FAQs for Insurance Excesses and Shortfalls

What is an insurance excess, and do I have one?
An insurance excess is a fixed amount that you, as the policyholder, are required to pay towards the cost of your treatment. This amount is generally outlined in your insurance policy documents and is applied to the first invoices you receive. Your insurer should inform you about the excess when you take out your policy. If you're unsure, please check your insurance certificate or policy documentation.

What is an insurance shortfall, and why have I received one?
An insurance shortfall occurs when your insurance policy does not cover the full cost of your treatment. This can happen for a variety of reasons, such as exceeding your policy limits, policy exclusions, or failure to pre-authorise the treatment. Kingsbridge will notify you of any shortfall, and your insurer should have informed you as well.

Why have I received a bill if I don’t have an insurance excess or co-payment arrangement?
There are several reasons why an insurer may not pay the full cost of your treatment:

• Exceeded Policy Limit: You may have exceeded a policy limit for outpatient, diagnostic, or mental health treatments.
• Treatment Not Covered: Your treatment may be excluded from coverage by your insurance policy.
• Treatment Not Pre-Authorised: Your treatment may not have been pre-authorised by your insurer, as many insurance companies require this before covering costs.
• Missing Documents: Your insurer may not have received required documents, such as a GP referral or claim form, and this could delay or reduce payment.

What if my treatment was not pre-authorised?
Most insurers require you to obtain pre-authorisation before receiving treatment. If your treatment was not pre-authorised, your insurer may not cover the costs. In some cases, they may approve the treatment retrospectively, but this is not guaranteed.

What if I disagree with the shortfall or declination from my insurer?
If you don’t agree with your insurer’s decision regarding a shortfall or declination of cover, your insurance policy may have an appeal process. Please contact your insurer to discuss this directly. Your payment to Kingsbridge remains due and must be paid in full. If your appeal is successful, your insurer will reimburse you, or Kingsbridge will refund you accordingly.

What should I do if I receive an invoice from a consultant directly?
Consultants at Kingsbridge Private Hospital operate independently and may invoice you separately for their services. These invoices could come directly from the consultant or through a third-party billing company, such as MedServ. Kingsbridge cannot accept payments for consultant invoices. Please follow the payment instructions on the invoice you receive from your consultant.

I’ve already paid for my Kingsbridge treatment. How can I get a receipt?
You can download a copy of your receipt from our Patient Portal.

Sign up using your email address, patient ID, and date of birth. Your patient ID can be found on any letters, invoices, or emails you have received from Kingsbridge.

What if I can’t afford to pay my bill or shortfall on time?
If you are experiencing financial difficulties and are unable to pay your bill or shortfall by the due date, please contact us. We can postpone your payment once and within reason, allowing time for you to manage the situation. We are happy to discuss your circumstances and set a new payment date.

How will Kingsbridge process my payment for an insurance shortfall or excess?
In most cases, Kingsbridge will automatically process your payment using the credit or debit card you provided when securing your booking. You will be notified of the payment date in advance, and if this date falls on a bank holiday, the payment will be processed on the next working day.