Private patient tariff - UHS · Complex e.g. with shell 10 6,359 Palliative treatment package 2 Simple 5 2,868 Complex e.g. with shell 5 3,179 Palliative ... Private patient tariff

Private Patient Tariff

Issue No. 2

2017 / 2018

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Contents

General Notes ................................................................................................................................... 3

Contacts ............................................................................................................................................ 4

Universal Charges ............................................................................................................................ 5

Theatre Charges ............................................................................................................................... 6

Critical Care Charges ....................................................................................................................... 6

Cancer Care ...................................................................................................................................... 7

Radiotherapy ................................................................................................................................... 7

Bone Marrow Tranplants ................................................................................................................. 9

Cardiothoracic Services ................................................................................................................. 10

Neurosciences ................................................................................................................................ 10

General Medicine ............................................................................................................................ 11

Obstetrics & Gynaecology ............................................................................................................. 13

Gynaecology ................................................................................................................................. 13

Gynaecology ................................................................................................................................. 13

Ophthalmology ............................................................................................................................... 14

Major Procedures .......................................................................................................................... 14

Intermediate Procedures ............................................................................................................... 15

Minor Procedures .......................................................................................................................... 15

Other procedures .......................................................................................................................... 15

Diagnostics & Imaging ................................................................................................................... 15

Orthopaedics .................................................................................................................................. 16

Paediatrics ...................................................................................................................................... 17

Pathology ........................................................................................................................................ 18

Laboratory Medicine ....................................................................................................................... 19

Medical Physics .............................................................................................................................. 20

Pharmacy ........................................................................................................................................ 20

Radiology ........................................................................................................................................ 21

Clinical radiology ........................................................................................................................... 21

CT scanning .................................................................................................................................. 21

Nuclear Medicine .......................................................................................................................... 23

Terms & Conditions ........................................................................................................................ 24

1.1 General............................................................................................................................... 24

1.2 Insurance Companies ......................................................................................................... 24

1.3 Insured Patients .................................................................................................................. 25

1.4 Self pay patients ................................................................................................................. 25

1.5 Cancellations ...................................................................................................................... 25

1.6 Late Payments.................................................................................................................... 26

1.7 Drugs and Consumable charges ........................................................................................ 26

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General Notes

• All charges apply to inpatients, outpatients and day cases. Charges shown assume that

consultants’ fees are charged separately unless otherwise indicated.

• Inpatient and day case charges include an accommodation charge and allowance for

drugs up to £25 and consumables up to £125 as specified below. An additional charge

will be made for any specialist high cost drugs, medical/surgical supplies used, and drugs

issued on discharge.

• For all inpatients, High Cost drugs will be charged in excess of £25 per the individual drug,

which excludes drugs that are issued by TTO for the patients discharge, where it will be

the patients responsibility to pay in full.

• All Private patients high cost consumables are those that exceed £125 per item, with the

exception of interventional radiology where a separate price list for these high cost

consumables applies (see page 26).

• Charges for Day Cases are based on the complexity of the surgery being performed as

documented in this Tariff Document 2017-2018.

• A charge will be made for the use of all non-urgent private patient transport, this will be

invoiced separately and in additional from the treatment price.

• A comprehensive list of pathology service tests is available upon request.

• All charges shown are in pounds sterling (£) and are inclusive of VAT.

• Private International patients will be charged 25% in addition to their invoice to cover

medical/professional fees.

Contacts

Name Division Department Job Title Telephone

Debbie Roberts Ian Godfray

Trust HQ General Enquiries/ Cashiers Chief Cashier Deputy Chief Cashiers

02381 20 6058

Charlotte McCaskie Trust HQ Commercial Enquiries Private Patient and Contracts Manager 02381 20 6260

Nathan Burnett Ann Clay

Division A Cancer Care Private Patient Co-ordinator Business Manager

02381 20 6598 02381 20 5437

Hayley Conway Division A Surgery Private Patient Coordinator 02381 20 6875

Sue Denton/ Elvena Prince

Division A Critical Care Private Patient Coordinator Ward Clerk

02381 20 8707 02381 20 6117

Carole Collins Division B ED/ CDU Office Manager 02381 20 6220

Lisa Burt Frost Division B AMU Office Manager 02381 20 8049

Susan Dance Leanne Beck

Division B Pathology Contracts and Information Manager Private Patient Coordinator

