Making a claim
Step 1
Ask your GP for an open referral which is a referral for private treatment that doesn’t name the hospital or consultant who will be treating you. It's important you get in touch with us on 0800 404 9454 before attending any appointments so we can make sure that your claim will be covered under your terms and conditions.
Step 2
Call through to your dedicated customer service helpline on 0800 404 9454 and we’ll assess your claim over the telephone wherever possible.
Step 3
Working together, we’ll identify a hospital and specialist which suits you – this will obviously focus on your medical needs but we’ll also look at location and what will work best for you. You choose the hospital and specialist from those identified and we can either send you the details for you to arrange the appointment at a time which suits you, or we can transfer you direct to the hospital there and then.
Mental health pathway
We know that prompt treatment can make a huge difference with physical issues and it’s no different for our mental wellbeing. The mental health pathway is our dedicated claims service which helps you receive support for any symptoms or concerns you have about your mental health, focussed on personalised care that is right for you.
If you'd like to make a claim through mental health pathway there is no need for you to see your GP. For more information on the mental health pathway please see your member guide in the Useful Documents section.
Following the telephone assessment, the therapist will agree on the most appropriate help for you from a range of options which may include self-directed online support, remote talking therapies or assessment by a psychiatrist, if clinically necessary.
For more information on the mental health pathway please see your member guide in the Useful Documents section.
Cancer care
We know that a cancer diagnosis is not the same as many of our claims and as such, have created an expert in-house oncology team to offer you consistency of care and support when dealing with your cancer treatment.
Call through to your dedicated customer service team on 0800 404 9454 who will provide you with some advice on next steps and introduce you to our dedicated claims team, who will help and support you for the duration of your claim.
For more information on the level of cancer benefits on your scheme and how we can help you, please see your member guide.
We also offer expert care throughout your cancer journey and have introduced a range of support services to help you and your loved ones. Further information can be found here (PDF 950 KB) along with our Cancer Care Guide in partnership with Macmillan Cancer Support here (PDF 19MB).
Backtobetter
BacktoBetter is a third party clinical case management service for back, neck, muscle or joint pain (musculoskeletal conditions). It gives you quick and easy access to appropriate support and treatment and aims to help you recover and get back on your feet as quickly as possible.
If you experience musculoskeletal pain or discomfort then you can simply call your dedicated customer service helpline on 0800 404 9454 There's no need to see your GP before calling us.
Providing it's a valid claim, our advisers will arrange for a case manager from our third party clinical provider to contact you at a convenient time, or provide you with a link to our supplier's online portal where you can either book your own appointment at a convenient time for you or complete a digital assessment.
The case manager will determine whether a referral for treatment is necessary. If treatment is not necessary then you'll be given advice on how to self-manage your condition.
If treatment is recommended you may be referred to a physiotherapist approved by the clinical case management provider for treatment and/or to a specialist for further treatment or diagnostic tests as necessary.