{
 "id": "getting-a-quote",
 "names": {
  "name": "Getting a quote",
  "aliases": [
   "estimate",
   "cost estimate",
   "package quotation"
  ],
  "said": "Hospitals say estimate. Brokers say quote. Neither word is a contract price unless the paper says so."
 },
 "facets": {
  "stage": "booking"
 },
 "x_order": 4,
 "text": {
  "what": "A provider or an intermediary puts a number on paper. The number is usually a package: a bundle of theatre time, a named number of nights and a set of professional fees, with a list of what falls outside it. What the number excludes is the part that moves.",
  "story": "Published price transparency is rare enough that its absence is the finding. Of 17 Canadian broker websites examined by Penney and colleagues in 2010, 29.4% included specific pricing at all; the other seven in ten invited an enquiry instead.\n\nWhere a duty to quote clearly exists, it is territorial. Directive 2011/24/EU requires that healthcare providers in the Member State of treatment provide \"clear invoices and clear information on prices\" (Article 4(2)(b)). That obligation binds a clinic in Kraków and says nothing about a clinic in Bangkok or Tijuana.\n\n*Inference —* the exclusion list is where a package and a bill diverge, and the divergence is structural rather than deceptive. A fixed price can only be fixed for the predictable part. The implant, the unplanned night, the intensive care bed, the second bag of blood and the histology are the unpredictable part, and they are commonly listed as excluded in the provider's own words. A package that names three nights has priced three nights.",
  "how": "A quote is normally produced from a description of the problem rather than from an examination — records emailed, photographs uploaded, a form filled. It is commonly revised on arrival, after the consultation and the pre-operative tests, and that revision is the first point at which the traveller is already in the country.\n\nThe documentary questions are: whether the paper is an estimate or an offer, what currency and what exchange date, what happens to the price if the operation takes longer or the stay runs over, who is the counter-party named on it, and whether a second procedure found during surgery is billed separately.",
  "today": "As of 16 September 2026 no cross-border standard this project could find requires a quote for treatment abroad to state inclusions, exclusions and the conditions on which it changes. The exclusion lists that do exist are published voluntarily, and the clearest of them sit on hospital package pages rather than on intermediaries' sites."
 },
 "kin": [
  {
   "to": "reading-the-exclusions",
   "as": "The half of the quote that decides what the bill becomes.",
   "rel": "step"
  },
  {
   "to": "choosing-a-facilitator",
   "as": "Who usually issues the quote, and who is paid on it.",
   "rel": "step"
  },
  {
   "to": "the-deposit",
   "as": "The step that turns the number into money already sent.",
   "rel": "step"
  },
  {
   "to": "package-price",
   "as": "The pricing form this step almost always takes.",
   "rel": "term"
  },
  {
   "to": "implant-excluded",
   "as": "The single line most often outside the quoted number.",
   "rel": "risk"
  },
  {
   "to": "the-price-that-isnt",
   "as": "What happens between a quoted package and a discharge bill.",
   "rel": "story"
  },
  {
   "to": "eu-directive-2011-24",
   "as": "The one instrument that obliges a provider to invoice and price clearly, and only inside the EU.",
   "rel": "governed-by"
  }
 ],
 "sources": [
  "s:penney-broker-websites",
  "s:dir-2011-24-chapter-ii"
 ],
 "provenance": {
  "default": {
   "tier": "cited"
  },
  "fields": {
   "text.how": {
    "tier": "tradition",
    "note": "how quotes are produced and revised, as the trade does it"
   },
   "text.today": {
    "tier": "inference"
   }
  }
 },
 "confidence": "high",
 "schema": 1,
 "type": "pathway",
 "region": [
  "global"
 ],
 "updated": "2026-09-16",
 "blurb": "A provider or an intermediary puts a number on paper. The number is usually a package: a bundle of theatre time, a named number of nights and a set of professional fees, with a list of what falls outside it.",
 "region_terms": [
  {
   "key": "global",
   "name": "Everywhere",
   "note": "use for a node that belongs to no one country — a standard, a word, a risk"
  }
 ],
 "kin_out": [
  {
   "to": "reading-the-exclusions",
   "type": "pathway",
   "name": "Reading the exclusions",
   "as": "The half of the quote that decides what the bill becomes.",
   "rel": "step"
  },
  {
   "to": "choosing-a-facilitator",
   "type": "pathway",
   "name": "Choosing a facilitator",
   "as": "Who usually issues the quote, and who is paid on it.",
   "rel": "step"
  },
  {
   "to": "the-deposit",
   "type": "pathway",