02381 20 8443 02381 20 8355

Linda Peart Division B Ophthalmology

Private Patient Coordinator 02381 20 6853

Tina Walsh Division C Women’s & Children’s Private Patient Coordinator 02381 20 5069

Angela Macaulay/ Jayne Christie

Division C Pharmacy High Cost Drugs Technicians 023 8120 8637

Sarah Hall Division D Radiology Office Manager

02381 20 4434

Emma Francis Division D Cardiothoracic, Neuro & Trauma and Orthopaedic

Private Patient Co-ordinator 02381 20 3211

Universal Charges Outpatient consultation Classification of Treatment Notes Tariff

Consultation appointment Charge is for the use of the room only. An additional charge will be made for all diagnostic procedures, all drugs and all medical and surgical devices.

75

Day case - non operative Classification of Treatment Notes Tariff

Hourly rate - capped at four (4) hours

Includes use of bed for observation, drug

monitoring, transfusion, infusion etc.

108

Accommodation charges Classification of Treatment Notes Tariff

Shared accommodation Charge per day or part thereof

343

Single room Charge per day or part thereof and subject to availability

379

Single room - en suite Charge per day or part thereof and subject to availability

414

Amenity bed 101

Clinical support services Classification of Treatment Notes Tariff

Physiotherapy per 15 minutes session 45

Dietetics per 15 minutes session 45

Occupational therapy per 15 minutes session 45

Sports injury clinic per 15 minutes session 45

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Theatre Charges

Theatre and catheter room Day case and Inpatients

Classification of Treatment Max Time (minutes) Tariff

Includes local anaesthetic Minor Up to 30 334

Includes local anaesthetic Intermediate Up to 60 987

Theatre and catheter room Day case and Inpatients

Classification of Treatment Max Time (minutes) Tariff

Includes General Anaesthetic

Minor Up to 30 642

Intermediate Up to 60 1,262

Major Up to 90 1,881

Major Plus Up to 120 2,502

Complex Major – 1 Up to 150 3,119



Complex Major – 4/5 Up to 240 4,965

Any Minor or Intermediate procedure that lasts longer than the specified time will incur an additional charge of £300 per 30 minutes in theatre or part thereof.

Any Major or Complex procedure that lasts longer than the specified time will incur an additional charge of £680 per 30 minutes in theatre or part thereof.

The charges above do include:

• General and local Anaesthetic

The charges above do not include:

• High cost consumables (over £125, including Trust handling fee) which will be charged separately

• Cardiac consumables/ pacemakers/ implantable devices, these will be charged separately.

• The Surgeon and Consultant Anaesthetist Fees, which will be billed separately.

Critical Care Charges

Critical care Classification of Treatment Notes Tariff

(per day or part thereof) Non ventilated High Care 1,163

Ventilated High Care 1,676

Intensive Care – Cardiac 2,758

Intensive Care – Neuro 2,758

Intensive Care - Other specialties

2,758

Haemofiltration therapy 1,289

Plasmapheresis therapy 1,586

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Cancer Care Chemotherapy

Hours Notes

Tariff

(per treatment session) Up to 2hrs 278

2 - 4hrs 377

4 - 6hrs 468

6 - 8hrs 561

Rate per Hour (over 8 hours) 164

Chemotherapy Classification of Treatment Notes Tariff

(per treatment session) Scalp cooling 138

Stem cell - white blood set 2-3 likely to be required 724

Stem cell - auto PBSC 2-3 likely to be required 724

Stem cell - red blood set 2-3 likely to be required 643

Stem cell - plasma exchange 2-3 likely to be required 708

Plasma exchange Patient to require every 3 - 4 weeks.

536

Other charges Classification of Treatment Notes Tariff

Blood test 40 Chemotherapy treatment cost

(excludes drugs) Per hour 105

Where a chemotherapy patient is an inpatient, and receives chemotherapy treatment from their bed, the standard bed day rate will apply and no chair cost will be made.

