TERMS & CONDITIONS
Mr Julian Stevens is a Consultant Ophthalmic Surgeon in London. He aims to provide the best possible care for his patients. These Terms and Conditions are to explain, and for you to understand, what can be expected at Julian Stevens’ private practice.
1 DEFINITION OF TERMS
1.1 “Julian Stevens Private Practice” means Julian Stevens’ Ophthalmic medical practice. This is Oculus Ltd., trading as Mr Julian Stevens private practice.
1.2 “Dry Eye Practitioner” refers to the practitioners who work with Mr Julian Stevens and who provide dry eye advice and treatment and who may be an Optometrist or Ophthalmic Technician. Julian Stevens provides integrated facilities (clinic, treatment, billing and administrative) for the Dry Eye Practitioner to undertake their practice.
2 PROVISION OF CARE
2.1 Mr Julian Stevens as a Consultant is professionally responsible for the care provided to the patient and is bound under obligation to the General Medical Council (GMC) and by the GMC guidance “Good Medical Practice”
2.2 Mr Stevens is registered on the Specialist Register with the General Medical Council. Consultants also undergo an annual appraisal and 5-year revalidation with the GMC and are independently indemnified / insured.
3 OUTCOMES & WARRANTIES
3.1 Whilst most patients for treatments and surgical procedures have extremely good outcomes, there can be individual reasons where outcomes may be less than expected or intended. Mr Julian Stevens will endeavour to provide the best outcome possible, however there can be biological, optical, and physical limitations where a patient’s expectations cannot be met. For this reason, Julian Stevens cannot guarantee outcomes. Julian Stevens does not provide a “money back guarantee” nor a warranty of 100% perfection.
The outcome of medical and surgical care depends on many variables including the patient’s individual response to treatment and surgery. Complications and adverse events can occur for a variety of reasons, including an unexpected response, reaction to medication, inflammation, infection, haemorrhage and possible problem with an implant or medical device. This list is not exhaustive. If further intervention is required for primary treatments, due to a complication of surgery during a package period, most charges are included within the package fee. However, this does not include referral to another Consultant, Dry Eye Spa™ treatment or post-cataract Nd:YAG laser capsulotomy.
If there are charges Mr Stevens will endeavour to minimise any additional costs. After the package period is expired any future ophthalmic condition will be looked at on an individual basis.
In advance of any surgery, Julian Stevens and his office will outline overall risks and specific risks to you where relevant.
3.2 Care outside of the inclusive follow-up period will incur a cost at the prevailing rate for a follow up consultation as per Julian Stevens’ prices at the time of any follow-up consultation or care.
3.3 Care for an eye condition unrelated to surgery will also incur a cost at the prevailing rate for a follow up consultation as per Julian Stevens’ prices at the time of any follow-up consultation or care.
3.4 Where there is no charge invoiced this is at the discretion of Julian Stevens and future rights to charge are reserved.
4.1 Self-Funding (applies to those not intending to claim from insurance)
Consultation fees are typically charged separately from investigations. The cost of the consultation and individual investigations are listed in the most current “Julian Stevens Prices and Procedures” booklet available online and from Julian Stevens and displayed on the website www.julianstevens.co.uk
Julian Stevens understands the worry of patients when it comes to unpredictable healthcare costs. To keep care affordable and transparent to those who are self-funding, Julian Stevens provides package pricing for several conditions. These are reduced bundled prices and include whatever investigations that are felt to be necessary specific to the procedure.
This pricing includes the provision of electronic copies of scans and records as part of UK GDPR regulation at the present time and a regular letter or electronic communication to the patient’s General Practitioner or source of referral. Julian Stevens reserves the right to charge for the provision of further copies of scans beyond this.
4.1.1 As a further commitment to keep pricing affordable, for primary new consultations a maximum fee of £500.00 will be charged irrelevant of the overall number and cost of investigations (excludes visual field tests, orthoptic assessment and procedures). For a second opinion or assessment after previous surgery elsewhere this will be £650.00. For follow up consultations outside the relevant diagnostic bundle, the maximal charge will be £500.00 and as for a new consultation includes the consultation and required investigations.
