PPP News, Out Patient Consultations

The "discussions" with PPP regarding patient reimbursement for follow up surgical post-operative consultation goes round in circles. There is no satisfactory answer. Members are advised to quote fees as accurately as possible to patients before treatment. The LCA does not condone unbundling of fees or excessive charges but reserves the right for its members to charge the normal post-operative fee in the usual way. Other insurance companies will reimburse patients for these fees and so PPP patients should be warned that they may face a shortfall and that this will be their responsibility. It should be noted that PPP will meet these fees if the consultation takes place more than ten days after the operation. Furthermore, if the consultation is earlier but is one of complexity or excess time (i.e. explaining the results of a malignant biopsy), then the patient may be reimbursed for the consultation.

more news stories...