Radiotherapy

Classification of Treatment Fractions included Tariff

Prostate by VMAT 37 21,228

Breast package 1 25 27,361

Breast package 2 15 20,520

Breast Boost 5 5,472

Head and Neck with shell and IMRT 33 20,985

Prostate by VMAT + Day case Single Brachytherapy HDR Treatment 15

21,060

HDR vault insertions as OP for endometrium patients 4 19,473

Cervix followed by 2 HDR full insertions as a daycase 25 40,475

Endometrium followed by 2 HDR vault insertions as an outpatient 25

24,058

Gynecological no HDR 28 17,435

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Radical Lungs package 1 30 18,681



Radical Lymphoma 15 9,538

Radical Lymphoma 10 6,482

Superficial treatment package 1 10 9,058

Superficial treatment package 2 5 4,529

Prophylactic Cranial Irradiation 10 6,359

Prostate LDR Seeds Brachytherapy (BT212) 1 13,574

HIPEC n/a POA

IOERT n/a POA

Classification of Treatment Fractions Included Tariff

Palliative treatment package 1

Simple 10 5,738

Complex e.g. with shell 10 6,359


Simple 5 2,868



Simple 1 1,367


Mould room charges Classification of Treatment Notes Tariff

Full shell 401

Head shell 319

Prone shell 733

Orfit shell 131

Electron shell 437

Conformal wax 171

Compensator 479

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Bone Marrow Tranplants

Peripheral blood stem cell transplant

Classification of Treatment Tariff

Full intensity, sibling allogeneic PBSCT 115,210

Full intensity, sibling allogeneic BMT 107,718

Full intensity, VUD allogeneic PBSCT 100,025

Full intensity, VUD allogeneic BMT 96,663

Reduced intensity, sibling allogeneic PBSCT 101,857

Reduced intensity, sibling allogeneic BMT 97,864

Reduced intensity, VUD allogeneic PBSCT 89,141

Reduced intensity, VUD Allogeneic BMT 90,001

Autologous PBSCT 51,833

Autologous BMT without TBI 52,125

Autologous BMT with TBI conditioning 58,573

PBSC harvest only 16,061

Bone marrow harvest only 12,038

Sibling donor lymphocyte infusion 5,406

Volunteer unrelated donor lymphocyte infusion 4,188

Harvests for Volunteer Unrelated Donors are charged separately. The charges made will vary significantly depending on the country supplying the donation.

These prices are based on a standard procedure with expected drug and blood products. Any additional drugs, blood products or procedures will be charged separately.

All prices include outpatient appointment costs and hospital stay costs.

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Cardiothoracic Services Cardiothoracic diagnostics

Classification of Treatment Notes Tariff

24 hour BP monitor 52

Flow rate U/S study 103

T.O.E 424

Cardiac investigations Classification of Treatment Notes Tariff

ECG Excludes Consultant Fees 69

Stress test Excludes Consultant Fees 224

Echocardiogram with doppler Excludes Consultant Fees 289

Tilt table test Excludes Consultant Fees 242

Automatic function test Excludes Consultant Fees 101

Cardiomemo Excludes Consultant Fees 56

24 hr heart monitor (fit & analysis) Excludes Consultant Fees 137

24 hr heart monitor (analyse only) Excludes Consultant Fees 64

24 hr blood pressure monitor Excludes Consultant Fees 116

7 day event recorder Excludes Consultant Fees 222

Pacemaker check Excludes Consultant Fees 67

ICD check Excludes Consultant Fees 70

Neurosciences Neurosciences Classification of Treatment Notes Tariff

E.M.G 133

E.E.G – routine 163

E.E.G – ambulatory 437

E.E.G. infected patient 180

Evoked potentials 173

Nerve Conduction Studies (NCS) 117

Visual fields 69

Intra operative Spinal/ Brainstem Monitoring

Per hour 151

Videotelemetry First 24 hour period or part thereof

1,704

Each subsequent 24 hour period or part thereof

1,482

All other procedure charges will be based on the theatre and day case rates specified in the Universal Charges section.

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General Medicine General Medicine Classification of Treatment Notes Tariff

High resolution oesophageal manometry

Excludes Consultant Fees 400

24 hour impedance testing


24 hour pH testing Excludes Consultant Fees 400 Combined High resolution

oesophageal manometry and 24 hour pH

Includes Consultant Fees 1000

Combined High resolution oesophageal manometry and 24 hour impedance

Includes Consultant Fees 1000

High resolution anorectal manometry (physiology)


Endoanal ultrasound Excludes Consultant Fees 264 Nerve conduction studies

(EMG/pudendal nerve) Excludes Consultant Fees 310

Sacral nerve neuromodulation Follow-up


Anorectal biofeedback Excludes Consultant Fees 605 Hydrogen/methane breath testing Excludes Consultant Fees 200 Sigmoidoscopy Excludes Consultant Fees 788 Anorectal Physiology Excludes Consultant Fees 202 Gastroscopy Excludes Consultant Fees 788 Bronchoscopy Excludes Consultant Fees 788 Colonoscopy Excludes Consultant Fees 788 Liver biopsy (excluding Pathology

