Guide to Consultants

This page is designed to provide Consultant/Specialists with guidance on how we apply the terms of the 'your choice' policy in relation to treatment and fees.

Fee Reimbursement
Surgeons Fees - this is the level of reimbursement for the principal practitioner performing the procedure, which could be a Consultant surgeon, physician, radiologist or anaesthetist. The listed fee will cover all pre and post operative assessments directly associated with a day case or in-patient stay and is also to cover those common variances and complications related to the original surgery or procedure such as:

Bleeding (with the exception of returning to theatre where a further appropriate code may be charged).
Provision of IV fluids and management of medications.
Infection & management of deep vein thrombosis.
Management of catheters and drains.
Removal of sutures and simple wound care.

Anaesthetist Fees – the level of reimbursement for the anaesthetist is to cover a general or regional anaesthetic (including epidurals), the listed fee is to include:

A simple pre-operative assessment.
The induction and maintenance of the anaesthesia, and related life support.
Pain relief post operatively and until discharge.
Intravenous / Central Line Management independent of:
High dependency / Intensive Care / Critical Care up to 24hrs post-operatively.

Epidural for analgesia set up in the period preceding surgery or 24 hours after the surgery will be settled in full according to the listed level of reimbursement.

Local anaesthesia, with or without IV sedation performed by the principal practitioner is covered by code AC100 and will be reimbursed in full in addition to the appropriate procedure code.

Please note: Where a patient requires a separate consultation prior to the admission for surgery, because they have co-morbidities which may need investigating, or discussion as to the type of anaesthesia and aftercare or whether they are suitable for a procedure. Subject to CS Healthcare being notified of the need, this will be covered.

Multiple Procedure Policy
For a single procedure we will pay the 100% customary and reasonable fee according to the required CCSD code and its recognised complexity.

Primary procedure - up to 100% of the listed fee price.
2nd procedure - up to 50% in addition to the primary procedure.
3rd procedure - up to 25% in addition to the primary and second procedure.
For bilateral procedures not identified within a specific CCSD code we will pay 100% of the actual procedure plus an additional 66%.

Critical Care
CS Healthcare policies automatically cover up to 3 days Critical Care following an elected pre-authorised procedure, the first 24 hours being covered within the listed procedure fee, and the further two days can be billed separately. Beyond this period the Managed Care Team at CS Healthcare must be contacted for further advice. They can be contacted on 020 8410 0440.

Other information
'Standby' Fees: These are billed for surgeons and anaesthetist who may need to intervene in an event of an emergency, where appropriate, these fees will be reimbursed according to the correct CCSD code.

Second Consultant: If out of medical necessity there is the need for a second consultant to assist during a procedure, please contact the Managed Care Team for assistance, and consideration for reimbursement can be given. Fees for a surgical assistant are not covered. If a second Consultant is to be present during a theatre time to perform a separate procedure under the same anaesthetic then they will be reimbursed accordingly using the allocated CCSD code.

Where there is no CCSD code appropriate to the procedures / surgery that is required: We are aware that on occasions there might not be a CCSD code appropriate to the procedure or surgery which needs to be performed – in these instances please provide the details to the Managed Care Team, who can be contacted on 020 8410 0440. Where you have a procedure which is likely to be performed on a regular basis and there is not a code you should inform the hospital that you are performing the procedure in, or member of the CCSD group at CCSD Project Office, c/o Westhill Consulting, Amadeus House, Floral Street, London, WC2E 9DP - or via their web site at www.ccsd.org.uk or by email at
ccsd@tribalgroup.com.

Experimental Treatment & Clinical Trials
CS Healthcare policies do not cover experimental treatment, unlicensed drugs or Clinical Trials. We do however cover cases where we would have covered an established procedure, up to a similar financial limit, providing a clear treatment plan is submitted to CS Healthcare, and we have the consent of the patient that they fully understand the nature of their treatment. Please contact the Managed Care Team for further advice on 020 8410 0440.

Payment
CS Healthcare will settle invoices directly to each provider within 28 days of receipt of the invoice by cheque; however, if you prefer BACS transfer we are happy to pay by this method.

To receive payment from CS Healthcare you will need to be recognised by us and added to our provider system. Therefore if you have not already received payments from CS Healthcare, you will have to provide us with a CV outlining your career, including your GMC number, your Consultants post and hospitals to which you have admitting rights; and as outlined above your preferred method of payment, and your billing address.

Co-payments & Excesses
Some CS Healthcare policy holders will have opted for a co-payment or excess arrangement in return for paying cheaper premiums, in a situation such as this any sum which we are not able to pay will be detailed on the payment advice sheet sent by us. The patient will also be sent information on how much to settle with you.

Shortfalls
CS Healthcare makes every effort to avoid our members having a shortfall on the levels of fee reimbursement, Where a fee cannot be paid in full because there is not a reason related to a medical necessity or major complications not normally covered by the surgeons or anaesthetist fees, you will need to liaise with your patient directly for the outstanding sum. We will have informed the policy holder of any shortfall that is their liability.

All CS Healthcare members must contact us prior to any, consultations investigations or treatment to enable us to confirm if benefit is available. They will then receive a Pre-Authorisation Certificate out-lining the terms of their insurance for each procedure they undergo. This certificate clearly states what level of fees we would expect to reimburse for each procedure.