   "name": "The deposit",
   "as": "The step that turns the number into money already sent.",
   "rel": "step"
  },
  {
   "to": "package-price",
   "type": "term",
   "name": "Package price",
   "as": "The pricing form this step almost always takes.",
   "rel": "term"
  },
  {
   "to": "implant-excluded",
   "type": "risk",
   "name": "The implant is excluded",
   "as": "The single line most often outside the quoted number.",
   "rel": "risk"
  },
  {
   "to": "the-price-that-isnt",
   "type": "story",
   "name": "The price that isn't",
   "as": "What happens between a quoted package and a discharge bill.",
   "rel": "story"
  },
  {
   "to": "eu-directive-2011-24",
   "type": "rule",
   "name": "Directive 2011/24/EU on patients' rights in cross-border healthcare",
   "as": "The one instrument that obliges a provider to invoice and price clearly, and only inside the EU.",
   "rel": "governed-by"
  }
 ],
 "source_list": [
  {
   "id": "s:penney-broker-websites",
   "kind": "paper",
   "title": "Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites",
   "publisher": "Penney K, Snyder J, Crooks VA, Johnston R. BMC Medical Ethics 2011;12:17",
   "url": "https://bmcmedethics.biomedcentral.com/articles/10.1186/1472-6939-12-17",
   "accessed": "2026-09-16",
   "note": "17 English-language Canadian broker sites, summer 2010"
  },
  {
   "id": "s:dir-2011-24-chapter-ii",
   "kind": "law",
   "title": "Directive 2011/24/EU, Chapter II — responsibilities of the Member State of treatment and of affiliation, Articles 4 to 6",
   "publisher": "legislation.gov.uk, retained text of Directive 2011/24/EU",
   "url": "https://www.legislation.gov.uk/cy/eudr/2011/24/chapter/II/data.htm?view=plain",
   "accessed": "2026-09-16",
   "note": "read for Art 4(2)(b) invoices and prices, 4(2)(c) complaints and redress, 4(2)(d) professional liability insurance, 4(2)(f) copy of the medical record, 5(d) access to records, and Art 6 national contact points"
  }
 ],
 "tiers": {
  "text.what": {
   "tier": "cited"
  },
  "text.story": {
   "tier": "cited"
  },
  "text.how": {
   "tier": "tradition",
   "note": "how quotes are produced and revised, as the trade does it"
  },
  "text.today": {
   "tier": "inference"
  }
 },
 "primary_image": null,
 "tag_facts": [],
 "recognition_facts": [],
 "acclaim": 0,
 "kin_in": [
  {
   "from": "panama-city",
   "type": "hub",
   "name": "Panama City",
   "as": "Quoted in US dollars here, which removes the currency argument and leaves the inclusion list.",
   "rel": "step"
  },
  {
   "from": "san-jose-cr",
   "type": "hub",
   "name": "San José, Costa Rica",
   "as": "In this city that is a form and a telephone call, not a page.",
   "rel": "step"
  },
  {
   "from": "abortion-care",
   "type": "procedure",
   "name": "Abortion",
   "as": "The step at which a resident's price of zero becomes a non-resident's telephone call.",
   "rel": "step"
  },
  {
   "from": "dental-crown",
   "type": "procedure",
   "name": "Dental crown",
   "as": "The step where a crown quote turns out to exclude the laboratory fee.",
   "rel": "step"
  },
  {
   "from": "dhi-hair-transplant",
   "type": "procedure",
   "name": "Direct hair implantation (DHI)",
   "as": "The step at which a technique name becomes a price tier.",
   "rel": "step"
  },
  {
   "from": "hair-transplant-fue",
   "type": "procedure",
   "name": "Follicular unit extraction",
   "as": "The step where a photograph produces a graft number, and the number produces the price.",
   "rel": "step"
  },
  {
   "from": "lasik",
   "type": "procedure",
   "name": "LASIK",
   "as": "The step at which a per-eye price turns into a per-patient one.",
   "rel": "step"
  },
  {
   "from": "phalloplasty",
   "type": "procedure",
   "name": "Phalloplasty",
   "as": "The step where a staged operation has to be added up, because no page adds it up.",
   "rel": "step"
  },
  {
   "from": "root-canal",
   "type": "procedure",
   "name": "Root canal treatment",
   "as": "The step at which by-the-tooth and by-the-hour turn out not to compare.",
   "rel": "step"
  },
  {
   "from": "shoulder-replacement",
   "type": "procedure",
   "name": "Total shoulder replacement",
   "as": "The step a shoulder patient cannot skip, because the package price does not exist.",
   "rel": "step"
  },
  {
   "from": "veneers",
   "type": "procedure",
   "name": "Dental veneers",
   "as": "The step where one tooth becomes ten and the quote multiplies.",
   "rel": "step"
  },
  {
   "from": "acibadem",
   "type": "facility",
   "name": "Acıbadem Healthcare Group",
   "as": "Where the Fiyat Sor button leads, and the step at which a price first exists.",
   "rel": "step"
  },
  {
   "from": "apollo-chennai",
   "type": "facility",
   "name": "Apollo Hospitals, Greams Road, Chennai",
