TOP 10 TIPS

1. Always see your General Practitioner first. Private Treatment must be on referral from your GP - self-referral will invalidate a claim on most policies.
2. If treatment is necessary, contact your insurance company as soon as you have seen your GP. You need to check the correct procedure for making a claim, that the consultant or provider of service (e.g. physiotherapist) is recognised by the insurer, and the treatment is acceptable under your policy.
3. When the insurer authorises treatment, it will usually give you a claim reference or authorisation number. Quote this when you contact them.
4. Once approved, make your own appointment direct with the Consultant or medical provider so you can ensure it is at a time to suit you.
5. Keep the insurer fully informed of your treatment progress, eg, of any tests required by your Specialist, such as MRI/CT scans. The Hospital where the tests are to be done needs to be a recognised one.
6. Do not continue indefinitely with any treatment in connection with manipulation, for example physiotherapy or chiropractic treatment. Most policies have limits and do not cover maintenance of a condition. If there has been no significant improvement after five to seven visits, return to your GP to see if other treatment would be more effective or they feel referral to a Specialist is necessary.
7. If the Specialist feels a certain procedure is best for the condition, check the limits with the insurers by obtaining a procedure code from the Specialist. The insurer will confirm the maximum payment it would make for the Specialist's and/or anaesthetist's charges for the treatment - you would then be able to check the charges for any shortfalls.
8. Where in-patient treatment is necessary, check the room to be provided and the Hospital itself is acceptable for the scale of cover selected under the policy.
9. If you need extra treatment or to be re-admitted to Hospital keep the insurer advised to avoid delays or shortfalls in bill settlement.
10. If the diagnosis shows the condition is likely to become of a chronic nature such as diabetes, check the extent of cover available. Once the condition is stabilised, routine check-ups will not be covered and you should request your Specialist to transfer you to the NHS list for the six monthly consultations. Only acute periods of chronic conditions will be covered in the future and you should check with your insurer before having further treatment.