Insurance Shortfalls

If your insurance policy does not cover the full cost of your treatment, you may receive a letter from Kingsbridge Private Hospital advising you of an insurance shortfall. Shortfalls occur when your insurer doesn’t cover certain treatments or when you exceed a policy limit.

Important Information

Insurance shortfalls can arise for various reasons, including policy limits or exclusions. If you receive a letter from Kingsbridge regarding a shortfall, the outstanding amount will be processed automatically using the payment card you provided for your booking. Your insurer should have informed you about the shortfall, and we advise contacting them directly if you have any questions.

Please note that consultants at Kingsbridge Private Hospital operate independently and may invoice you separately for their services. These invoices may come directly from the consultant or through a third-party billing company. If you receive an invoice from a consultant, please follow the payment instructions provided on that invoice, as Kingsbridge cannot accept payments for consultant invoices.

Why have I received a shortfall bill?
Shortfalls can occur for several reasons:

• You may have exceeded a policy limit for a certain type of treatment.
• Your treatment may not be covered under your policy.
• Your treatment was not pre-authorised by your insurer.
• Your insurer did not receive the required documents for your claim.

What should I do if I disagree with the shortfall?
If you disagree with the shortfall, please follow your insurer’s appeal process. Your payment to Kingsbridge remains due and must be paid in full, but if your appeal is successful, your insurer will reimburse you, or Kingsbridge will refund you.

What if I can’t afford to pay the shortfall?
If paying the shortfall would cause financial difficulty, please contact us to discuss postponing the payment or arranging a new due date.