   "as": "Publishes no price; a foreign patient here gets an emailed estimate instead.",
   "rel": "step"
  },
  {
   "from": "clinica-biblica",
   "type": "facility",
   "name": "Hospital Clínica Bíblica",
   "as": "The Presupuestos form is where the price starts existing, and the only place it does.",
   "rel": "step"
  },
  {
   "from": "fundacion-santa-fe",
   "type": "facility",
   "name": "Fundación Santa Fe de Bogotá",
   "as": "With no price published, the estimate after the records are read is the only figure.",
   "rel": "step"
  },
  {
   "from": "heidelberg-university-hospital",
   "type": "facility",
   "name": "Heidelberg University Hospital",
   "as": "No estimate exists until its specialists have read the records, and the hospital says the estimate may move.",
   "rel": "step"
  },
  {
   "from": "liv-hospital",
   "type": "facility",
   "name": "Liv Hospital",
   "as": "A published starting price is where a quotation begins, not where it ends.",
   "rel": "step"
  },
  {
   "from": "max-saket",
   "type": "facility",
   "name": "Max Super Speciality Hospital, Saket",
   "as": "Publishes no price; the quote is an email against a named surgeon and a named stay.",
   "rel": "step"
  },
  {
   "from": "medicana",
   "type": "facility",
   "name": "Medicana Health Group",
   "as": "With nothing published, the quotation is the only price that exists here.",
   "rel": "step"
  },
  {
   "from": "mount-elizabeth",
   "type": "facility",
   "name": "Mount Elizabeth Hospital",
   "as": "The surgeon has rooms in the medical centre and bills separately from the hospital, which is two quotations and not one.",
   "rel": "step"
  },
  {
   "from": "severance",
   "type": "facility",
   "name": "Severance Hospital",
   "as": "Its international centre states it can give an estimated cost before medical consent, which is where the price starts existing.",
   "rel": "step"
  },
  {
   "from": "wooridul",
   "type": "facility",
   "name": "Wooridul Spine Hospital",
   "as": "An estimate on request and no published figure, which is the Korean pattern rather than this hospital's choice.",
   "rel": "step"
  },
  {
   "from": "choosing-a-facilitator",
   "type": "pathway",
   "name": "Choosing a facilitator",
   "as": "The document this party usually issues.",
   "rel": "step"
  },
  {
   "from": "deciding-whether",
   "type": "pathway",
   "name": "Deciding whether to go",
   "as": "Where the price being weighed here turns into a document with exclusions.",
   "rel": "step"
  },
  {
   "from": "reading-the-exclusions",
   "type": "pathway",
   "name": "Reading the exclusions",
   "as": "The number these lists qualify.",
   "rel": "step"
  },
  {
   "from": "second-opinion",
   "type": "pathway",
   "name": "The second opinion",
   "as": "What a hospital's remote opinion usually arrives as.",
   "rel": "step"
  },
  {
   "from": "the-deposit",
   "type": "pathway",
   "name": "The deposit",
   "as": "The number this payment attaches to.",
   "rel": "step"
  },
  {
   "from": "deposit-and-refund",
   "type": "risk",
   "name": "The deposit, and whether it comes back",
   "as": "The step at which the number is given and the conditions are not.",
   "rel": "step"
  },
  {
   "from": "implant-excluded",
   "type": "risk",
   "name": "The implant is excluded",
   "as": "The step at which the headline number is supplied and the device price is not.",
   "rel": "step"
  },
  {
   "from": "advertising-rules",
   "type": "rule",
   "name": "What a clinic may say",
   "as": "The step where the claim meets a number.",
   "rel": "step"
  },
  {
   "from": "s2-route",
   "type": "rule",
   "name": "The S2 route",
   "as": "The step this route removes, by paying at the destination's own tariff.",
   "rel": "step"
  },
  {
   "from": "defiant",
   "type": "org",
   "name": "Defiant",
   "as": "The step where a facilitator like this one enters the story.",
   "rel": "step"
  },
  {
   "from": "case-rate",
   "type": "term",
   "name": "Case rate",
   "as": "The step where a flat figure is handed over without its severity clause.",
   "rel": "step"
  },
  {
   "from": "cycle",
   "type": "term",
   "name": "Cycle",
   "as": "The step where a per-cycle figure is first quoted, usually without its denominator.",
   "rel": "step"
  },
  {
   "from": "package-price",
   "type": "term",
   "name": "Package price",
   "as": "Where a package number is first put in front of a patient.",
   "rel": "step"
  },
  {
   "from": "is-it-cheaper",
   "type": "story",
   "name": "Is it cheaper",
   "as": "The step where a headline number arrives and the device price does not.",
   "rel": "step"
  },
  {
   "from": "the-price-that-isnt",
   "type": "story",
   "name": "The price that isn't",
   "as": "Where the headline number arrives and the excluded lines do not.",
   "rel": "step"
  }
 ]
}