For hospitals
If you treat international patients, some of your claims settled short.
The question is by how much, and whether the difference is worth recovering. A sample review answers both before you commit to anything.
Who this is for
Three kinds of provider.
NHS trusts
Trusts with international patient activity, where overseas insurer settlements sit outside the tariff arrangements the wider organisation is built around, and often outside anyone's remit to question.
Private hospitals
UK private hospitals and groups billing international insurers directly, where settlement shortfalls arrive quietly across many payers and many currencies, and rarely get reconciled claim by claim.
Overseas providers
Hospitals outside the UK treating insured medical travellers, where the insurer is remote, the correspondence is slow, and accepting the first settlement figure has become routine.
The first engagement
A no-cost review of settled claims.
Before any commitment, we quantify the problem. You choose a sample of settled international claims. We review each one against the clinical record and the billed amount, and give you a written account of where the settlements fell short and by how much. If the numbers do not justify an engagement, we say so and return the data. The findings are yours to keep either way.
Common questions
Asked by most finance teams. Answered plainly.
How does the contingency fee work?
The fee is a fixed percentage of recovered value, agreed in writing before work begins. It is only payable on sums actually received by the hospital. If a claim recovers nothing, no fee arises on it. There are no retainers, no hourly rates, and no charge for the initial review.
Who carries out the clinical review?
Clinicians. Each opinion on what care was justified, and whether it was coded correctly, is formed against published clinical standards and coding guidance, documented in the working papers, and referenced to the clinical record. The methodology is set out on the how it works page.
How is patient data protected?
Clinical records sit in the most protected category of personal data, and we handle them to that standard under whichever data protection law governs the engagement, UK GDPR included. A data processing agreement is signed with each hospital before any record moves. Working papers identify patients by initials only, we take only the data the disputed claims require, and everything is returned or destroyed when the matter closes.
What happens if the insurer will not move?
Most matters settle in negotiation, because the file puts a documented clinical position against a settlement figure that usually has none. Where a claim remains unresolved, it can pass to a solicitor through a separate legal entity, with the file already prepared to legal standard. That step is taken only with the hospital's agreement, and the contingency basis holds throughout.
Next step
Put a number on the deficit.
Tell us about your international patient activity and we will arrange the sample review. It costs nothing, and it obliges you to nothing.
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