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Fee Schedule

CIGNA HealthCare is part of the Clinical Coding and Schedule Development (CCSD) group with four other major private insurers. The group was formed to oversee the improvement of coding standards used in the private medical sector. To review the aims and objectives of CCSD please see www.ccsd.org.uk

The key initiative was to develop a common set of codes and descriptions across the industry. Codes have also been brought up to date to more accurately describe modern medical practice. New codes have been added, split or merged, plus significant number have been deleted to reflect the current set of procedures practised for that speciality. The work has resulted in the publication of the CCSD Schedule and our schedule has been produced using these codes.

The CIGNA Fee Schedule contains fair and reasonable maximum fees, based on relativities which reflect such factors as complexity, duration and comparing one procedure with another. Where possible, we have considered information derived from our claims experience and other schedules available in the United Kingdom. We do recognise that due to evolving medical practice, the complexities of procedures may change slowly over time. We do keep our approach to specialist fees under continuous review. This schedule is formally reviewed twice a year and fees can go up as well as down.

All specialists in private practise should advise their patients of the likely costs of treatment proactively. Where professional fees are likely to exceed the CIGNA Fee Schedule limits, patients should be given a written estimate and advised to contact CIGNA before treatment takes place. Surgeon and anaesthetist fees represent a significant element of total private medical insurance claims and as such, have a major impact on premiums. For these to remain affordable, doctors, hospitals and insurers must work together to provide quality healthcare at a reasonable and realistic cost.

Information provided to CIGNA HealthCare by specialists will be processed for the purposes of policy and claims administration and associated activities including payment for your services, maintenance of your provider records and fraud detection and prevention. The data controllers are CIGNA HealthCare.