least 7 days of notice to you.

Part F – Overseas Patients

This section applies to all Patients who are not ordinarily resident in the UK

  1. If you are not ordinarily resident in the UK you will be liable to pay charges if you require NHS treatment whilst in the UK, whether related to your Care at HMT (for example if you require treatment that HMT does not agree to provide) or not.
  1. By signing a Registration Form and agreeing to these Terms you confirm that you have leave to enter the UK and that you meet all relevant immigration criteria. You also confirm that you have made adequate arrangements to pay for your Care.  HMT may contact the Home Office or UK Border Agency (as relevant) to the extent necessary to clarify any information regarding your leave to enter or remain in the UK in connection with your Care.

Part G – Other Terms and Conditions – All Patients

This section applies to all Patients

  1. Your Contract with HMT: By signing the Registration Form you agree to be bound by these Terms. If there is any conflict between these Terms and the Treatment Letter or Registration Form, these Terms will take precedence.  If there is any inconsistency between the Contract and any marketing material, the Contract will take precedence.  HMT may update these Terms from time to time however any changes will only apply to any new episode of Care or new Treatment Package that you receive, and you will be asked to agree to any new Terms before they become effective for you.  Note that any new Terms will not apply to any Treatment Package which is part- way through when the Terms are changed.
  1. HMT Standard Rates: Unless the Terms or your Treatment Letter (if applicable) provide otherwise, the HMT Standard Rates will apply to your Care. If you want to check how much something costs, please ask.  You can always check HMT Standard Rates on our website or by contacting your local Hospital or by asking for a copy when you are at any Hospital.
  1. Notices and your contact details: It is important that you keep us updated of any changes in your contact details, including specifying your preferred method of communication.
  1. Your property: Hospitals can be busy environments. While we will take all Care to ensure the safety of your belongings, HMT does not accept any responsibility for the theft or loss of, or damage to, any of your or your visitors’ property.
  1. Changes in Applicable Law: You acknowledge and accept that Applicable Law may change and prevent HMT from providing certain Care. If HMT becomes aware that such a change has occurred, and the change has an effect on your Care, HMT will contact you to inform you off this and its consequences.
  1. Assignment: HMT may transfer and assign your Contract to any person who acquires all or substantially all of the assets of HMT.
  1. Third Party Rights: Except for you or HMT, no person will have any rights under or in connection with these Terms.
  1. Law and the Courts: These Terms are governed by and shall be construed in accordance with English law and the courts of England and Wales shall have non-exclusive jurisdiction.
  1. Definitions:
  • “Applicable Law” means any and all laws, regulations, guidelines and professional obligations applicable to the provision of Care or the performance of services for you, including the requirements as regards treatment, procurement, research and storage of reproductive material;
  • “Care” means care, treatment, diagnosis, services (including Sundry Items) and goods provided by us;
  • “Consultants” means all consultants, surgeons, anaesthetists and self- employed GPs involved in your Care;
  • “Contract” means these Terms, along with the Registration Form and, if applicable, your Treatment Letter;
  • “Inclusive care package” means how much you will pay for your Treatment Package, as set out in your Treatment Letter issued by the Hospital;
  • “Hospital” means an HMT Hospital, clinic or facility; “Private Patients” means all patients that are not NHS patients and includes patients who are covered by medical insurance and patients who are paying for their own treatment, whether by way of a Treatment Package or otherwise;
  • “HMT”, “we” or “us” means (a) HMT Healthcare Limited where the Hospital in which you receive your Care is operated by HMT Healthcare Limited;
  • “Sundry Items” means personal items incidental to your Care, including meals for your visitors, newspapers and phone calls; “Terms” means these terms and conditions;
  • “Treatment Letter” means the letter that we send to you (if applicable) regarding your Treatment Package or Care; and
  • “Treatment Package” means the treatment or procedures that will be carried out at the Hospital as set out in your Treatment Letter and for which you have agreed to pay an inclusive care package.

PAYING FOR YOUR OUTPATIENT TREATMENT

Self Pay Pathway – Paying for your own treatment.