& Radiology procedures) Excludes Consultant Fees 896

Fibroscan (Hepatology) Excludes Consultant Fees 314 ERCP Excludes Consultant Fees 1,199 Sphincterotomy Excludes Consultant Fees 1,199 Stone removal (Lithotripsy) Excludes Consultant Fees 1,199 Naso biliary drainage Excludes Consultant Fees 896 EUS (endoscopic ultrasound) Excludes Consultant Fees 690 Cardio-pulmonary exercise test Excludes Consultant Fees 341 Endobronchial Ultrasound (EBUS) Excludes Consultant Fees 3,996 Respiratory Classification of Treatment Notes Tariff

Pulmonary Function Tests

Aeroallergens 100

Food Allergens 125

Consultation appointment 75

Spirometry 56

Spirometry with Ventolin 80

Spirometry with Ipratopium 110

Spirometry (Ventolin/Ipratopium) 110

Bronchial Challenge 260

Transfer factor 63

Flight assessment (Fit to Fly) 122

Helium-Rebreathing (lung volumes) 62

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Plethysmography 113

Six minute walk 54

Muscle testing 76

Oscillatory 57

Nitric Oxide Measurement 63

Aero Allergens 101

Food Allergens 124

Areo/Food Allergens Combination 150

Cardio Pulmonary exercise testing (CPET)

506

FENO 50

Histamine Challenge 111

BDR Ipratopium 116

BDR Salbutamol 111

Capilliary Blood Gas 78

Other tests available upon request POA

Dermatology Classification of Treatment Notes Tariff

Photo dynamic therapy

Single area (per session)

Multiple lesions (per session)

Excludes Consultant Fee Excludes Consultant Fee

448

601

PUVA (photo chemotherapy)

First Session

Additional sessions

2 hour session

30min session

122.35

50

Light therapy First session (including MED test)

Additional sessions

Excludes Consultant Fee 131

31

Iontophoresis treatment

Excludes Consultant Fee POA

Patch Test Patch test - 3 sessions

Photo patch test (including out-patient consultant fee)

Includes Consultant Fee

Excludes Consultant Fee

487

168

Skin surgery

Minor procedures including simple excision, shave excision, curettage including local anaesthetic (30 min)


Intermediate procedures including up 3 excisions, larger excisions for skin cancer trunk/ limbs, multiple mole removal (60 min)


Day case procedures incl. skin flaps, skin graft, excisions for skin cancer on the face


Nurse Led Consultation

Per session 70

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All prices for treatments and packages include room costs, all procedures, anaesthetic (if required) and consumables. Prices exclude Consultant and Histopathology fees unless stated otherwise.

Any other Dermatology procedures prices are available upon request.

Obstetrics & Gynaecology

Gynaecology

Classification of Treatment

Notes

Tariff

Minor procedure cervix / uterus

Excludes Consultant Fee, High costs drugs will be charged separately. 338

Minor procedure cervix (uterus collagen injection)


Minor procedure uterus / adnexae


Hysteroscopy


Colposcopy

Excludes Consultant Fee, High costs drugs will be charged separately.. 701

Gynaecology


Notes

Tariff

Ultrasound Excludes Consultant Fee 134

Foetal medicine outpatient ultrasound assessment


Delivery - normal including 1 night stay

Excludes Consultant Fee 1,480

Any necessary surgical procedures will be charged in accordance with the theatre categories stated in the Universal Charges section.

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Ophthalmology All Major and Minor procedures include the use of ophthalmology theatres, all procedures exclude surgeon and anaesthetic fees.

