Many patients tell us they find the billing procedure confusing if they are claiming on a UK health insurance policy. We hope this page will clarify what you should do.

A health insurance policy is a contract between the policy holder and their insurance company, and not between the doctor and the insurer. We will do our best to assist patients if they have questions about their claim but we cannot make insurance claims, nor can we act as the policy holder's agent. Our charges are often for an hour's work, and it is impractical to provide a further hour's work handling a claim, Our surgical colleagues normally charge a much higher hourly rate so they can absorb these extra costs.

Different insurers pay their policy holders different levels of benefit for the same operation. The benefit is set by the insurer and is neither agreed nor negotiated with the medical profession. Benefits for anaesthesia are often set by the work undertaken by the surgeon and not the anaesthetist, and in some cases this may result in inappropriate cover. Policies may also have excesses or limitations so that some procedures are paid for but others are not. Anaesthetic fees may be paid only after all other consultants so that policy limitations arising from another doctor's charges are offset against Anaesthesia's invoice.

We charge all patients the same fee for a particular operation regardless of whether they are paying their own account, are insured, or are guaranteed by an embassy. Most of our procedures are charged in line with WPA's schedule, which is the commonest schedule used by anaesthetists. However, for some procedures and lengthy or unusual operations these will not apply. In this case we will charge our services at £310 per hour of anaesthesia. Please ask us for a quotation in advance and compare this with the benefits payable under your policy. Quotations provided by or for other doctors may be inaccurate and cannot be honoured.

We send invoices to the patient or parent with the sole exception of PPP. This is the recommendation of our professional bodies (the Federation of Independent Practitioner Organisations and the Association of Anaesthetists of Great Britain and Ireland). If you wish to claim on an insurance policy you should send a copy of the invoice to your insurer.

Many insurers pay Anaesthesia Ltd direct but some, most noticeably BUPA, will send any benefits to the policy holder who will then need to pay us. We are not in direct settlement with BUPA because they will not pay for individual claims but operate an account and not infrequently revise the claim and deduct money from another patient's payment months later. This makes it impossible for us to ensure any account has been settled.

Benefits paid by many insurers have been effectively frozen for a quarter of a century; small increases to some benefits have been offset by the removal of benefits from other procedures. Over that time anaesthesia has changed dramatically. The introduction of monitoring, the use of ultrasound and development of nerve blocks, the roll out of intensive care and the transfer of much postoperative care from surgeon to anaesthetist have all increased the time and complexity of anaesthesia in comparison with other specialties.

Anaesthetic fees in the UK are some of the lowest in the developed world. They are considerably lower than our surgical and medical colleagues even though anaesthetists do not benefit from subsidies for practice costs received by many other specialties. As a result anaesthetists' mandatory costs may well be higher than those of other doctors. We have tried to minimise shortfalls for patients by keeping our charges unchanged for many years, but we can only do so if accounts are settled promptly. We ask for your cooperation in achieving this. If your insurer has not informed you that your account has been settled, please contact them.

We ask all patients to complete a credit card form and to give it to us on admission. If your account is unpaid after 60 days we will take the balance from your card and send an itemised receipt. UK insurers will pay any benefits due to the policy holder. In return we offer a discount on our normal fees to UK policy holders.