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Direct Claims for Clients 060421 pdf Flipbook PDF
Direct Claims for Clients 060421 pdf
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Direct Claims for Clients
A direct claim is when an insurance company pays Vets4Pets directly for treatment carried out. To enable us to claim directly from an insurance company they must be able to provide pre-authorisation for treatment. We send your pets clinical records and an estimate for treatment to your insurance company and they assess it to see if it is something they will provide cover for. The reason we like to have this pre-authorisation in place is to ensure that we will receive payment for the treatment and also to give you peace of mind that the treatment is going to be covered so you won’t have an unexpected and potentially large payment to make at the end of treatment. Please be aware not all insurance companies carry out these pre-authorisations and if they do not then we will be unable to set up a direct claim for you. For each pre-authorisation that we submit for you there will be an admin fee. This admin fee also applies to each claim that we submit for you. We will ask for this insurance completion fee to be paid each time you ask us to submit a pre authorisation or claim. This admin fee is for the time it takes for your pre authorisation or claim to be created and submitted and also all the communication with your insurance company regarding that pre-authorisation or claim. If your insurance company are able to provide the pre-authorisation and it is approved then we are able to carry out the veterinary treatment as a direct claim with the insurance company. In order to set up the direct claim we will need some information from you and there will be payment of excesses and admin fees for you to make. We will need a copy of your certificate of insurance and a way of submitting your claim to your insurance company. Please note that some insurance companies use claim forms, some will email a link to us and some have their own portals we need to use to submit claims. If you are unsure how your insurance company processes claims or you need help to obtain a claim form please contact them directly. It is important to have this information before the day of your appointment. On the day of the procedure we will ask you to pay your excess and two claim form completion fees at your admit appointment. Once the initial procedure has been carried
out we will submit the first part of the claim to your insurance company. A second claim for any follow up visits or further treatment will be submitted once the treatment is finished. For conditions that continue after the initial treatment is complete we can arrange for an ongoing direct claim. For these chronic conditions we will a submit claim to your insurance company every three months. This will tie in with your three monthly revisit consults with the vet. Please ensure that you have arranged a claim form or other method of submitting a claim when you attend these appointments. The admin fee will be taken at this time along with any excesses you have to pay. For most policies a new excess will need to be paid each year and if you have a percentage excess on your policy then this will need to be paid each time you come into the clinic. Once we have submitted a direct claim and receive payment from your insurance company we will contact you to let you know if there is a balance to pay or any money to be returned to you. This balance may be due to your policy not covering certain items or charges. We will ask that payment is made as soon as possible. We appreciate that direct claims are very convenient and often mean a pet can have treatment that the owners perhaps couldn’t otherwise afford but please be aware that ultimately the payment of any outstanding vet bills are the responsibility of the owner. Whilst we make every effort to do all the checks possible to ensure the treatment is covered it would be impossible for us to know the terms and conditions of each policy of each insurer in great detail. We advise that you keep track of the cost of your pets treatment, excesses that are due and dates of renewal for your policy. If your pet attends another vet clinic, referral centre or out of hours clinic we will not be aware of costs that have been used there. It would be advisable to request an invoice from each clinic any time treatment is carried out so you are aware of the costs and know when you may be reaching to limit of your insurance policy. If you need any help with this process please contact Vets4Pets Fort Kinnaird on 0131 603 4730.