Insurance (PMI)

Private Medical Insurance

Dr Lubel is registered with all the major UK providers of Private Medical Insurance (PMI)

Please read the information below if your private medical insurer is either AVIVA, AXA-PPP or BUPA.

AXA PPP

Please note that we have declined AXA PPP's recent invitation to become "Fee Approved" because we would be forced to accept lower fees than we consider fair.

Consequently we shall become "Fee Limited" and not "Fee Approved". This means that patients will generally have to pay any shortfall.

As a guide there is likely to be a shortfall as indicated below:

Initial consultations - generally a shortfall of between £5 and £90 depending on duration of appointment

Follow-up consultations - generally a shortfall of between £5 and £45 depending on duration of appointment

Inpatient treatment - there is likely to be a shortfall of about £45 per day for each and every day spent in hospital

When you speak to PPP about me you will now be read the following message:

“It is possible that this specialist's fees will not be paid in full by AXA and you may be expected to pay any shortfalls incurred during the length of your treatment with them. This could include fees for consultations, diagnostics and any further treatment provided by them. If you would like us to, we can find you an alternative specialist whose charges will be paid in full. We can even book the appointment for you. Would you like me to arrange that?”

BUPA

Dr Lubel's BUPA provider number is 02843186

Dr Lubel is a "BUPA Consultant Partner" which means that he has agreed to charge within the BUPA schedule of fees (primarily for inpatient care).

There are several issues with BUPA that you need to be aware of because they may result in unexpected charges to you.

BUPA have for some time prevented us from using the code (E000660) for "inpatient consultation" and instead are converting this to the code (20300) for "outpatient consultation". This means that if you are admitted to hospital then the charge for the the initial inpatient consultation may be allocated to your outpatient budget. If you discover that this has happened then please let us know and we will advise you on how to deal with BUPA.

BUPA will usually not authorise an inpatient stay without the consultant having seen the patient first. Therefore when a patient is referred by a GP for urgent admission there will first need to be a consultation. This can take place in consulting rooms (but usually this isn't feasible), in the urgent care centre (where patients are often sent by GPs for admission) or on a domiciliary basis. The patient will need to pay for this consultation (even if they have no outpatient cover) and the fee may be higher than usual for the reason outlined below.

BUPA have a policy of refusing to pay for two "treatments" by a specialist on a single day. Therefore, for example, when a patient is admitted from clinic BUPA will not pay for both the consultation fee and the first day's treatment. Consequently we will not be able to bill BUPA for the first day (and BUPA will not allow us to charge the patient for inpatient treatment) and so we there fore have to increase the consultation fee to take account of the extra time spent admitting the patient and organising their investigations and treatment on the first day.

Finally if your premium is rising year on year please don't blame the consultants whose fees from BUPA have generally not increased over the last 20 years!

AVIVA

Dr Lubel's Aviva provider number is: 100093828

Patients and potential patients of Dr Lubel regularly inform us that AVIVA has advised them that "Dr Lubel has elected not to use the AVIVA scale of fees and that there is likely therefore to be a shortfall to pay".

Whist it is true that he has not signed up to their scale of fees, Dr Lubel has treated hundreds of AVIVA patients over recent years and AVIVA subscribers are virtually never left with a shortfall to pay - other than due to an excess or limit on the policy.

AVIVA have confirmed to Dr Lubel: "We have reviewed your billing practice over the past 3 years and can confirm that there has only been one instance where a policy holder faced a shortfall for proposed treatment."

We believe that AVIVA have a policy to attempt to re-direct patients to other consultants who have agreed to abide by AVIVA's own, much lower than industry standard, scale of fees, and who may not be suitable to the patient's requirement.

We feel that AVIVA are at best being economic with the truth when they tell their clients there is likely to be a shortfall and we would be grateful if you could inform us if this happens to you.