Healthcare Providers

PruHealth is committed to providing our members with access to high quality, affordable healthcare.

We offer our members full refund for eligible professional fees which means we will never pass on a shortfall in respect of your procedure fees.

However, we regularly undertake benchmarking reviews to identify fees that we believe are reasonable and customary for the service provided and that reflect current clinical best practice and market rates. If we believe that your fees are not in line with these guidelines, we would seek to work with you to agree reimbursement that is mutually acceptable and enables us to continue to offer the best possible service to our members.

The following pages provide further information about our benchmarking exercise, rates for specific procedures and our recognition criteria.

  • Consultant fees

    Find out about fee eligibility, multiple procedure billing guidelines and unbundling rules.

    Please note that some of our fees may have recently changed. To see our reasonable and customary fee for any procedure, please access our search facility here.

    More about consultant fees
  • Good practice

    Our advice on good clinical and financial practice for all consultants and therapists we recognise.

    Read our advice
  • Invoices and electronic billing

    All about electronic billing through Healthcode - or if you'd prefer to invoice directly, find out how to format it, where to send it and who to call if you have questions.

    More about invoicing

Get recognised as a

How we recognise providers

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Find out everything you need to know about our criteria for recognising you as a healthcare provider.

Provider recognition criteria

Search for procedures

Search by procedure code or description, or browse our index.


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