What a written quotation should contain

A number in an email is not a quotation.

A quotation states what is included, what is not, and what happens when reality departs from the plan.

Items that must appear

• Initial consultation and any repeat consultations.
• Pre-operative investigations.
• The procedure itself.
• Surgeon and anaesthetist fees, stated separately.
• Theatre and facility charges.
• Implants, devices or prostheses.
• Expected inpatient days and the daily rate.
• Medicines during admission and on discharge.
• Follow-up consultations and for how long.

Items that must be addressed even if zero

• Interpreting services.
• Medical records and report copies.
• Translation of discharge documents.
• Airport transfer if offered.
• Accommodation if arranged by the hospital.
• Administrative or international patient fees.

The exclusions section

• This is the most important part of the document.
• Ask for exclusions to be listed explicitly.
• A quotation with no exclusions section is incomplete.
• Common exclusions are complications, extra days and extra tests.
• Read it before you look at the total.

Complications

• Ask how complications are charged.
• Ask whether intensive care is included or billed separately.
• Ask what a day in intensive care costs.
• Ask whether transfer to another hospital would be charged to you.
• This is where unlimited exposure usually sits.
• A centre that answers clearly is a better centre.

Longer stays

• Ask the daily rate beyond the quoted length of stay.
• Ask what typically causes a longer stay.
• Ask how additional medicines are billed.
• Budget for a longer stay than quoted.
• Recovery rarely follows the brochure exactly.

Package prices

• Convenient, but only as good as their boundaries.
• Ask precisely where the package stops.
• Ask what happens if you need less than the package.
• Ask whether unused elements are refunded.
• Full prepayment carries more risk than staged payment.

Deposits and payment

• Pay only against a formal invoice.
• Pay only into an account in the institution's name.
• Never pay into a personal account.
• Ask the refund policy if you cannot travel.
• Ask whether any portion is non-refundable and why.
• Keep bank confirmations and all correspondence.

Who issued the quotation

• A quotation should come from the treating institution.
• An agency quotation may include an undisclosed margin.
• Ask the hospital to confirm the figures directly.
• Compare the two documents carefully.
• Differences must be explained before you pay anything.

Diagnostic phase costs

• Many trips begin with reassessment, not treatment.
• Ask what the assessment phase alone will cost.
• Ask how long it takes to reach a treatment decision.
• Ask what happens if the centre decides not to treat you.
• Ask whether any deposit is refunded in that case.
• This scenario is more common than people expect.

Non-medical costs to add yourself

• Flights for you and a companion.
• Accommodation for the full stay including recovery.
• Food and local transport.
• Visa and document fees.
• Lost income for both travellers.
• These rarely appear on any quotation.

Currency and transfer costs

• Confirm the billing currency.
• Ask whether the quotation is fixed or exchange-rate linked.
• Ask about international transfer fees.
• Ask how long the quotation remains valid.
• Exchange movement can add a meaningful amount.

Authorising extra spending

• Ask who may authorise additional treatment.
• Ask how you will be informed.
• Ask whether a ceiling can be agreed.
• Nominate a family member who can be contacted.
• Agree this before admission, not during it.

If you have insurance

• Obtain written pre-authorisation before any booking.
• Confirm whether the hospital bills the insurer directly.
• Confirm which fees the policy excludes.
• Keep original invoices for the claim.
• Ask the claim deadline and diarise it.

Getting a second quotation

• Request quotations from two or three centres.
• Ensure each covers the same scope of work.
• Large differences usually mean different scopes, not better value.
• Ask each centre to explain what the others omitted.
• Compare scope first and price second.

Reviewing the final bill

• Request an itemised account, not a total.
• Compare it line by line with the quotation.
• Query anything that was not anticipated.
• Ask for explanations in writing.
• Do not settle items you do not understand.

Ask about cancellation by the hospital

• Dates are sometimes moved by the centre itself.
• Ask what happens to your deposit if they postpone.
• Ask whether they contribute to changed travel costs.
• Ask how much notice you would receive.
• Book flexible travel where the fare difference is small.

Warning signs in a quotation

• A single total with no breakdown.
• No exclusions listed.
• Pressure to pay quickly for a discount.
• Payment requested to an individual.
• Refusal to confirm complication costs.
• Quotation issued by an agency rather than the hospital.

Tax and reimbursement records

• Some jurisdictions allow relief on medical expenses.
• Keep original invoices with full institutional details.
• Keep proof of payment separately from invoices.
• Ask whether certified translations are needed.
• Check the deadline for any claim.

Confirm the total before you travel

• Ask for the quotation to be reconfirmed close to the date.
• Prices and exchange rates move.
• Ask whether the earlier figure still stands.

Keep the paperwork

• Store quotation, invoices and receipts together.
• Photograph everything on the day you receive it.
• Keep correspondence in one thread.
• Retain it for several years.
• It is needed for claims, disputes and tax purposes.

The point to remember

Three things:

1. Read the exclusions before the total.
2. Ask specifically how complications and extra days are charged.
3. Pay only into an account in the institution's name, against an invoice.

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