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  • FIRST POST
    • Jujuju
    • By Jujuju 9th Feb 18, 1:46 PM
    • 3Posts
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    Jujuju
    bupa - charging for mole check in 2016 -
    • #1
    • 9th Feb 18, 1:46 PM
    bupa - charging for mole check in 2016 - 9th Feb 18 at 1:46 PM
    Help!
    In 2016 I undertook a health check as part of my private insurance. As part of this check I was referred for a mole check which was also backed by my GP. When I arrived for the mole check I was told I was due to pay 325 for the consultation which I challenged and they said they would look into and chase wit my employer - I had the mole check.


    I called the central Bupa call centre and got an athorisation code which I called into the Bristol office - the central call centre and local bupa offices do not seem to have joined up processes.


    Then after some time my employer was charged for the mole check which they challenged. Now after nearly 2 years I have been sent a payment demand letter.


    I would love some advice on next steps as I feel like I am a victim of poor administration of BUPA and apart from relying on recorded calls [hopefully they have].
Page 1
    • lisyloo
    • By lisyloo 9th Feb 18, 1:52 PM
    • 21,719 Posts
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    lisyloo
    • #2
    • 9th Feb 18, 1:52 PM
    • #2
    • 9th Feb 18, 1:52 PM
    I called the central Bupa call centre and got an athorisation code which I called into the Bristol office - the central call centre and local bupa offices do not seem to have joined up processes.
    Do you still have the authorisation code?

    Do you have times and dates of calls, person you spoke to? (they aren't going to be able to listen to over a years worth unless you can narrow it down).

    Whn I get anything important like this I always record dates/times/names for exactly this reason.

    There are several options

    1) tell them to "sue me"
    2) raise a formal complaint
    3) Ask for a subject access request under the data protection act for all the details on your file (max charge used to be 10 to my knowledge)

    I'd be interested to know how much detail you have as per above questions.
    • Jujuju
    • By Jujuju 9th Feb 18, 1:56 PM
    • 3 Posts
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    Jujuju
    • #3
    • 9th Feb 18, 1:56 PM
    • #3
    • 9th Feb 18, 1:56 PM
    Thank you so much for replying.


    I did keep the autho code and call details for a while - but given the timescales I have got rid of this - I will be able to narrow down the dates though. I think this is why I am worrying because I always keep all of this information but it is such a long time ago...........
    • lisyloo
    • By lisyloo 9th Feb 18, 2:18 PM
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    lisyloo
    • #4
    • 9th Feb 18, 2:18 PM
    • #4
    • 9th Feb 18, 2:18 PM
    I doubt the phone recordings are going to help here unless you have specifics. For example if you could narrow it down to 1 day but there are 20 employees then that's 20 days worth of audio, so would be impossible to find.

    If you suspect it's administrative incompetance and you want to do something to put your mind at rest the you could ask for the subject access request if you are prepared to pay the fee (usual max 10). This is a right under the data protection act. That will show you what information they have and will either back you up completely, or at least you know where you stand going forward. I think that's what I would do.
    • agrinnall
    • By agrinnall 9th Feb 18, 3:02 PM
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    agrinnall
    • #5
    • 9th Feb 18, 3:02 PM
    • #5
    • 9th Feb 18, 3:02 PM
    Do you still work for the same employer? If you do I would get them to make the same response to BUPA that they did previously.
    • Caz3121
    • By Caz3121 9th Feb 18, 4:00 PM
    • 11,153 Posts
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    Caz3121
    • #6
    • 9th Feb 18, 4:00 PM
    • #6
    • 9th Feb 18, 4:00 PM
    hen I arrived for the mole check I was told I was due to pay 325 for the consultation which I challenged and they said they would look into and chase wit my employer - I had the mole check.

    I called the central Bupa call centre and got an athorisation code which I called into the Bristol office - the central call centre and local bupa offices do not seem to have joined up processes.
    Originally posted by Jujuju
    can you confirm if you received the authorisation code before you went for the appointment?
    could the issue be that the pre-authorisation was sought after the treatment?
    IMPORTANT: You must call us to pre-authorise any claim before arranging or receiving any treatment. Failure to obtain pre-authorisation from us means that you will be responsible for paying for all such treatment.
    • seashore22
    • By seashore22 9th Feb 18, 4:22 PM
    • 933 Posts
    • 1,995 Thanks
    seashore22
    • #7
    • 9th Feb 18, 4:22 PM
    • #7
    • 9th Feb 18, 4:22 PM
    can you confirm if you received the authorisation code before you went for the appointment?
    could the issue be that the pre-authorisation was sought after the treatment?
    IMPORTANT: You must call us to pre-authorise any claim before arranging or receiving any treatment. Failure to obtain pre-authorisation from us means that you will be responsible for paying for all such treatment.
    Originally posted by Caz3121
    This is the important question as the op makes it sound like they got the code after treatment, not before.

    My husband has workplace medical insurance through Bupa and has been having treatment for 9 years now. He always has to phone for a pre authorisation code before he attends the next procedure.
    • Jujuju
    • By Jujuju 9th Feb 18, 5:35 PM
    • 3 Posts
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    Jujuju
    • #8
    • 9th Feb 18, 5:35 PM
    • #8
    • 9th Feb 18, 5:35 PM
    Thanks everyone. No I work for a different employer now - although they have been brilliant at providing some advice.
    I hadn't thought about the pre autho - bit - I know when I went onto have treatment the central BUPA team emphasized that - but it was never mentioned to me for this particular session and was arranged via the local office and when I called through with the autho - it didn't seem a problem - there did seem to be of confusion about the process - between the local centre and central call centre. It also seems strange that they tried to charge my employer as well - who have also refused to pay.
    I suppose all I can do is explain the situation and see what they say............bit of a tricky one ...... as it might be a case of their word against mine. Shame though as the actual consultant was very professional as was the central team - the local team just didn't seem well informed.
    Thanks again - really do appreciate the help here.
    • Quentin
    • By Quentin 9th Feb 18, 11:20 PM
    • 35,135 Posts
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    Quentin
    • #9
    • 9th Feb 18, 11:20 PM
    • #9
    • 9th Feb 18, 11:20 PM
    The timescale is irrelevant as creditors have 6 years to start legal proceedings to get paid.

    This does look to be an issue over the "backdated" pre-authorisation, and the TS & CS.

    Check the wording to see if you have any argument that you did comply and if so make your case that the invoice was raised in error.
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