Independence
How we’re paid, and who doesn’t pay us
You should not have to take this on trust. So here’s the whole commercial structure, including the parts that are awkward for us.
You pay us. No hospital, clinic, surgeon, airline, hotel or insurer pays us anything, at any time, in any form. We take no commission, no referral fee, no rebate and no marketing payment.
Our only income is the flat fee you agree with us before we start work.
Why this matters
Free advice isn't free. It's paid for somewhere else.
Most traditional medical travel companies don’t charge the patient. Their service feels free. It isn’t free. The hospital pays them a commission when you arrive and have treatment.
That arrangement isn’t hidden fraud. Several companies state it openly on their own websites. But it creates a problem that no amount of good intention fixes. The company advising you on which hospital to choose is paid by the hospitals it is choosing between. And it earns nothing at all if the honest answer is that you should not travel.
We’re not saying those people are dishonest. We’re saying the incentive points the wrong way, and you can’t see it from where you’re sitting.
7.5 to 30 percent
Facilitators are typically paid between 7.5 and 30 percent commission by the hospital they refer a patient to
Several independent industry sources Checked 2026-08-19.
Stated as a typical range, not as universal. Commission is the dominant model in this market, not the only one. We say most traditional facilitators, never every company.
Maria K Todd, a long-standing medical tourism consultant, describes hospitals quoting a facilitator a higher price than a local patient pays, with the commission added on top rather than taken out, and puts the padding at roughly 25 to 35 percent for India and Turkey
Maria K Todd, medical tourism consultant Checked 2026-08-19.
This is her account, not our claim. We have not seen contracts. We state the conflict of interest and we do not accuse any hospital.
The whole picture
Every rupee that comes in, and where from.
If you ever find a source of income on this list that we haven't disclosed, we'll refund your fee in full.
Money we do take
Your fee, and nothing else. $349 to $499 for an independent second opinion. $2,500 to $3,500 for full case management. Both indicative, both agreed in writing before we begin.
Money we pay out
We pay the independent specialists a flat professional fee for writing their opinion. The fee is the same whether they conclude that you should travel, or that you should not. They have no share of your case and no interest in the outcome.
This is the single most important detail on this page. A specialist paid per surgery has a reason to recommend surgery. A specialist paid to give an opinion has a reason to give a good opinion.
Money we refuse
Hospital commission. Surgeon referral fees. Rebates on your treatment bill. Marketing payments from providers. Diagnostic lab kickbacks. Airline or hotel affiliate income. Insurance introduction fees.
Some of these would be easy money and completely invisible to you. That’s exactly why the answer is no to all of them.
How the hospital price is set
We ask hospitals for their net price, which is the price without any commission built in for us, because we’re not taking one. You pay the hospital directly for your treatment. We never handle your treatment money and we never mark it up.
Our fee appears as its own separate line in your total, never buried inside a package price.
The uncomfortable part
Being paid by you is a real disadvantage for us.
We may as well say this plainly, because you’ll work it out anyway. Our competitors cost you nothing upfront and we cost you money upfront. At the moment you’re choosing who to talk to, free beats paid. Every time.
We accept that. It’s the price of being able to tell you the truth, including the version of the truth where you don’t need an operation and we make nothing from you beyond the first fee.
What you’re actually buying isn’t information. Information is free and mostly useless. You’re buying advice from someone whose income doesn’t depend on your answer.
One more disclosure
Our medical director is a co-founder. Here's how we handle that.
Dr Gunjan Patel is both our medical director and a co-founder of this company. That is worth telling you about, because it is a conflict of interest if it is handled badly.
So she doesn’t write your opinion. The independent specialists do, and they are paid the same fee whatever they conclude. Her job is to make sure the right clinical question is put to them, and then to explain their answer to you.
We could have kept quiet about her shareholding. Disclosing it is the same principle as everything else on this page.
Who does what
- Independent specialists, external and arm’s length, write the clinical opinion
- They are paid a flat fee, identical whatever they recommend
- They cannot operate on the case they reviewed, and their hospital is not where it happens
- Dr Gunjan Patel frames the question, checks the records are complete, and explains the findings to you
- You and your own doctor make the decision
Read more on the independent second opinion page.
The harder question
A flat fee does not make a surgeon neutral.
It is fair to ask what stops a specialist recommending an operation because they expect to be the one performing it. Paying them the same either way does not answer that, so we answer it a different way.
A reviewer is never the operator
The specialist who reviews your case is never the surgeon who operates on it, and their hospital is not where it happens. So nobody writing an opinion for you stands to gain from the answer being surgery.
It costs us something. We keep a wider bench of specialists than we would otherwise need, and when a patient tells us they liked a reviewer and would like that person to do the surgery, the answer has to be no. We think that is the right trade.
When they disagree, we pay
If your reviewers reach different conclusions, we pay for a further opinion. You do not. A disagreement is the moment a second opinion is worth the most, and charging you again exactly then would be charging you for our own uncertainty.
Reviewers also write separately and never see each other’s conclusions. Agreement between people who have not spoken means something. Agreement after a conversation means much less.
The wider context
India's own rules point the same way.
A registered doctor in India isn’t permitted to give or receive commission for referring or procuring a patient. The rule has been in place for many years.
Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, clause 6.4.1 Checked 2026-08-24.
This corrects an earlier version of our own brief, which cited the NMC Registered Medical Practitioner (Professional Conduct) Regulations 2023. Those were kept in abeyance in August 2023 and later reported as withdrawn. The 2002 regulations are the instrument to cite.
We mention this for context, not to claim we’re the only lawful option. Our model avoids provider paid referral entirely, which is cleaner. But we’re not going to pretend that makes our own structure legally settled. It raises its own questions, particularly around advising patients across borders, and we’re taking proper legal advice on them rather than assuming.
Now you know how we make money. Ask us anything else.
A free twenty minute conversation. If we’re not right for you, we’ll tell you that too.