AXA PPP Healthcare - Are they pulling a fast one on their customers?

Hi All, this month saw the issuing of letter to UK physiotherapits who have recognition with AXA PPP. Now we all know that for many years:

• AXA PPP have not been permitting any new Physio's on their books
• AXA PPP has restricted all consultation reimbursements to 30min sessions
• AXA PPP has restricted the maximum they will pay towards that 30min consultation (gap fees have been allowed unlike BUPA)
• Where AXA know there will be a gap they try to refer the client to someone else where the insurance will cover it all. This is biasing treatment on price alone and not on any meaningful treatment effect to the client.

Well now they are sending letter that ask the physiotherapist

Quote:

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"..If you are able to confirm your agreement in writing to provide treatment at an average episode per patient of less than £300, we will be happy to continue recognising you for benefit purposes, please confirm your agreement in writing to me within the next 14 days.If you are unable to agree to continue to treat our members based on the above average episode cost per patient basis, then we will withdraw your recognition for benefit purposes..."

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Now this seems to me to be AXA PPP restricting the amount that they will pay towards the coverage for their clients for any episode. However rather than saying that to the client, they are making us to agree to never treat their clients for an 'average' of anything more than that. i.e. They are making inform their customers of their policy on benefits. Why should we do this? It's bad PR for them so they are pushing it onto us.

Now I wonder if I have 5 clients, 4 of which are one-off assessments costing £100 and the other is more significant costing £1000. Total cost to AXA PPP of £1400 which is an average treatment cost per episode of under £300. Will this suffice. Are they actually agreeing to that? OR are they putting it that way so they can say to the customer we cover you for a different amount but that they can vary that based on the practitioner who is seeing them and how they have treated other clients.

How can clients be compared. I have such variation in my clinic that treatment time and injury are so varied they cannot be compared. Then to try to compare that amongst the 5-4 PPP clients I have would be even more futile.

I would over others thoughts on this! :eek: