The inSpire health plan gives you easy access to private medical care at Spire Healthcare hospitals. From diagnosis to treatment and aftercare, you can tailor your cover to focus on what matters to you and your family. Policy holders will benefit from:
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When a charge has been submitted to your insurer but a shortfall has meant you have a balance to pay, your insurer will usually contact you to confirm the level of contribution you will need to make and the reasoning for their assessment.
Once Spire Healthcare has been made aware of the shortfall we will write to you and our correspondence will confirm we had attempted to submit the balance to your insurers, but have been advised you have a contribution to make. The breakdown of the charges you receive from us will also state “Insurer advised patient liability” along with the balance that has not been covered by your policy.
If you are ever unsure we recommend you call your insurer to confirm what they have assessed or speak to our Customer Services team.
The first thing to do is contact your insurer directly to discuss this with them. Any shortfall we present to you will have been based on your insurer’s advice. If your insurer confirms you have been billed in error, please let our Customer Services team know, and we can hold the case while we await a reassessment and payment from your insurer.
Each insurer that Spire Healthcare is permitted to bill directly will agree their own rate for each procedure. These rates can be higher or lower than the hospital’s self-funding rate, or other different insurers’ rates, for any particular treatment, but they enable insurers to provide pre-authorisation and take their member’s policy limits into account.
For us to send a charge to an insurer, they must be sent at these contractually agreed rates. These rates will also apply to any shortfall or non-payment returned by your insurer.