1.1. How to Work Effectively with Insurance Providers

As an orthopaedic consultant in the UK, registering with and accredited by private medical insurers (PMIs) can be a critical step in growing your private practice. PMIs represent a significant share of revenue for private consultants, with some estimates suggesting they account for up to 71% of total revenue. Understanding how to optimise your PMI profiles can ensure you attract and retain more patients while maintaining control of your practice.

Insurance relationships matter more than ever

With PMIs contributing up to 71% of private revenue for some consultants, ensuring you're visible, accessible and appealing to insured patients is crucial. A strategic approach can boost your bookings and help you maintain greater control over referrals.

PMI visibility is a major growth opportunity

Patients with private insurance typically rely on their insurer’s recommendation when selecting a consultant. Often, they’re shown a shortlist of just three options, making visibility on platforms like Bupa Finder and the Private Practice Register (PPR) a competitive advantage. If your information is outdated or incomplete, you may miss out on dozens of potential referrals.

The essentials of a high-impact insurer profile

Make a strong first impression

• Include direct contact details to your practice (not just the hospital)
• Keep details fresh. Recent updates improve your profile’s visibility
• Use keywords patients search for (e.g., "hip replacement surgeon London")

Add patient-friendly features

• Include professional photos and up-to-date credentials
• Embed direct booking links to reduce friction and boost conversions

Highlight what sets you apart

• Showcase special interests, experience and outcomes
• Help patients understand why they should choose you over others
  
  

Preferred Status: Is it worth it?

Being part of a PMI’s preferred or platinum network can significantly boost your visibility and referral volume. But getting there, and staying there, requires meeting specific criteria.

Benefits of Platinum/Preferred Status:

• Increased visibility: Being part of a preferred network may position you as a top recommendation within a patient’s search radius.
• Higher patient volumes: Consultants in higher-ranking networks often receive more referrals due to perceived quality and cost-effectiveness.
• Improved patient experience: PMIs are more likely to promote consultants who provide seamless experiences, such as easy booking and efficient care pathways.
  
  

How insurers assess and rank you

PMIs conduct periodic reviews, usually every 1–2 years, based on several years of data to decide how to increase volume to their “preferred” providers. Understanding what they track can help you proactively align your practice.

Key metrics they monitor

• Complaints received: PMIs track the number of direct complaints against you. They also assess whether these complaints are attributable to you or external factors.
• Billing amounts: Your performance is compared against expected total costs for typical pathways, (such as W4210 Total Prosthetic Replacement of Knee Joint), including consultations, imaging, implants and follow-ups. High resource use may impact your status.
• Clinical practice standardisation: PMIs evaluate whether your clinical activity aligns with evidence-based best practices. Outlier behaviour, e.g. frequent meniscectomies in patients over 40, can raise red flags.
• Billing behaviour: Sticking to the insurer’s fee structure is essential. Exceeding rates or using non-fee-assured anaesthetists may result in losing your “Fee Assured” status.

Practical ways to attract more PMI patients now

Refresh your insurer profiles
Keep them updated with:

• Direct contact info
• Clear specialisation descriptions
• Online booking functionality
• A professional headshot and credentials

Optimise for PMI metrics

• Standardise treatments and optimise pathway costs
• Avoid being flagged as an outlier
• Ensure anaesthetists you use are fee-assured

Tip: If you’re labelled as an outlier, consider challenging the decision. Historically, providing clinical explanations and evidence has been a valid way to address concerns. Although this process may have evolved, it is worth exploring with your insurers.

Explore Preferred Status opportunities

• Review current ranking and insurer network inclusion
• Aim for metrics that unlock platinum or preferred status with your providers
  
  

Add booking links across platforms

• Include booking links not only on PMI profiles, but also your own website
• Ensure the process is quick and frictionless
  
  

Boost online discoverability with ads

• Run targeted Google Ads on your name and speciality
• Link to a fast, mobile-friendly booking page
  
  

Schedule quarterly profile reviews

• Add a recurring task to refresh your profiles, update outcomes and check links
• Small updates can have a big impact on visibility and trust

How Medbelle can help you grow your PMI patients

Medbelle PatientConnect is designed to help consultants:

• Optimise insurer profiles
• Add direct booking tools to key platforms
• Improve visibility and appeal to PMIs
• Align your practice with insurer expectations to protect or grow status
• Capture and convert more insured patients without increasing admin