Major Procedures Classification of Treatment Tariff £’s

Cornea lamella graft (keratoplasty) to cornea 2555 Iris & Anterior Chamber Combined Phacoemulsification, implant and trabeculectomy 1922

Surgical Trabeculectomy 1922

Eyebrow & Lid Correction of ptosis of eyelid (simple, including tarsomullerectomy) 1922

Muscles Surgical correction of squint – horizontal 1 muscle 1922

Surgical correction of squint – horizontal 2 muscle 1922 Vitreous Vitreous biopsy/ pars plana vitrectomy 1922 Pars plana vitrectomy 2555 Pars plana vitrectomy with internal tamponade, scleral buckling

and retinpexy 2555 Pars plana vitrectomy with internal tampondae, scleral buckling

and retinopexy, including dissection of excision of epiretinal membrane/macular surgery 3189

Combined pars plana vitrectromy 3189 Eyebrow & Lid Correction of ptosis of eyelid - simple, including

tarsomullerectomy 2555 Correction of ptosis of eyelid - complex 2555 Correction of ptosis of eyelid with autologous fascia lata 2555 Bilateral upper lid and lower lid blepharoplasty GA 1969 Lid reconstruction 2619 Cataract Choice Inclusive Package price 1,600

Cataract Surgery Consultant Choice 1,900 To note any procedures not mentioned above are available on request.

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Intermediate Procedures Classification of Treatment Tariff

Lens Phaoemulsification of lens with implant – unilateral 997 Eyebrow & Lid Blepharoplasty (Bilateral) 997

Correction of lower lid ectropion without graft/ flap 997 Correction of lower lid ectropion with graft/ flap 997

Correction of entropion - lower lid 997 Correction of entropion - upper lid, including graft/ flap 997

Minor Procedures Classification of Treatment Tariff

Eyebrow & Lid Excision of lesion of eyelid 337

Correction of entropion 337 To note any procedures not mentioned above are available on request. Minor and intermediate charges do not include the cost of a general anaesthetic which will be charged separately if required. This will be charged at £334 for all minor and intermediate procedures.

Other procedures Classification of Treatment Tariff Treatment room procedures Intravitreal triamcinalone injection 337 Intravitreal antibiotic injection 337

Macula Degeneration Intravitreal Injection (excl drug) 337

Miscellaneous YAG Laser Capsulotomy - Unilateral 337 YAG Laser Capsulotomy - bilateral 337 Argon Laser 314

Diagnostics & Imaging


Tariff

Imaging Fundus Flourescein angiography (FFA) 255 Fundus photography 73 Optical Coherance Tomography (OCT) 73 Indocyanine Green Angiography (ICG) 255 Combined Flourescein/IGS 275 Heidelberg Retinal Tomography (HRT) 73 Endothelial cell count 82 Corneal Topography 73 Anterior segment photography 73 Corneal Pachymetry 73 Stereo Disc Photos 73

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Treatment room procedures

Pachymetry 73

Miscellaneous

Biometry Pre-op Assessment

73 73

Orthoptic Assessment Ocuscan

73 73

Ultrasound (B scan ) Refraction

73 73 73

Low vision assessment 73 Contact lens fitting 402 Visual Evoked Response (VEP) and Pattern Electro-Retinogram

(PERG) 355 VEP, PERG and Electro-Retinogram (ERG) 466 VEP, PERG, ERG and Electro-Ocular Gram (EOG) 566 Electrodiagnostic tests for a Child 402 100 Hue test 73 24 Hour phasing 73 12 Hour phasing 73 Visual Fields 73 Colour Photography 73 Punctual Plugs 176 Radio Surgery 289 Botulinum Toxin 289 Glaucoma Screening 161 Visudyne Therapy 2123

Orthopaedics Orthopaedics


Tariff

Xiapex Clinic 1,569

Plaster of paris

Dynocast/Bay Cast:

Below Elbow 102

Above Elbow 169

Below Knee 210

Above Knee 347

Jacket/Hip Cast 1,029

Other procedures available upon request

POA

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Paediatrics Orthopaedics Classification of Treatment Notes Tariff

Tongue Tie Package Price – includes consultant fee

164

Major release of muscle (excluding hamstring - cost per case basis)

Includes high cost consumables, excludes consultant and anaesthetist fees

2,802

Pelvic osteotomy Includes high cost consumables, excludes consultant and anaesthetist fees

11,210

Open reduction - complex Includes high cost consumables, excludes consultant and anaesthetist fees

11,210

Spica to Broomsticks Includes high cost consumables, excludes consultant and anaesthetist fees

1,681

Broomsticks to splints Includes high cost consumables, excludes consultant and anaesthetist fees

1,681

Adductor release and arthogram Includes high cost consumables, excludes consultant and anaesthetist fees

2,129

Femoral osteotomy Includes high cost consumables, excludes consultant and anaesthetist fees

11,210

Guided growth Includes high cost consumables, excludes consultant and anaesthetist fees

5,605

Removal of hip spica and pins (after pelvic osteotomy)


2,556

Open reduction and femoral osteotomy combined


16,814

All other paediatric orthopaedic cases will be charged on a cost per case basis.

