RSA Statement

RE: RSA Statement

patrick murphy — Sat, 19 Dec 2015 12:21:23 GMT

so if we want to refer to a centre of excellence and there is only X left in the insurance kitty, we telephone asking for a price, but then stipulate which company insures them before a quote? and they give us Pet Plan/private fees or RSA fees? ?

RE: RSA Statement

grumpyoldman — Fri, 18 Dec 2015 23:05:41 GMT

I had the list today , we do not refer a great deal but most of the places we use ( on cost grounds ) were not on the lists ,as well as, some of the really expensive asset strippers. I would love to see the actual benchmarking that has really taken place. Practically there have always been some extremely able/brilliant certificate holders out there as well as a few very young diplomates who may appear to lack experience and street credibility resulting in an unhappy disgruntled and laterally mobile client with a recently asset stripped tesco policy. .Practically its out of our control and it has been on the horizon for a while. The only legitimate demands to be made are transparency in the benchmarking and publishing of stats comparing like for like clinical audits .

RE: RSA Statement

Richard Carter — Fri, 18 Dec 2015 16:46:47 GMT

on the human side 'contracted in' means the costs are agreed per procedure between the insurer and the doctors practice, the patient is not required to 'top up' the fees charged; 'contracted out' means the doctor deals with the patient who covers the bill who then recovers what they can from their insurance.

RE: RSA Statement

Bob Russell — Fri, 18 Dec 2015 16:44:17 GMT

I use several referral centres and only one is on the list so far. Charges tend to be fairly in line with each other. Kit Sturgess offers very good value for money, but does not claim to be 24/7.

I am really quite spoilt for choice around here!

RE: RSA Statement

Martin Atkinson — Fri, 18 Dec 2015 16:30:03 GMT

[quote user="Bob Russell"]

What are the savings? I suspect there will be a pretty solid non-disclosure clause in the agreement but someone must be willing to post Anon with where RSA believe the savings will come from.

Discount or bribes?

[/quote]Maybe just from using referral practices that don't charge exorbitant and unnecessary fees?

RE: RSA Statement

Bob Russell — Fri, 18 Dec 2015 16:26:21 GMT

The change in terms starts with new policies and at renewal. If RSA is demanding kickbacks and discounts, it is pretty likely that all referral practices will offer to pay the £200!

What are the savings? I suspect there will be a pretty solid non-disclosure clause in the agreement but someone must be willing to post Anon with where RSA believe the savings will come from.

Discount or bribes?

RE: RSA Statement

Utlendigur — Fri, 18 Dec 2015 15:29:14 GMT

[quote user="Martin Atkinson"]

Do mean veterinary fees insurers? In which case AFAIA it is just More Than and Tesco.

[/quote]

Plus M&S, Argos, Homebase and John Lewis I think.

RE: RSA Statement

patrick murphy — Fri, 18 Dec 2015 15:27:48 GMT

am I the only one (I did ask Arlo) who does not understand how (especially with the insurance form caveats re. normal prices charged) the practices can have a list for RSA and then charge the public or other insurer's more? or has everything now come down for us? inexpensive referrals for all?

RE: RSA Statement

Martin Atkinson — Fri, 18 Dec 2015 15:24:48 GMT

Do mean veterinary fees insurers? In which case AFAIA it is just More Than and Tesco.

RE: RSA Statement

Evelyn Barbour-Hill — Fri, 18 Dec 2015 15:22:52 GMT

I don't know how this is going to work for me. I never enquire whether clients are insured and I'm not going to start doing so.

Could someone give us a list of insurances that are underwritten by RSA?

RE: RSA Statement

Martin Atkinson — Fri, 18 Dec 2015 13:00:12 GMT

[quote user="Bob Russell"]I will not be renewing the RSA insurance for my younger pets (will go elsewhere) and will judge the value for the older ones at renewal.[/quote]I suspect that RSA will find that they are shooting themselves in the foot and vets will (quietly) advise clients not to use their companies. I used to 'recommend' Tesco as one of the better companies but I will advise clients differently now.

