Private Medical Insurance (PMI) is an insurance policy designed to cover the cost of accessing medical advice and treatment in the private sector, usually after being referred by a GP, rather than waiting for it to be available on the NHS. There are several companies in the UK market offering policies with differing levels of cover and premiums. Around three quarters of those with PMI have cover for themselves, and sometimes for their families, through a work-place scheme which is referred to as a “benefit in kind” and taxed accordingly. The rest of the PMI market is made up of individuals and their families.
The PPR presents an overview of the recognition statuses the practitioner has with the insurance companies, all of whom are listed within the profile. For those companies with whom they do not have recognition (and who subscribe to The PPR) the practitioner is able to apply to them directly. The details in this section are mainly managed by the insurance companies.
Data elements required for each PMI and their visibility to insurer and hospital organisations:
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NAME |
DESCRIPTION |
INSURANCE |
HOSPITAL |
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Insurer ID |
The unique provider number issued to the practitioner by the insurer when recognition has been granted. |
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Application Date* |
The date the practitioner submits their insurer recognition application. |
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Decision Date* |
The date the insurer updates the recognition status on the system after making its decision regarding the practitioner. |
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Recognition Status |
Status of The PPR application and insurance registration/recognition prior to completion of the setup, which will also reflect the eBilling status once complete. |
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Insurer Fee Schedule |
Confirmation by the practitioner as to whether they will adhere to the insurers' fee schedules. |
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*These fields will not be populated for those practitioners who were recognised by some or all of the PMIs before completing a profile on The PPR.
Red = Mandatory Blue = Conditional Green = Automatically populated