4.1.2 Full payment of all fees will be required at the time of consultation
4.2.1 Patients are ultimately responsible for the costs of care whether insured or not. Patients have a responsibility to contact their provider to obtain pre- authorisation prior to their consultation if they would like Julian Stevens’ Team to bill the insurance company on their behalf. In the absence of proof of pre-authorisation, patients will be billed fully for the consultation and all investigations and provided with a receipt marked paid. Self-pay reduced bundle pricing does not apply to those intending to be reimbursed by their insurance company.
4.2.2 EXCESS – by asking Julian Stevens to bill on their behalf, patients are providing assurance that there is no excess fee remaining on their policy. If an excess remains, then patients are required to pay Julian Stevens for the consultation and investigations and claim back the balance from their insurance company. An invoice and receipt will be provided.
4.2.3 Full payment of all fees will be required at the time of consultation unless patients have evidence of pre- authorisation. If the insurance company fails to pay the bill within 60 days, the patient or account holder will be liable to pay the balance that is due before being seen for any further appointments.
4.2.4 REQUESTS FOR MEDICAL REPORTS AND COPIES OF TEST RESULTS
Requests for copies of scans and test results require proof of identity, which will normally be the email, Date of birth, or postal name and address originally supplied. Written requests by email or surface mail must be provided by the patient. It is the patient’s responsibility to update Mr Stevens’ team, in writing, if any personal details have changed.
Self-funding patients undergoing surgery will be charged a “procedure package fee”, which is based on Mr Stevens’ procedure fee, any implant(s), the facility fee, anaesthetist fees as well as any ancillary requirements. A lens implant if used is supplied either within the procedure package fee, of for some Premium Lenses, this is supplied from the manufacturer to Structured Light Ltd. Structured Light Ltd. supplies lenses directly for surgery and a Premium Lens additional fee contains two components, the cost of the lens implant (to Structured Light Ltd.) and for additional consultation chair time and possible additional follow-up consultations (Oculus Ltd). The procedure fee also includes a post-operative follow-up period of care which is defined based upon the procedure – please refer to point 6.7 Procedure Terms.
5.2.1 Patients are ultimately responsible for the costs of care whether insured or not. Patients have a responsibility to contact their provider to obtain pre- authorisation for the intended procedure. Patients must also find out the extent of the coverage by their insurance company as there may be a shortfall to pay. Any shortfall is the responsibility of the patient and must be paid.
5.2.2 BUPA™ UK has previously been in dispute over reimbursement and what can be provided for their members with many Consultants for several years. For those with BUPA cover please be aware this does not cover Consultation or treatment with Mr Julian Stevens. BUPA International have no such restriction at the time of review of this document. Other Healthcare Insurers have varying levels of cover for standard and advanced or new procedures and the policy holder should check with Mr Stevens’ office and their insurer once a procedure code is available.
5.2.3 Surgeon fees for insured patients will be billed by Mr Julian Stevens’ team and where applicable shortfalls will be collected on behalf of Mr Stevens.
5.2.4 Insurer Shortfalls depend upon the procedure(s) and the implant(s) used. The amount of shortfall will be determined by the insurer reimbursement the resultant difference payable.
5.2.5 For those wishing to undergo Premium surgery, where there may be a Premium lens implant, refractive management including astigmatism, there will be an additional charge made by Mr Stevens for such a procedure. This fee includes use of the femtosecond laser, management of astigmatism, premium optics lens (supplied by Structured Light Ltd.) and the cost of top-up laser refractive surgery and ongoing investigations if this is needed following surgery.
5.2.6 Julian Stevens’ Team will bill the surgeon fee and facility fee to the insurance company where there is an agreement or contract with the insurance company.
5.2.7 In the absence of an agreement with the patient’s insurance company, Julian Stevens’ Team will bill an all-inclusive global fee to the patient like self-funding patients to cover all costs along similar terms.
5.2.8 The anaesthetist where required will bill a separate fee directly to the patient or insurance company. The patient will ultimately be liable for the anaesthetist’s fee and any shortfall.
