Follow this road map to recovery

Simon Brignall signals the best route to follow to ensure your practice is best placed to benefit from the recovery.

The independent sector continues to benefit from the increased demand from patients wishing to access private healthcare. 

At Medical Billing and Collec­tion, we are pleased to see the growth in the activity conducted by the practices we partner with and, judging by the number of inquiries I am receiving, there are plenty of practices keen to benefit from this recovery.  

As a result of these conversations, I thought it would be useful to provide some simple directions to follow to ensure your practice is also best positioned to benefit. 

Stay in your lane. Make sure you spend as much time as possible focusing on your core skill set.

It seems obvious, but it is important to prioritise seeing and treating patients. If you and your secretary can focus on the medical side of the practice, this will not only benefit your patients but also lead to increases in the revenue for the practice. 

Running a private practice is not easy and many tasks do not fall naturally into a consultant’s skill set or even those of their medical secretary. Take stock and consider what elements of your practice could be outsourced, leaving you and your team to prioritise the clinical side of the practice. 



Queues likely. Make sure your practice is ready to accommodate the increase in demand for your services resulting from NHS waiting lists.

Headlines about NHS waiting lists have always translated to increases in demand for the services of consultants working in the independent sector. 

This typically has meant more self-pay patients. It is important that your practice has the full range of functionality a modern practice needs to service these patients. This includes the ability to invoice these patients electronically and take payment on a 24/7 basis. 



No parking. Avoid unnecessary delays. Make sure your work is invoiced in a timely fashion.

It is only natural that on seeing this increase in demand for their services, most consultants will try to treat as many patients as possible. Not only so they can deliver the urgent care they require, but also to make up for the practice’s lost income. 

This work should be invoiced as soon as possible, as this function not only reflects on the professionalism of the practice, but also ensures you obtain the benefit from your activity and are not just storing up problems for the future.

Some major insurers now enforce time limits for submitting invoices and if you miss the deadline, they will not pay. Late invoices are indicative of poor service to patients. They are a major contributor to their dissatisfaction and often lead to bad debts.

Delaying the patient’s awareness of a shortfall means the patient assumes the invoice has been settled, which can lead to disputes over the bill.

Late invoices sent direct to patients may be ignored by them if they think you are not serious about wanting payment.


Review your fees. It is always important to regularly review your fee structure and so if it has been a while since you have done this, this could be a good time to review your rates for consultations and procedures.

I still come across practices who have not reviewed their prices for many years and even decades.

If you bill your procedures to insurance guidelines, make sure your price list is up to date, as these constantly change and are not always communicated clearly. This means you may be charging less than you could or more than you should. 

I quite often see practices who are still making wrong assumptions that lead to issues with insurance companies, delays in payments and losses in revenue.


Be vigilant. Review the way your work is being billed to ensure you are compliant with the regulations communicated monthly from the Clinical Coding and Schedule Development Group (CCSD).   

If you are taking the time to review your fees, this would also be a good opportunity to check that  you are abreast of the latest CCSD changes and establish if/how they affect your specialty and possibly your income.

Practices commonly make billing errors through being unaware of the changes and so it is important to establish what rules each insurer adopts, as each insurance company can differ.


Clearly signpost relevant Information. Make sure your price policy is clear and that your patients are notified of it before commencing treatment.

All modern practices should have a clear fee structure and payment terms that are both well documented and communicated to their patients. This is a key requirement of the Competition and Markets Authority (CMA). 

Alongside a transparent fee policy, a patient registration form outlining the terms and conditions of the practice can be useful.  

Having terms and conditions will ensure there is no room for ambiguity by laying out responsibilities and methods available for the payment of your medical invoice. And that leads to fewer delays in getting your money.


Police problem payers by having a robust chasing process in place for outstanding invoices.

The past year has highlighted the need to have strong procedures in place to resolve aged debt. But, for these to be effective, they need to be applied on a consistent and continual basis to ensure invoices are paid in full and cash flow improves.

If you do not do this, you will end up regularly throwing money away by adding to the problem.

The vast majority of calls we have received over the last year have been from practices with issues in this vital area, which is why they continued to run high levels of debt. 

Almost every practice which joins us has an outstanding backlog of invoicing going back years. 

Debt levels can typically be over 20% of turnover and sometimes have reached 50% of annual turnover. I am pleased to say we achieve bad debts of less than 0.5%. 

Visibility around problem payers means you can ensure the patient settles any outstanding invoices before you allow them to make their next appointment. 

When we take on a practice’s backlog of outstanding invoices, there are often patients who have built up debt over years, yet the practice has continued to see them.


Dashboard data. Ensure you have key management information on your practice to allow for informed decision-making.

I often speak to consultants who have no minimum access to up-to-date accurate data on their practice. 

But every practice should be able to see the number and income derived from the patients they treat. It needs to be broken down by location, payment type – self-pay, private medical insurer – or individual payment company as well as payment information relating to these invoices. 

Our consultants can access a market leading reporting dashboard that shows all the key performance indicators (KPIs) for their practice. The dashboard also has as range of reports providing financial information at both the summary and granular level, including aged debt and patient activity.

Without access to any of this key data, it is extremely difficult to understand in which direction your practice is going and so it is very easy to make wrong decisions based on outdated assumptions.  


Full speed ahead. Consider whether now is the time to join thousands of other doctors who have outsourced this vital role to a professional billing company.  

Most consultants find the billing and collection side of the practice a challenge to manage and this can often result in unnecessary and consistent financial losses.

Outsourcing could be the best decision you make this year to guarantee your practice benefits from the recovery.

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