Phew! That's a relief.
Taken from Tower Hamlet NHS trust:
Section C: Patients Liable to Settle Charges Personally
3.8 When the Admission Record Form is completed, if it appears from the address that the
patient is from a country without reciprocal arrangements, the Chief Cashier is contacted
by telephone.
3.9 As a method of cross check, when the Admission Record is entered onto the Patient
Management System the software includes a table of countries which will indicate both
on screen and in printed reports patients from countries with no reciprocal
arrangements.
3.10 As soon as possible after notification the Chief Cashier will interview the patient, if
necessary with the assistance of an interpreter.
3.11 A form "NHS Charges to Overseas Visitors" is completed and signed by the person
undertaking to pay for the treatment. This could be someone other than the patient.
3.12 The Chief Cashier then prepares an invoice for submission to the person signing the
undertaking to pay for the treatment.
3.13 Prices are determined by reference to the Trust’s activity price list.
3.14 The income is only bought to account when payment is received.
3.15 Every attempt is made to obtain payment prior to the patient's discharge. Payment can
be made by major credit cards in addition to cheques, sterling and foreign currency. For
foreign currency the rate of exchange is ascertained from the Trust's bankers.
3.16 If payment is not obtained prior to the patient’s discharge an invoice is sent to the given
address requesting payment.
3.17 If payment is not received within one month the Finance Department then follow up with
two further reminders.
3.18 As income is only bought to account when payment is received there is no requirement
to write off any sums not received.
Maybe all NHS trusts are different but surely the person getting the treatment should be told there is a change up front? I'm guessing the only way they wouldn't bill you up front if they were going to bill you would be if you needed the treatment on an urgent basis (not in ER though as that's free)
Also found this from the new guidlines from August 2011Recommended timeline for establishing a patient’s entitlement to free treatment and applying relevant charges
4.21 When a patient is in need of immediately necessary treatment, it may not be appropriate, or possible, to inform them ahead of treatment commencing that charges might apply, nor to secure from them an agreement to pay those charges. Patients who, after baseline questioning (see paragraph 5.20 to 5.28), appear not to have lived lawfully in the UK for the previous 12 months, should be notified that charges might apply at the earliest appropriate opportunity and they should subsequently be interviewed by an OVM to establish this definitively when it is medically appropriate to do so. Patients should not be told by anyone that charges will not apply until this is formally established.
4.22 In circumstances where it is possible and appropriate to assess charges and request payment before or during a course of immediately necessary treatment, relevant NHS bodies should be clear to the patient that treatment will not be withheld or delayed if they do not pay in advance.
4.23 If and when it is established that charges apply, the patient should be informed and presented with a bill for the treatment they have received, but patients who may be in need of further immediately necessary or urgent treatment should not be discouraged from receiving it, even if they indicate that they are unable to pay. In some cases, it may be appropriate not to present a bill until all immediately necessary or urgent treatment has completed, but patients should nevertheless be fully informed about the charges they might face.
4.24 An overseas visitor whose need for treatment after admission from A&E or from a GP referral is not immediate, should be interviewed by the OVM at the earliest appropriate
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opportunity and before a course of treatment commences to establish if they are entitled to free treatment or have to pay.
4.25 However, if it is established that the patient is a chargeable overseas visitor who claims he cannot pay, and this has been done before the patient has seen the clinician, the patient must not then be prevented from going on to see the clinician, since it will be necessary for the clinician to determine what treatment is needed and the level of urgency. Only when a clinician confirms that the need for treatment is non-urgent should treatment be withheld, pending payment.
4.26 When, after this initial assessment, clinicians consider the need for treatment to be urgent, relevant NHS bodies are strongly advised to seek a deposit equivalent to the estimated full cost of treatment during the period before treatment is to commence. If it is not possible to secure payment, treatment should not be cancelled or delayed.
4.27 However, where a clinician considers that a chargeable patient’s need for treatment is non-urgent, further treatment processes, eg putting the patient on a waiting list or booking outpatient clinics, should not be initiated until a deposit equivalent to the estimated full cost of treatment has been obtained. Any surplus which is paid can be returned to the patient on completion of treatment. This is not refusing to provide treatment, it is requiring payment conditions to be met in accordance with the Charging Regulations before treatment can commence.
4.28 When providing immediately necessary or urgent treatment clinicians should be asked to complete an advice from Doctors or Dentists form at Appendix 2 which should then be documented in the patient’s notes and a copy sent to the relevant service/delivery manager.
