Make sure to review your record-keeping

Is the financial data about your private practice fit for purpose? Simon Brignall advises consultants to ensure the important area of practice information reflects the needs of a modern private practice.

It is important for all businesses to keep accurate financial records and ensure data published across a variety of platforms is accurate. 

But for consultants working in private practice this can prove quite a challenge on top of the requirements to maintain clinical information about each patient’s treatment.

I have come across many private practices who experienced difficulties in this area resulting in:

 Cash flow problems;

 Lost income;

 HM Revenue and Customs (HMRC) issues;

 Unnecessary problems with patients.

Published private practice information

As private practice information is available to patients across a wide range of platforms, it is easy to lose track of all the sites where this data is stored. Keeping it up to date can prove  challenging.

Consultants often have information about their practice included on the following:

  • Bupa profile or other private medical insurer (PMI) referral platforms;
  • Individual private practice website;
  • Hospital and clinics sites where the consultant practises;
  • Sites for groups – when applicable;
  • Third-party review sites;
  • The Private Healthcare Infor­mation Network (PHIN).

It is important to check all this information is consistent and up to date across all these various sources. 

The information available will be tailored to the site where it is being shown, but should include:

 All the locations where you practice;

 Contact information;

 Pricing policy;

 Payment terms and options.

A review of the practice’s data is often an ideal time to evaluate your pricing structure. It should consider the consultant’s experience, the demand for their services, the location and the consultant’s individual contractual relationships with each PMI. 

Lack of clarity around your pricing policy can lead to patient dissatisfaction and can also mean invoices are raised incorrectly. Invoice errors can result in problems with both patients or insurance companies and income losses. 

Ensuring your pricing is transparent means that the patients are aware of the costs up front and so disputes are less likely.

Patient registration forms

It is best practice to confirm with each patient the practice’s fee structure before treatment, while also making them aware of their responsibility for any liability should their insurance policy not cover the cost of treatment in full. 

This simple step ensures that any ambiguity is removed and can be referred to during any dispute.   

In the commercial world, companies have terms and conditions detailing how the business will conduct its activity with its clients, which forms a contract that can be referred to. In private healthcare, the patient registration form is typically where this area is covered. It is a good idea to ensure that the registration form includes wording covering patient liability.

We find most patients with medical insurance think all the treatment costs are covered, when in many cases there can be an outstanding balance that the patient will be required to pay.

Most patients’ private health insurance is provided through their employer and so they are unlikely to have examined the fine print of the policy. In many instances, the full cost of treatment is not covered in full for a variety of reasons. 

Here are some of the main ones:

  • The patient could have an excess or shortfall under the terms of the insurance policy;
  • The patient has exceeded the benefit limit of the policy;
  • The patient could have a policy with a co-pay clause requiring the patient to pay a percentage of each invoice.

The patient registration form should also inform the patient if the practice has any other commercial terms, such as for non-attendance, commonly referred to as DNA (Did Not Attend) clauses.

Timely invoicing

Patient registration forms are a good way to ensure the practice has all the relevant information to raise an invoice promptly. 

This will include the following information:

 Date of birth;

 Contact details;

 Insurance information.

All successful practices realise how important it is to obtain this information up front, removing the need to chase patients after treatment, which can be both problematic and time-consuming.

Missing data can lead to unnecessary delays, invoices being rejected by insurers and difficulties in chasing patients for payment. This often results in aged debt mounting up for the practice and can mean that the consultant is owed tens of thousands of pounds.

At Medical Billing and Collec­tion, our procedures immediately highlight when data is missing, and steps are taken to resolve the problem as swiftly as possible either internally or with the practice/patient. As with most matters related to billing, the quicker you identify the problem, the more likely you are to resolve it.

Tax implications

Consultants trading as either sole traders or limited companies are required to provide accurate tax reporting either directly to HMRC or via their accountants. 

HMRC is in the process of transitioning its Make Tax Digital initiative, which is currently scheduled to become mandatory in April 2023 for income tax and April 2026 for corporation tax.

This will require the submission of income data on a quarterly basis rather than the current system which allows this to be provided at the relevant accounting year-end.

HMRC says this will enable a more accurate projection of tax that is due, but considering the number of inquiries we have from consultants at their year-end, I think it is fair to assume many practices will find this difficult.

Tax inspectors often target private consultants due to a perception of deficiencies in their record-keeping. A request by a practice’s accountant to improve the quality of the financial information available can often be a reason a doctor is referred to us.

Every practice should be able to produce accurate reports that show the total invoices raised, payments received and its aged debt for a given tax period. 

At Medical Billing and Collect­ion, we supply all these reports directly to our client or their accountant and our clients can access this information via our reporting platform 24/7.


There is no time like the present to conduct a review of all of the data published about your practice and also the financial records that you keep.

It is important to see they are accurate and reflect the current situation; ensure you highlight any issues and then put steps in place to address these.

If all of this is just adding to your workload or you feel you would like to speak to an expert, then one simple solution might be to seek assistance from a medical billing company with years of experience in this area.

Simon Brignall (right) is director of business development at Medical Billing and Collection