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Pathology

Cellular Pathology Classification of Treatment Notes Tariff

Referred stained slides or blocks-this covers administration costs and report production only.

Excluding medical fees 45

Where technical work is carried out on wax blocks or unstained slides supplied with or produced from a referred case the following additional charges will apply

Special stains 26

Immunohistochemical Tests - first 2 (excluding ER & PR)

Including controls 98

Additional immunohistochemical test – ER

43

Additional immunohistochemical test – PR

43

Immunofluorescence Per case 105

Electron microscopy Per case 311

Renal biopsy Full examination including electron microscopy

629

Liver biopsy - routine case No immunostaining 188

Liver biopsy - complex case Including immunostaining 309

Radical prostatectomy Includes large blocks with levels

238

Bone marrow trephine Includes levels and special stains

200

Acetyl Cholinesterase 137

HER2 IHC 120

SISH 167

HER2 plus SISH 268

EMU 268

Histopathology Classification of Treatment Notes Tariff

(excludes medical fees)

Basic routine case Up to 2 standard blocks with H&Es and levels

84

Each additional standard block With H&Es and levels 22

Large blocks Each with H&Es and levels 45

Frozen sections Per case, initial report 91

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Neuropathology Classification of Treatment Tariff

(excludes medical fees)

Muscle biopsy 620

Nerve biopsy 353

Eye (globe) 166

CSF 103

Non-Gynae Cytology Classification of Treatment Notes Tariff

(includes medical fees but price will be broken down within the invoice)

Cervical smear 84

Body fluids 155

Sputum 155

Brushings 155

Electron Microscopy Classification of Treatment Notes Tariff

(includes medical fees)

Electron Microscopy from fixed tissue including processing, sectioning and photography

365

X-ray analysis including processing, sectioning and Analysis

436

Report sent to pathologist concerned

121-242.50

Brushings 157

Out of Hours Testing per test Between 17:00-08:00hrs Monday – Thursday Friday 17:00 – Monday 08:00hrs including Public Holidays

44

Laboratory Medicine Clinical pathology Classification of Treatment Notes Tariff

(includes medical fees, price will be broken down within the invoice)

Various tests, for example:

Biochemistry ‘Full Profile’

Individual tests from £15.60 each please call lab on 023 81 20 6435 for further details

37

Renal profile 24

Liver profile 24

Bone profile 24

Blood gases 37

INR 13

Phlebotomy 36

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Haematology & blood transfusion


(includes medical fees, price will be broken down within the invoice)

Various tests for example: Full blood count (FBC) 24

Cross match per unit (excluding cost of blood)

67

Coagulation screen 18

APTR 18

HEP 13

Immunology Classification of Treatment

Tariff

Various tests available; prices upon request

Microbiology Classification of Treatment

Venesection


Tariff

Phlebotomy 36

All Pathology tests requiring 'out of hours' service will levy an additional fee per test.

40

Medical Physics Medical Physics Classification of Treatment Notes Tariff

Sub-Arachnoid haemorrhage monitoring

Per assessment 19

Microvascular assessment 151

Vascular ultrasound Dupple or transcranial 224

Bone densitometry 75

Displacement measurement Neuro otological 300

Displacement measurement Neuro only 194

Pharmacy Pharmacy Classification of Treatment

Tariff

Drugs for TOP UP and Co-Payment Patients;

POA

See 1.7 of the Terms and Conditions for other associated charges

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Radiology This includes interventional radiology procedures and nuclear medicine. All prices under the Radiology section exclude High costs drugs (over £125 per item), General Anaesthetic, Consultant and Consultant Anaesthetist fees unless specified otherwise: Group Classification Notes Tariff

Group A 47 Group B 130

Group C 238 Group D 427 Group E 681

Group F 1,095

These charges will apply in the absence of a specific tariff.

Clinical radiology


PACS Storage POA Plain X Ray Group A 47

Ultrasound Group B 130

Drainage 867

Biopsy 867

Price excludes Consultant & Consultant Anaesthetist charge.

