Private Medical Insurance FAQs

1. How do I book at Pure Sports Medicine if I have private medical insurance? #

For Patients with private medical insurance, you should contact your provider prior to booking in to see one of our clinicians. 

Tell them which service you require and which of our clinics you’d like to attend. They should provide you with an authorisation/​claim code that you can give us when you attend your first appointment. 

Then you can contact our Bookings team or book an appointment online.

2. Will Pure Sports Medicine invoice directly to my insurer? #

If your policy is with one of the major insurance providers that we are covered by we will be able to invoice them directly. You can find a list of insurers that we are covered by on our website. 

3. What information do I need to provide? #

Prior to your first visit, we will request your policy details. This will include:

• the name of your insurance provider
• your policy/​membership number
• your authorisation code and how many sessions that will cover you for

4. Which services are covered under my policy? #

Most of our services are covered, depending on which insurance provider you are with. The main exceptions are Strength an Conditioning, Soft Tissue Therapy, Nutrition and Exercise Physiology. 

To see which services your provider covers click here and download the document for your insurance provider. If you do not see their name, then we are unable to bill to them directly on your behalf. 

5. What happens when I run out of sessions? #

As you come to the end of your allotted sessions, should you need extra sessions, your clinician will write a request for additional treatment and it will be sent directly to your insurance provider. They will then contact you directly and provide you with a new code.

6. How long are my appointments? #

This will be dependant on which of our services you require. For Physiotherapy an initial session will be one hour and follow ups will be half an hour. For Sport, Exercise & Musculoskeletal Medicine Consultant visits an initial appointment will be 40 minutes and follow ups will be 25 minutes. 

For information on any of the other services, we recommend using the chat function on our website. 

7. Is Pure Sports Medicine able to contact my insurer on my behalf? #

Unfortunately, due to GDPR policies we are often not able to get the information we need from contacting an insurer directly. We would always recommend you reach out to your insurance providers directly if you have any queries regarding your policy.

8. What do I do if my insurer asks me for a provider number or a billing code? #

If your insurance provider requests a billing code, speak to one of our reception teams and they will be able to provide this. 

9. What is an excess or a cost-share? #

An excess is the amount that you will contribute towards the overall cost of your treatment. This is triggered when you employ the use of your insurance, or the beginning of your treatment. 

It will either return in an agreed lump sum broken down in to the cost of each appointment until the agreed amount has been reached, or it will be a percentage of each appointment’s invoice.

Each time an invoice comes back to Pure Sports Medicine from your insurer, you are liable to pay this amount directly to Pure Sports Medicine. 

10. How will I know when I need to pay an invoice? #

Your insurer will likely send you an email or a letter confirming the amount you owe. 

We will also send you an invoice via email once we receive it back from your insurance provider. 

11. When is my excess triggered, and how will I know? #

Excess is triggered when you make your first claim, this can be at any point in your policy year depending on when you make your first claim. 

It will reset at the beginning of each policy year and so it is best to make yourself familiar with those dates. 

12. Will there be any other fees? #

There are a number of products that will not be covered by your insurer, this includes Orthotics, Braces and Hand putty. You will only need to pay for these should your treatment require them. Your treating clinician will discuss this with you during your treatment. 

13. What do I do if my insurer rejects an invoice? #

If your insurer rejects an invoice, we will inform you. You are then liable to pay the invoice directly to Pure Sports Medicine.

Should you wish to contest it we can provide you with a paid receipt and invoice which you can take to your insurer. However we are unable to do this on your behalf. 

We recommend that you reach out to them directly should this occur, as we only get a brief summary as to why they have rejected it.