An excellent value for money service.
The first step is for us to carefully study the information that you provide us with via our questionnaire, and often means that we contact you to discuss certain aspects of your claim in more detail.
Unless we believe that there is at least a 70% chance of your claim being successful we will not take it on.
If we believe that the claim is viable we claim for ONGOING FUNDING, we also put in a claim for a REBATE of some care home fees already paid because in the majority of cases patients have qualified for CHC Funding for months, if not years prior to our involvement.
Continuing Health Care claims are extremely complicated, and they are costly to run, and we are sure you will agree that it would be a waste of everyone's time and money to pursue claims with very little chance of success. On average we only accept 50 -60% of applications.
There is no charge for us to analyse the information that you submit on our questionnaire.
If we do believe that there is a good case to answer we ask for a one off fee of £625 plus VAT ( £750 including VAT), this is around the cost of a week's care home fee and it is a contribution towards:
- Getting the patient properly assessed for CHC funding. NHS guidelines state that patients must be assessed "at least annually" for funding, and it just doesn't happen. If the NHS take too long to assess the patient we will apply to send one of our highly qualified, and experienced nursing assessors to visit the patient and conduct an independent assessment. But please bear in mind that this is only possible if the CCG agree to accept our independent expert's findings. Family members are encouraged to go along to the meeting as their views and insights can tell us things that care home records sometimes miss, or do not attach sufficient importance to.
- The cost of obtaining patient's records from the care home.
- The cost of obtaining patient's records from the relevant GP.
- The cost of sending personnel to attend appeal hearings to argue your case (family members are encouraged to attend these hearings).
- The cost of sending personnel to a second appeal hearing at NHS England if required.
- The cost of referring the claim to the NHS Ombudsman if required.
Running these cases is an expensive undertaking for us but asking for a relatively modest contribution towards our costs gives us the confidence that the claimant is serious, and will give us their co-operation when we need it.
WE OBTAIN ONGOING FUNDING, AND REBATES WORTH
TENS OF THOUSANDS OF POUNDS FOR OUR CLIENTS
BUT IF WE ARE NOT SUCCESFUL ON YOUR BEHALF YOU DO NOT PAY US ANOTHER PENNY, WE BEAR ALL OF THE COSTS OF PURSUING THE CLAIM
When we are victorious on your behalf our success fee applies, but in effect you only pay us out of the savings that we negotiate for the patient.
How our success fee is calculated
Only when we are victorious do we charge a success fee.
Not only do we submit a claim for ongoing funding, we also submit a claim for a rebate of some fees that the patient has already paid.
A typical example:
We obtain future funding for the patient at the rate of £800 per week, £41,600 per year. This is the amount that the care home will receive on weekly basis direct from the NHS. The patient, or their family are free to make a top up payment if they wish.
Our success fee would be 30% including VAT, of the amount that the NHS agree to pay the patient for the next 12 months, £12,480 in total.
BUT WE DON'T ASK FOR THE SUCCESS FEE TO BE PAID IN A LUMP SUM
The fee is paid in 26 weekly instalments, so in this example the patient would be paying off our agreed fee at the rate of £480 per week leaving them £320 a week in pocket.
From week 27 onwards our fee would be paid in full and the patient would now be saving £800 per week.
We only charge a fee on monies that we have saved the patient, so if the patient passes away before the 26 weeks have passed weekly instalments are no longer due and we write off any remaining balance.
SO IN THIS EXAMPLE:
After funding is in place if the patient lives for;
Just 6 weeks, their estate would be £1,920 better off, we write off £10,560
Just 12 weeks, their estate would be £3,840 better off, we write off £8,640
Just 20 weeks, their estate would be £6,400 better off, we write off £6,080
After 26 weeks our success fee has been paid in full and the patient retains the full £800 per week. If the patient lives for 12 months after we get funding in place they will be £29,120 better off.
The rebate
In the vast majority of cases we are able to get the funding backdated giving the patient a lump sum payment. This element of our success fee is payable from that lump sum as a one off payment.
On average we get funding backdated by 6 months, so in the above example the patient would receive a refund of £20,800 of which they retain £14,560 after settlement of our success fee.