CT scanning Classification of Treatment Notes Tariff

CT scan 1 area (+/- contrast) Includes consultant fee 471

CT Scan 2 areas (+/- contrast) Includes consultant fee 622

CT scan 3 areas (+/- contrast) Includes consultant fee 889

CT scan brain (+/- contrast) Includes consultant fee 490

MR scanning Classification of Treatment Notes Tariff

1 Area Includes consultant fee 453

2 Related areas Includes consultant fee 629

2 Unrelated areas Includes consultant fee 895 3 Related areas Includes consultant fee 899 3 Unrelated areas Includes consultant fee 1,487 Cardiac scan Includes consultant fee 1,309 Cardiac scan under stress Includes consultant fee 1,765

Gadolinium 150

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Interventional Radiology – Prices exclude Consultant or Consultant Anaesthetist charges.

Tariff

Paediatric Minor 379

Intermediate 566

Major 1,028

Fixed price treatments


Discogram 362

Joint injection 214

Nephrostogram 252

Longline 431

PICC - single lumen 727

PICC - double lumen 776

Chest drain 612

Liver bx 537

Balloon dilatation 1,133

Basic package price - with some additional consumables to be charged on a case by case basis

Nephrostomy 977

Ureteric stent 665

Gastrostomy 685

Transjug liver bx 1,811

Ureteric stent change 665

Tace 1,085

IVC filter 2,542

IVC filter retrieval 1,360

TIPSS 1,299

RFA 2,439

RFA cryo 2,623

Atherectomy 2,314

AAA 3,363

Colonic stent 868

PCNL 3,684

Renal artery stenting 1,355

The lead consultant may be able to give advice on an approximate total cost in advance of the procedure being undertaken, this is because the volumes change on a case by case basis.

Cost per case TIPSS venogram POA

PTC POA

Angiogram POA

Angioplasty POA

Fibroid embolisation POA

Embolisation POA

Complex embolisation POA

Biliary stent POA

SIRT POA

For all embolisation treatments the quantity of embolic agent is unknown until the procedure is underway. Additional consumables will therefore vary from case to case and are not predictable.

Prices for all other procedures will be undertaken on a cost per case basis

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Nuclear Medicine Classification of Treatment Notes Tariff

Bone Bone Whole Body with SPECT CT 435

DXA Scan

Bone mineral density scan for osteoporosis 75

Brain Brain perfusion imaging SPECT 577

Brain dopaminergic system imaging 1,016

Cardiac MPS Tf stress gated 515

MPS Tf rest gated 515

Cardiac ventriculography rest (MUGA) 515

Renal Renal DMSA 434

Renogram with diuretic 538

GFR estimation 3 samples 434 Thyroid Thyroid Scan (Pertechnetate) 309 Iodine 123 (Whole Body + SPECT

CT) 509 Thyroid I131 thyrotoxicosis therapy 672 Parathyroid scan SPECT CT 652 Other Liquid gastric emptying study 595 Lung Perfusion Scan (VQ) 540 Lymphoscintigram 661 Radionuclide SeHCAT bile study 929 White Cell Fab Leukoscan SPECT 1,297 MIBG iodine 123 SPECT CT 2,365 Octreotide scan SPECT CT 2,491 Urea breath test 272 Phosphorus 32 therapy 1,192 Blood Volume 464 Lacrimal Scintidacrocystogram 525 Meckels Scan 435 Iodine 131 no drink 272 Iodine 131 (Whole Body + SPECT

CT) 435 Sentinel Lymph node SPECT CT 544

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Terms & Conditions

1.1 General

1.1.1 Please read these terms and conditions below carefully prior to agreeing to undertake treatment as they set out the terms upon which you will be provided with treatment and replace any previous terms and conditions which you may have received.

1.1.2 The tariff applies to private patient admissions from 1 April 2017 to 31 March 2018.

1.1.3 The prices included within this tariff are in the main hospital charges for private patients and do not include the costs of Consultants and Consultant Anaesthetists who will agree charges and bill you directly unless specified otherwise.

1.1.4 All patients are required to sign an ‘Undertaking to Pay’ agreement before an outpatient, day case or inpatient appointment or treatment can proceed. This applies to self paying and overseas patients as well as those with insurance and will cover any unforeseen costs.

1.1.5 No variations to this tariff will be made unless specifically agreed to in writing by the Trust authorised representative.

1.1.6 Patients should ensure that they understand which Universal Charges will be charged in addition to specified treatment costs prior to undergoing treatment as well as the expected costs for high cost consumables and drugs which will be charged.

1.1.7 The Trust is unable to accept responsibility for any personal property lost, stolen or damaged during a Hospital stay or visit and therefore advises that property brought into the Hospital is done so at the owner’s risk.