Fresh allegations have surfaced about US spying activities in Europe. The Spanish press are reporting that the National Security Agency may have been monitoring up to 60 million calls in a month. Meanwhile Germany is sending intelligence chiefs to Washington for discussions over the admission that Chancellor Angela Merkel’s mobile phone may have been tapped for a decade. VoR’s Tom Spender reports. - voiceofRussia

Following allegations of mass spying against Germany, France and Italy, it’s now being reported that Spain was also targeted by the Americans, who are said to have secretly monitored 60 million phone calls there in a month.

Spain | On Monday the Spanish government summoned the US ambassador for an explanation and said the spying was “unacceptable between friends”. Martin Roberts, a freelance journalist in Madrid, says there is so far no suggestion that current Spanish government ministers have been spied on – although ministers from previous governments may have been.

And he says most people’s main concern is the continuing recession in the country.

….the crown international affair

Germany | But while reaction in Madrid has been muted, German anger is continuing to mount. Over the weekend new allegations surfaced that the chancellor Angela Merkel’s phone may have been tapped for a decade. And in a rare public statement, America’s NSA denied it had told US President Barack Obama directly that it was eavesdropping on Mrs Merkel.

Mrs Merkel is dispatching intelligence chiefs to Washington to demand more answers. On Sunday, Der Speigel magazine published details of what it said was a sophisticated listening post hidden in an anonymous-looking structure on the roof of the American embassy in Berlin.

The embassy is located in Pariser Platz, within sight of the German parliament and government ministries. The listening post is reportedly able to monitor much of all mobile phone communication in the government quarter. Dr James Boys is an American policy expert at Kings College London.

He says it’s embarrassing for the US but most countries use their embassies around the world to gather data. However, Dr Boys says that in future, host countries may place restrictions upon the locations of foreign embassies over spying concerns. With the list of countries targeted for spying growing almost by the day, pressure is mounting on the US government.

Japan, China | A Japanese news agency has reported that the US asked it for help in monitoring fibre optic cables carrying data to the Asia-Pacific region in a bid to spy on China. Japan is said to have refused, citing legal restrictions and a shortage of personnel. However, US  members of Congress have suggested Germany in particular should not be surprised it is being spied upon because the 9/11 hijackers were able to hatch their plot while living in the north German city of Hamburg.

But James Boys says the spying affair is a “hiccough” in transatlantic relations rather than a long-term crisis. Last week, EU leaders said that US spying activity against friendly countries could damage trust harm and the fight against terrorism.  And Germany and Brazil – which was also targeted – are leading efforts to pass a United Nations resolution condemning excessive spying and invasion of privacy.

Would love, on the windows side, a right click context menu entry kind of like what E has to "open as project"

As an avid activist for a distance of sports, visit many places where people sweat runs out in the service of their health. Zwiedzam them, because I like to watch others tire:) And soon to join them.

I've always been attracted to combat sports. I did so recently a practical review of the styles in which people struggle with each other. And I came across MMA.

Here I saw the hardest. On their faces clearly etched "molluscs are loitering!". Air until dense from the adrenaline.

And in their midst: boss of it all-coach. But, but-he doesn't look like a tough guy. Kind of has a broken nose, but back thinner truck. And somehow calm. Maybe it is the substitute?

Here We Go! The trainer shows the first grip by translating "you catch an opponent for stem, flip it to Bacon, then hold down the handle." I am in shock. What Bacon? What handle? I wasn't expecting this, it will throw the students on the walls, but LEG?!? I think I was right: proxy.

An hour later I had no doubt, however, that the guy is a warrior. Firmly, without hesitation he seemed, by teaching others what he can. He did it at the same time with a lot of respect for the other, carefully listening to what they need. The authority for many a manager could envy.

What's the secret to the authority of the boss? In how it looks? As it says? How much is experienced?

What is the essence of the Manager? What is your essence? Courage in making the decision? Bold vision? Niezłomność policy? Think what You appreciate reports. Or what would you like to be appreciated. And peel it for dating.

Not enough knowledge of management techniques, master. It obviously helps. It is necessary, in order to be effective.

But what really stands out and makes you believable, it's your personal figure. You might want to have something of his, what to keep, even though I do not know what.

What is your essence?

Additional Notes:
http://westhill.pl/Klienci_o_nas
http://westhill.pl/Pieniadze_to_nie_wszystko

OECD urges reforms to avoid era of sluggish growth

The world risks slipping into an era of slower growth and high unemployment unless governments push ahead with sweeping structural reforms, the Organisation for Economic Co-operation and Development warned ahead of this weekend’s talks between G20 finance ministers and central bankers in Sydney.

In a report published on Friday, the Paris-based group became the latest to warn that failure to reform is costing growth. Earlier this month the International Monetary Fund said aggressive reforms could add $2.25tn to the size of the global economy by 2018.

The OECD said the pace of reform had slowed over the past two years. This is leaving emerging economies vulnerable to the tightening of monetary policy as the financial crisis abates, exposing some European countries to persistently high unemployment, it cautioned.

This warning was echoed by the US, which pushed back against the concerns of emerging countries – expected to dominate the G20 talks – over the Federal Reserve’s decision to taper its quantitative easing programme.