5.2.9 Some insurance companies (e.g., Aviva) will not pay for an anaesthetist unless there are special circumstances which will require pre-approval. In the absence of pre-approval, patients who wish to receive intravenous sedation monitored by a Consultant Anaesthetist will be required to pay for a separate charge. Julian Stevens’ Team will bill for this on a separate invoice on behalf of the consultant anaesthetist.
5.2.10 Post-operative consultations are important following surgery. The consultations and investigations will incur a charge. Insured patients are responsible for finding out to what extent their insurance company covers postoperative consultations and are responsible for any shortfall in costs.
6.1 For many patients, having eye surgery is stressful and can cause considerable concern. For this reason, most patients undergo intraocular surgery including cataract surgery under intravenous sedation administered and monitored by a Consultant Anaesthetist.
While sedation for those procedures requiring it, is included in the self-pay global fee care bundle, unfortunately for those who are insured, the anaesthetist must bill for this service separately, usually to the insurance company. However, some insurance companies (specifically Aviva and Simply Health and in the future possibly others) will not pay for sedation unless there is a specific medical reason.
If you would like to have sedation and have a specific reason why, e.g., anxiety, claustrophobia, Parkinson’s disease, significant hypertension, ischaemic heart disease or any other valid reason, you should discuss this with your insurance company and have your GP as an independent and primary care provider certify that this is the case. Your insurance company will need to provide prior approval.
In the absence of such approval if you wish to have your cataract surgery under sedation, this can be provided but there will be an additional anaesthetic charge per surgical case for a single eye and for bilateral surgery. Please inform us well in advance if you would like to have sedation administered so that arrangements can be made accordingly.
6.2 INTERNATIONAL INSURANCE
Julian Stevens regrets that we will not bill international insurance companies on behalf of the patient. For those with international insurance (e.g., BUPA International), a global fee for surgery without itemisation will be charged and needs to be paid for by the patient in advance of surgery. A paid receipt will be provided to the patient for submission to the insurance company.
6.3 INTERNATIONAL PATIENTS
6.3.1 Self-funding patients from overseas will be treated in a similar manner to self-funding patients outlined above.
6.3.2 International patients intending to be reimbursed by their insurance company will be billed for the consultation and all individual investigations and provided with an itemised invoice and paid receipt for submission to their insurance company.
6.3.3 Those requiring a letter for the purposes of obtaining a UK Visa will be required to pay a deposit of £395.00 in advance to cover a new consultation and investigations. Should the consultation be cancelled funds will be returned less a £75.00 administrative charge.
7 PAYMENTS AND DEPOSITS
7.1.1 Deposits are required to guarantee a surgical date.
7.1.2 Deposits for surgery are not refundable for graft tissue (cornea, sclera, amniotic membrane) and lenses that must be ordered in advance of surgery (includes Toric lenses, Implantable contact lenses, special order lenses and bespoke manufactured lenses). Deposits are otherwise refundable if circumstances change, and Mr Stevens and the patient feel that surgery is no longer necessary. Deposits are also refundable less an administrative fee of £75.00 if a patient changes their mind about proceeding.
7.1.3 All outstanding payments or shortfalls are due 5 working days before your surgery date.
7.1.4 Shortfalls from insurers or outstanding invoices are payable within 30 days of the date of the invoice. Late payment will incur interest charges of the Bank of England base-rate plus 8%. Failure to settle a debt after 60 days will then incur additional administrative charges to recover the debt.
7.1.5 Rescheduling surgery: Should surgery need to be rescheduled by the patient, Julian Stevens will, depending on the reasons provided, use their discretion, and keep any additional costs to the minimum.
7.1.6 Cancellation and rescheduling of a consultation and or surgery we understand is necessary for many reasons. However, following two cancellations, to obtain a further booking payment must be made up front. Any further cancellation would result in a 50% non-refundable charge.
8.1.1 Finance including 0% interest is available for selected self-funded procedures. Terms and conditions apply and are subject to change from time to time. Finance options are available for selected self-funded procedures. Full terms and conditions are provided by the financial company (Omni Capital Finance) and are separate to these terms.
