£¾bn debts recovered

By Robin Stride

Consultants in private practice have been saved from huge losses after hiring billing experts who successfully chased and recouped more than £¾bn.

That is the value of the outstanding invoices collected from patients and debtors over the last three decades by financial specialists at Medical Billing & Collection (MBC).

The highest figure retrieved amounted to more than £1m for a clinic and £400,000 for an individual consultant. 

But as the company divulged these figures, published as part of its 30th anniversary celebrations, it warned independent practitioners to be on the alert for a mounting threat of non-payments in the wake of Covid-19.

It warned that some problems were likely to come from an increase in self-pay caused by the growing NHS waiting lists, now consisting of a record 6.1m people.

MBC business director Simon Brignall said: ‘On realising we had passed £750m for our clients, I felt this needed more investigation. Private consultants are still finding that ensuring they get paid for their services is very challenging.’ 

The pandemic has already hit many practices’ finances due to:

  • Unpredictable incomes and problems with outstanding invoices; 
  • Revenue fluctuations resulting from the impact of various lockdowns and restricted access to hospital facilities; 
  • Cash flow problems due to a combination of reasons such as absences of staff employed by the practice and the administration departments of the insurance companies that consultants bill. 

MBC also reported a reluctance among some practices to chase patients during a time of crisis.

Supporting the NHS

It told Independent Practitioner Today another factor was the many consultants whose focus has been on supporting the NHS – at the expense of their private practice. 

Mr Brignall added: ‘While the pandemic has had its own set of unique challenges, there were still well-established trends we have noticed that have been in place for the past ten years. 

‘We partner with many practices that now come to us with 25-30% more outstanding invoices than they did a decade ago. Many now write off 5% or more in bad debts a year, which is ten times the bad debt rate we achieve at MBC. The pandemic has only made this worse.

‘There is now the usual problem around identifying, invoicing and chasing shortfalls and excesses for insured patients, but consultants are facing a raft of other issues. 

‘Staff absences from Covid at any point in the revenue cycle have led to bottlenecks and delays in payments. 

‘Consultants have been reluctant to spend money on adequate infrastructure due to the unpredictability of their incomes over the last two years. 

‘This has meant that, when they reach out to us, many of these problems have been going on for some time.’

Growth in self-pay

Mr Brignall said: ‘Another of the trends we have identified is the growth in the self-pay market. MBC has seen the proportion of self-pay invoices that we raise annually increase by 50% in ten years. 

‘We expect the impact of the coronavirus on NHS waiting lists will only ensure that this trend is enhanced. Practices now need to be able to offer a range of payment options and pathways to accommodate these patients.’ 

He added that new MBC consultant clients, typically billing for about £150,000 a year, were often writing off £5,000 annually and had £25,000 outstanding. 

Asked how consultants reacted to the recovery of their money, he said: ‘One consultant was so delighted he bought a nice new car. The most common and immediate reaction is expressions of genuine relief, especially when they had assumed their money was unlikely to be recovered. 

‘There are stages, though, so after relief comes happiness and comments about what they will do with the funds. However, some express frustration about why they had chosen to leave it so long.’ 

  • See ‘Collecting pearls of wisdom’
  • See ‘Make it easy for patients to pay’