Medical Insurer Policy

Claiming Through Your Medical Insurer

Southfields Physiotherapy is an approved physiotherapy clinic with BUPA and AXA and are recognised by most insurers. All of our physiotherapists are members of the Health and Care Professions Council (HCPC). BUPA and AXA patients will need to provide us with their policy number, authorisation code and where it applies pay any excess amount prior to commencing treatment. Your claim will be handled in accordance with our medical claims policy below.

Patients who have private medical insurance with anyone other than BUPA or AXA are requested to pay the clinic directly for treatment and you will be provided with an invoice to submit to your insurer.

If you are claiming for treatment through your medical insurer we kindly ask that you read the following medical claims policy as it contains important information which relates to your medical insurance claim.

Medical Claims Policy

Southfields Physiotherapy act only as a healthcare provider, it remains at all times the patient’s responsibility to know and understand all the terms of their policy cover which they currently hold with their respective medical insurer. The policy management is strictly between the patient and their insurer, and we Southfields Physiotherapy as a healthcare provider, beyond treatment, are merely a facilitator in the invoicing process.

It’s the patient’s responsibility to ensure that they obtain approval from their medical insurer and will be required to provide Southfields Physiotherapy with their policy number, authorisation code and any excess amount which is payable upfront prior to commencing treatment.
If the information above is not provided the patient will need to pay for their appointment and claim this back directly with their medical insurer, Southfields Physiotherapy will not refund any appointments where retrospective approval has been agreed with their insurer. Any excess amount which is not applied to a claim will be refunded to the patient at the end of their treatment episode.

It’s the patient’s responsibility to ensure that throughout their claim they contact their medical insurer directly to confirm their approved or remaining number of sessions which relates to their current claim as shortfalls to outpatient benefits and policy terms may affect their current claim or insurance policy. It’s the insurers responsibly to inform the policy holder of all the terms which apply to their medical insurance claim and policy terms.

Any information that we provide to the patient will be based on our records and may not be accurate in relation to their individual policy cover as we have no access to this. Therefore Southfields Physiotherapy cannot accept any responsibility if a patient’s claim is unsuccessful, and the patient will be liable for immediate payment as requested by Southfields Physiotherapy should there be any excess or shortfall applied by their medical insurer.

Under Data Protection Law we may not attempt to gain any information about your policy and therefore Southfields Physiotherapy do not negotiate anything with the medical insurer on behalf of the patient as this information relates only to the policy holder.   
If you are unsure at any stage then please contact your insurer directly to discuss your claim.

Requesting Further Treatment

You may request further treatment from your insurer in cases where the therapist has agreed that there is clinical reason to so. Please ask reception for details of how to do so following the discussion with your therapist.

When we request treatment for a patient, we do this with a team of therapists who assess your treatment plan and may approve more treatment sessions. This team is often not connected to those administering your policy and your policy management is strictly between yourself and your insurer, and any healthcare provider, beyond treatment, is merely a facilitator in the invoicing process.

Once the request has been submitted to your insurer we will inform you by email and you will then need to contact your insurer directly to confirm the number of approved session, check if an excess applies to your policy or whether you may have a shortfall of outpatient benefits relating to your claim or policy. It remains your responsibility to know and understand all the terms of your policy cover.  Please note, it takes most insurer’s 3-5 days to process the request for further treatment.

If you are unsure at any stage then please contact your insurer directly to discuss your claim.

Payment

Patient relationships are as important to us as patient care and we aim to receive all outstanding payments from patients affably and within the requested time. In the unlikely case where payment is not received for treatment we have already provided we will regrettably pass this onto our credit control team for formal collection. All treatment fees, interest and charges to recover the debt will be the liability of the patient.