9 LASER REFRACTIVE SURGERY ENHANCEMENT
9.1.1 For those seeking vision correction surgery, there are times when the vision may not be as good as expected because of an under or over-correction or change in power in the initial postoperative period. For those where Mr Stevens performed the original treatment, should there be a significant residual correction within the post-operative package period, then a laser enhancement will be provided by Julian Stevens at no further charge. Outside of the package period any further treatment may incur further charges. Where Mr Stevens is performing remedial refractive surgical or laser correction then further treatment may incur further charges. This will be advised on an individual basis.
9.1.2 There are instances when Mr Stevens will prior to initial surgery consider that further laser enhancement surgery is quite likely e.g., where astigmatism may not be fully correctible or if previous laser eye surgery has been performed. This is termed “bioptics”, where there are a staged series of procedures, commonly two or even three procedures. This will be discussed with the patient in advance and the cost of this in advance of surgery will be quoted.
10 PROCEDURE TERMS
10.1.1. The Postoperative Self-Pay Care Bundle will include a period for follow up with Mr Julian Stevens and or his team and may involve a different Consultant. Please see below for the relevant time period.
Cataract & Refractive Lens Exchange - 6 months
Cataract & Refractive Lens Exchange with excimer laser Bioptics - 6 months
Corneal cross linking - 6 months
Implantable Collamer Lenses (ICL) - 6 months
LASIK / surface excimer refractive treatment - 2 years
Excimer laser phototherapeutic keratectomy (PTK) - First two follow-up visits
Corneal transplantation and pterygium - First two follow-up visits
Nd:YAG laser capsulotomy - One follow-up visit
11 SECOND OPINION CONSULTATIONS & THERAPEUTIC TREATMENT AFTER PREVIOUS SURGERY PERFORMED ELSEWHERE
Those who seek a further opinion after previous treatment performed elsewhere commonly require additional scans and assessment. The consultation fee including all scans depends upon complexity and ranges from £650.00 to £500.00.
Therapeutic surgery aiming to improve or correct the optical situation can range from simple to highly complex and may be a series of remedial procedures (bioptics, trioptics). Each procedure is charged separately, or you may be offered a total package price. Therapeutic treatment fees normally include the treatment itself and two follow-up clinic visits. After this each visit is charged separately as a clinic visit / consultation.
12 UNEXPECTED CIRCUMSTANCES
12.1 From time-to-time clinics and operations may need to be cancelled or postponed due to unforeseen circumstances such as illness, technological problems or for other situations that might arise that are out of our control. Julian Stevens will endeavour to do all he can to inform patients of any changes at the earliest opportunity.
12.2 COVID-19 and other respiratory virus testing does not require testing before attending the clinic but if you have symptoms of COVID-19 or there is antigen positivity, then it will not be possible to attend the clinic and any surgery will require rescheduling when recovered. COVID-19 antigen or antibody testing will require your consent.
In clinic and in the treatment facility there may remain restrictions on accompanying persons visiting and due to the rapidly changing situation, please contact Mr Stevens’ office for up-to-date advice. We aim to keep you safe whilst you are with us.
In these circumstances, if cancellation or postponement takes place Julian Stevens will not take financial responsibility for any loss of earnings or additional costs (flights, trains, hotels etc.) incurred by the patient and accompanying persons. Julian Stevens will of course do everything possible to avoid situations where this might arise.
13 EXISTING PATIENTS
13.1.1 Patients seen within 24 months for the same condition will be charged as a follow-up consultation. If a visit is for a completely unrelated and new condition, then this visit will be charged as a new episode and consultation. All consultations more than 24 months after the last consultation will be treated as a new consultation and charged accordingly.
13.1.2 As a world-class eye care provider and Ophthalmic Surgeon, Julian Stevens makes all efforts to exceed patient expectations, both in terms of outcomes and the patient experience. Julian Stevens, and his team strive to provide the best possible outcomes by providing the best patient care through education, team development and technology.
Patients and staff are treated with dignity and respect in a safe and friendly environment.
13 DATA PROTECTION
13.1 Your information in Mr Stevens practice is kept confidential. Treatment facilities are keen to monitor information about activity so wish to have a copy of your medical records. A minimum dataset is required to have surgery performed, such as name, date of birth, any allergies, the procedure to be / performed. You may or may not wish to give permission for transfer of your complete records. You do not have to give permission to transfer more than the minimum dataset / your records.