If you are a self-pay patient, we will ask you to pay for your consultation or any hospital treatment upon contacting our customer services department. A receipt for your payment can be provided upon request.

Your invoice for your consultation or treatment will be generated on the day of attendance, should you wish for a copy to be submitted to a third party, we can provide this on request.

Your consultant may request diagnostic investigations on the day of your appointment, such as x-rays or MRI scans. You will be required to pay for these tests on the day.

Should you wish to know the cost of the investigation in advance, we will be happy to provide you with an estimate of charges, however final price will vary depending on investigations advised by your consultant. Payment will need to be made with a credit/debit card as we do not accept cash or cheques.

Private Medical Insurance pathway

If you have private medical insurance, we want to make sure that your treatment process is as seamless as possible. Before your consultation, we advise you to contact your insurer to confirm that your cover is adequate and that the condition for which you seek treatment is covered under your policy.

Your insurers will notify you of any excess fees, annual benefit charge limits or any exclusions to your cover.

When you attend the hospital for your treatment, please bring the following information;

  • The name of your insurance company and the scheme details
  • Your membership/policy number
  • Any confirmation of eligibility provided by the insurance company, such as pre-authorisation/claim reference number.

It is important to note that some people may not be fully covered by their insurance policy. This is usually due to having an excess on the policy or because certain investigations or treatments are not covered due to an annual limit. Also, please note that pharmacy items prescribed on a private prescriptions, or medical ‘take home’ consumables, for outpatient visits are excluded from most schemes. You will need to pay for these items separately using a credit/debit card.

If you have incurred any charges that are not covered by your policy, we will ask you for a credit/debit card details, which will enable us to take care of any outstanding payments. We will hold your card details for a period but may need to request them again for future visits.

The claims process is simple. Your insurer will inform you once they have processed the claim for your treatment and will confirm any outstanding charges due to the hospital. We will also write to you to confirm your liability. You will have 7 days from the date of your letter to confirm the charges.

If you are unable to provide us with your full private medical insurance details, including a current authorisation code, you will be asked to pay the hospital charges on the day of your appointment. This is made easy by providing us with your credit/debit card details.

We will provide you with a receipt for you to present to your insurance company for reimbursement. You will always be informed of the cost of any treatment before or at the time that this takes place.

 

Third party liability or non -contract insurers

We have contracts with all major UK-based insurers. If you are covered by a non-UK based insurer, Medico legal company, sports club, employer or any other third party, we will communicate with them prior to your treatment, providing quotations for your treatment and provide any pre-pay invoices as necessary.

If we are not made aware of third-party liability, you will be required to make payment for your treatment on the day. We will provide you with a receipted invoice so that you can reclaim your fees directly.

 

Please note that all patients credit/debit card details are securely stored in accordance with industry standards on the hospital system. You will have a period of 7 days to raise any queries regarding the charges. The hospitals central finance office is available to discuss any queries related to charges on your invoice statement. For your convenience, we have provided a list if telephone numbers for major UK insurers;

BUPA – 0345 6090 111

AXA – 0800 132 203

Aviva – 0800 068 5821

Vitality – 0345 602 3523

WPA – 01823 625230

Claiming fees from your insurer and non-reimbursement

We will make every effort to claim directly from your insurer for the treatment you have received using the membership/policy number and authorisation/claim numbers provided to us.

Most invoices are submitted via electronic portal so will have been received by the insurer within days of your discharge from hospital.

If your insurance company has not reimbursed us within 40 days from the date of submission of our invoice for treatment, we will write to you and respectfully request that you contact your insurer to ask the reason for the delay.

Should the invoice be outstanding 60 days from the date of treatment, we will then consider the outstanding balance due from yourself and we will write to you to notify you of this.

Failure to settle the outstanding within 14 days of notification will result in the debt being transferred to the hospital’s legal representatives for debt collection proceedings to commence.

During this period, we are more than happy to communicate any additional information as requested by your insurer to resolve any outstanding queries, and we ask that communication is maintained should such issues occur.