If we determine that the patient is a chargeable overseas visitor, we must charge the patient for the NHS care they receive under the government guidance for charging overseas visitors.
If the patient refuses to pay or states that they have no funds available to pay (this is treated as a refusal to pay), in exceptional circumstances we may consider an informal payment arrangement in order to settle the debt. We would seek evidence to support this through income and expenditure analysis and financial evidence, such as bank statements. However, this is at our discretion and is not guaranteed.
By law, we must raise an invoice for all treatment, regardless of an inability to pay.
Overseas visitors with travel insurance will be required to pay for their treatment and then claim back from their insurer on their return home. In some circumstances we can liaise with the insurer, however the patient must provide all of the insurance documents, contact information, and email address as a guarantee of payment.
Treatment is not free of charge based on being provided on an immediately necessary or urgent basis. If it is found that charges apply, these cannot be waived. However, any patient undergoing “immediately necessary” treatment will be reassured that this will not be withheld or withdrawn in the event of the patient being unable to pay, but will still be chargeable.
Tariff and payments
The overseas visitors team is required to ask for an upfront deposit in line with the specialty that the patient has been admitted to. The team may be able to advise the patient what the likely cost of treatment will be, however this is not always possible. All treatment will be invoiced on discharge and any deposits the patient has paid will go towards the final bill. If the bill is more than the deposit paid, a final value invoice will be raised. If the bill is less than the deposit paid, the patient will receive a refund.
All treatment for overseas visitors is charged at 150% of the national tariff in line with government’s NHS Charging Regulations.
Payments will be taken from overseas patients at the earliest opportunity, this may be while you are still an inpatient.
Deceased patients
Where a patient dies without making or completing a payment to the Trust, the debt then becomes recoverable from the deceased’s UK estate. An offer from relatives or another person to meet the debt can be accepted, but will not be actively pursued, unless they signed the ‘undertaking to pay’ form.
Recovery of income
Reasonable measures are taken to pursue overseas visitors’ debt and international debt recovery agencies will be employed.
Patients should be aware that under immigration rules 320, 321, 321A, and 322, a person with outstanding debts for NHS treatment of over £500 that are not paid within eight weeks of invoicing may be denied a further immigration application to enter or remain in the UK.
In the absence of prompt, full settlement or a reasonable repayment schedule, non-clinical information relating to the debt is provided routinely to the Home Office and may be used by the Home Office to apply the above immigration rules. The information will remain active for the purpose of the above rules until the debt is settled. A record of the settled debt will also be retained, both subject to normal limitation periods.
In the event that a person may seek entry to the UK or make an advance immigration application after settling an NHS debt in the previous three months, they are advised to retain and carry evidence of payment for potential examination by Home Office officials as they may be stopped at border force when trying to re-enter the UK.