RE: RSA Statement

Anthony Dennison — Fri, 18 Dec 2015 12:39:11 GMT

I got a letter from North West Surgeons saying they disagree with the RSA and they are infact going to cover any extra fees that might be incurred.

I like them even more now.

RE: RSA Statement

Richard Carter — Fri, 18 Dec 2015 12:26:00 GMT

I think it is actually now long overdue where the policy has limits per procedure as they do on the human medicine side so if your provider is not going to follow the guideline price (i.e. contracted out), the owner pays the difference.

The blank cheque approach has been abused and I have two clients maxed out of their insurance of 1000's on the investigations, never mind the treatment.

Guess depo and amox la going to make a serious come-back

RE: RSA Statement

Bob Russell — Fri, 18 Dec 2015 11:27:01 GMT

RSA is talking about 'engagement' with the profession (actually BVA/BSAVA/RCVS) and an email from BVA states this should not be taken as compliance or acceptance.

Once again the fragmented profession and lack of a strong voice from anyone means RSA can introduce whatever they wish. Preferred centres are allowing them to get away with this! The more the profession gives, the more RSA will take. I will be changing my policy at renewal (to NFU) and will continue to advise clients go where I feel is best!

RE: RSA Statement

grumpyoldman — Thu, 17 Dec 2015 17:22:50 GMT

Did anyone seriously think that these people were going to listen to the BVA/BSAVA/RCVS ?.

RE: RSA Statement

Bob Russell — Thu, 17 Dec 2015 09:46:23 GMT

Demanding an extra £200 from a client to use a non-network centre seems to go against everything RSA stated it would do!

They gave the impression that they were helping clients by keeping costs down and savings would be with the % excess they paid. Clearly honesty is not one of RSA's stronger points!

I will not be renewing the RSA insurance for my younger pets (will go elsewhere) and will judge the value for the older ones at renewal.

Has any insurance holder been notified of any changes to the rules? I certainly haven't!

RE: RSA Statement

Kishor Mahind — Thu, 17 Dec 2015 09:39:26 GMT

What would happen if you use services of a visiting specialist? Say if a TPLO is done in-house by a visiting specialist will RSA consider this as referral outside the network and ask clients to pay £200 for it?

RE: RSA Statement

Hannah Wynne Richards — Thu, 17 Dec 2015 09:16:03 GMT

May or may not be connected. Yesterday morning. I decided to refer a case to my favourite multi-disciplinary referral centre (which isn't on the list) The owner informed the insurence company, but I don't know whether it's part of the RSA group. Next thing, I had a pre-authorization form to fill in. If the insurence company attempt to re-direct the client to another referral centre, I'll be so annoyed that I'll tell the owner to take the policy to a solicitor, with a view to reporting to the Insurence Ombudsman

Wynne

RE: RSA Statement

Claire Fisher — Wed, 16 Dec 2015 19:19:21 GMT

[quote user="Arlo Guthrie"]

Incidentally, my reaction when I saw the latest update was

a) well, it may be the case that the pet owner has to cough up an extra £200 to go outside the network (stress may, because that is the word RSA used, suggesting a degree of flexibility if there were valid reasons for doing so). I thought this didn't sound too exorbitant (though of course I understand that is an awful lot of money for some).

b) Well, at least there is a decent showing of Specialists / Diplomates now.

[/quote]

I know of at least one referral centre (North West Surgeons) who have said they will pay the £200 for the client if necessary.

RE: RSA Statement

Mark Hedberg — Wed, 16 Dec 2015 15:08:06 GMT

[quote user="David Mills"]

I agree with Atko on this, the profession has to an extent brought it on themselves with asset stripping and tests which whilst nice are not essential. Malcolm Ness has written eloquently on this forum about the abuse of MRI in everything from orthopaedics to neuro, and when I was in private practice the repetition of tests (e.g. biochem at £250 a pop when one had been taken not 24h before) was astounding.

[/quote]

Eloquently put!