1.1.8 No clinical treatment is without risk and therefore patients should ensure that they are fully aware of the risks and potential complications arising from treatments prior to undergoing treatments.

1.2 Insurance Companies

1.2.1 The prices listed in the tariff are those which will be billed to insurers by the Trust from 1st April 2017 to 31st March 2018.

1.2.2 A referral of an insured patient to the Trust after 31 March 2017 by the insurer constitutes acceptance of these terms and conditions.

1.2.3 Any signed agreement / contract made between the Trust and the insurer for the provision of Private Patient Treatment to their insured members is made on the basis of this published tariff and any variation to prices contained therein, as agreed in writing.

1.2.4 In the absence of an alternative agreement in writing between the Trust and insurer made by 31 March 2017, the prices contained within this tariff will always apply between 1st April 2017 and 31 March 2018.

1.2.5 The insurer accepts the incorporation of this published tariff and any supporting price schedules referred to in the tariff (i.e. high value drugs costing over £25), into any standard contract for the provision of Private Patient Treatment services by the Trust. The tariff supersedes any listed procedure prices, treatments, procedures, drugs, consumables or other service inclusions or exclusions which may be included in the insurers standard contract.

1.2.6 Where full payment is not made and this has not been agreed in writing between the insurance company and the Trust the Trust reserves the right to collect the shortfall made against these tariff prices by an insurer from the insured patient. The Trust also reserves the right to charge a fee of £25 to the patient, to cover the cost of additional administrative services.

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1.3 Insured Patients

1.3.1 The Trust is recognised by most UK insurers and charges will be recoverable under standard health insurance policies within the individual subscriber’s agreement.

1.3.2 The medical insurance is a contract between the patient and the insurance company.

1.3.3 It is the responsibility of individual patients to obtain confirmation that any benefits will be sufficient to meet the anticipated cost of the treatment prior to hospital admission. Individuals must ensure that their insurance policy will meet the anticipated cost of the treatment to avoid delays as this confirmation will be required prior to the commencement of treatment.

1.3.4 If subsequent to treatment your insurance company does not recognise your claim then you will be personally responsible for payment. In addition should your insurance company refuse to pay a portion of your bill you will be responsible for payment along with any surcharges for additional costs incurred by the Trust.

1.3.5 Patients should also ensure that exclusions and waiting periods are adhered to prior to arranging for treatment to be undertaken, as defined in their policy (GP referral).

1.4 Self pay patients

1.4.6 Patients will also be charged additional amounts for sundry items such as telephone calls.

1.4.7 If you decide not to complete your treatment plan you will be charged in full up to the date of cancellation of treatment at the rates specified in the private patient tariff. If your consultant decides to amend or cancel your treatment you will be reimbursed for any amounts paid in advance at the rates specified in the private patient tariff.

1.4.8 All outpatients will be required to pay prior to the day of attending the appointment or on the day of the appointment prior to the appointment. Inpatient and day case patients will be required to pay a deposit equivalent to the estimated total cost of treatment 7 days prior to admission. All additional charges incurred above the estimated total cost of treatment must be paid prior to discharge.

1.4.9 Patients are required to inform the Cashiers Office on 02381 206058 of any changes to their contact details.

1.5 Cancellations

1.5.1 The Trust reserves the right to charge for cancellations made by the patient as set out below:

Within 7 days of admission/ consultation 50% Between 2 and 7 days of admission / consultation 75% On day of admission/ consultation 100%

1.5.2 The Trust will reimburse the patient who has pre-paid for a treatment or appointment in advance, that has been cancelled by the Trust for reasons deemed unrelated to the patients health.

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1.6 Late Payments

1.6.1 The Trust reserves the right to charge interest at 5% above the Bank of England base rate for any overdue amounts.

1.7 Drugs and Consumable charges

The standard the trust applies for drugs is BNF plus VAT + 15%. The standard the trust applies for high cost consumables is VAT (if applicable) plus 10%. A dispensing fee of £8.50 will be applied per every oral medication dispensed. An Aseptic fee for chemotherapy drugs will be applied according to the complexity of a product that is made. (The cost of diluents and intravenous fluids is included in the cost of the drug).

Documents

Private patient tariff - UHS · Complex e.g. with shell 10 6,359 Palliative treatment package 2 Simple 5 2,868 Complex e.g. with shell 5 3,179 Palliative ... Private patient tariff