RE: RSA Statement

Bob Russell — Wed, 16 Dec 2015 14:57:38 GMT

I tend to refer based on trust. I did change referral centres because they went absolutely to town with every test under the sun. It was an elderly giant breed dog and they came up with a million issues but essentially it had diabetes insipidus which was my suspected diagnosis. Bloods were run again days after a very competent external laboratory had run them.

The insurance fund was decimated and left nothing for treatment which came out of the owners pocket!

I discuss costs and benefits with owners irrespective of who is funding treatment and expect others to do the same. Insurance money is just clients money put into a big pot for a rainy day. The company that organises the pot take a commission.

RSA is losing Tesco Insurance clients by hiking the premiums big time! Heads they win, tails you lose!

RE: RSA Statement

Anthony Todd — Wed, 16 Dec 2015 14:00:38 GMT

[quote user="David Mills"]I'm uncomfortable with 'professional relations'. It is nebulous, subjective and open to abuse on both sides.[/quote]

I think that this is a theoretical discomfit rather than a practical one.

My experience with referrals and their success or otherwise was variable by any measure and had no connection with fees or post-grad qualification.

I tried to use the place which fixed the animals best, and was diagnostically sensible [didn't repeat bloods for skins] and diagnostically and therapeutically logical.

I never saw any evidence of abuse financially but the end result could vary enormously and success was not related to fees.

RE: RSA Statement

Arlo Guthrie — Wed, 16 Dec 2015 13:15:30 GMT

Incidentally, my reaction when I saw the latest update was

b) Well, at least there is a decent showing of Specialists / Diplomates now.

RE: RSA Statement

David Mills — Wed, 16 Dec 2015 13:09:31 GMT

[quote user="Anthony Dennison"]It's all about professional relationships though - I refer to certain centres because I know the clinicians, I know how they work and I have a good dialogue with them. [/quote]

I'm uncomfortable with 'professional relations'. It is nebulous, subjective and open to abuse on both sides.

[quote user="Francisco Gomez"]

But are you certain that these preferred centres aren't just going to do the same and suck dry the last penny of the insurance money when given a chance? I guess that if it is a preferred centre and their point is making insurance affordable, there is a chance these centres will have a knowledge of 'how far they can go charging'.

I'm open to opinion and even change my mind, but this seems obvious to me.

[/quote]

Not being party to RSA internal dialogue means none of us know, but I suspect they have assessed their claims over the last, say, 5 years and thought "why is there so much discrepancy between treatment of condition A at centre X and centre Y" (and I suspect surgery where costs can be better anticipated than medicine has been one of the main determinants). They have probably then thought well we're paying out a lot when we could be paying out less. We can set up a network where we will pay a standard price, in return for more work being referred to centres in the network.

It comes down to what centres have been doing in the name of 'gold standard' - another nebulous, ill-defined concept which is eminently abusable. An example. Some centres won't send things home til stitches are virtually due out (£400/day hospitalisation), others discharge the day after. Why should an insurance company pay for the former?

[quote user="Francisco Gomez"]

3rd point

Somehow guessing how much money your client has is not sufficient defence against a RCVS complaint for not offering the best possible service. If (and only if) we consider a Recognised Specialist a better service than that of an advanced Practitioner, referring to a 'preferred' could became a matter of negligence. Note I'm not against the work of Advanced Practioners, not at all, but I think we should be very careful making sure our clients know where we send them and why

[/quote]

This is getting a bit giddy. Doesn't everyone not just ask their clients and then make a decision partly based on that? As far as negligence is concerned, pure poppycock.

RE: RSA Statement

Arlo Guthrie — Wed, 16 Dec 2015 13:07:34 GMT

[quote user="David Mills"]

[quote user="Anthony Dennison"]Currently none in the North West.[/quote]

Hmm may not be the case - St Helens, Chester and Brighouse all listed under Midlands![/quote]

Sorry, my fault, I'm quite good on SW, SE, E and Scotland. But rubbish at where you draw the line between the Midlands and NE/NW.

Have updated story!