Make it easy to get the money

This month and for the next two issues of Independent Practitioner Today, Simon Brignall will highlight 30 key areas for practices to consider to overcome their billing and collection challenges. The first ten start here.

Best practice

1 Do the splits

If you split the medical billing from the many other tasks your medical secretary carries out, then you will find it is a real benefit. 

Separating the billing process from the patient’s clinical journey allows your medical secretary to maintain a warm and engaging relationship with the patient, because they are no longer required to make those difficult segues into conversations about money. 

By removing the burden of the billing process, this allows your secretary to respond to any new inquiries or patient queries more effectively – which, in turn, boosts revenue.  

2 Focus on your skills

Many consultants and medical secretaries make the mistake of not focusing on their core skill set: treating patients and growing the practice. 

Just because you can do something does not mean you should. I often meet consultants who are spending their weekends carrying out the medical billing and collection role for their practice. 

This is not a valuable use of their time and experience, which could be much better employed if they opted to conduct an additional morning clinic and by choosing to outsource their billing. 

A medical secretary’s time is better spent efficiently managing patient inquiries than being on hold on the phone with insurance companies or reconciling payments.

Billing companies are not only more experienced in this area but will often add functionality to improve the patient experience and allow the practice to grow.

It’s all in the set-up

3 Boost cash flow

Many new consultants entering private practice find that, due to the reduced re-imbursement levels available to them from insurers, it is even more important to ensure the billing and collection is quick, accurate and efficient. 

They face an array of fixed costs – such as medical indemnity premiums, medical secretary fees and possibly practice management software – but enjoy a distinct advantage in choosing to outsource their billing. 

This is because most billing companies’ fees are calculated against monies received and often billed in arrears. That comes as a welcome relief to the practice cash flow when you start out.

4 Use a medical accountant

Deciding on your practice structure is a conversation that needs to take place with your accountant. This is because the regulations and reporting requirements are subject to change that will dictate which option is best for you. 

These options will include limited company or sole trader status. Some independent practitioners, due to the nature of the services they provide, may be able to opt for a limited liability partnership (LLP) and a good medical accountant will be able to explore these options with you.

5 Group structure matters

Practice groups come in a range of structures and sizes. Groups’ sizes can be organic in nature and their administration needs to be able to accommodate any fluctuations in size. This can often lead to difficult binary decisions around staffing. 

Group structures can include virtual groups, which appear to the patient as one entity but, effectively, they are made up of a loose group of individual practices. 

Other groups have more formal structures such as limited companies or LLPs, with a central bank account where funds and costs are allocated based on an agreed model. 

This means a consultant is paid based on either their activity or their longevity/hierarchy within the group. Some groups are more equitable and choose to make adjustments by granting time off.

We are very experienced with managing all these group structures and can accommodate whatever payment pathways they adopt. 

As we replicate the group structure in our proprietary software, this means that access to their data can be provided at either the group or consultant level. 

Groups by their very nature can suffer from a range of problems that often arise from their volume of activity. 

Pricing can vary between consultants and even by the location where the activity is conducted. This can make them hard to manage unless robust processes are
put in place alongside accurate reporting. 

The devil is in the details

6Fee transparency

Make sure that your patients are aware of your fees up front.

This should also include notification of their liability for any outstanding balances that are not re-imbursed by their private medical insurer. 

This is not only a Competition and Markets Authority requirement but it will also minimise the potential for disputes over payment. 

7 Adopt a patient registration form

Your form should ideally be part of any new patient process in the practice. 

It details all the patient demo-graphics, including mobile number and email address as well as their insurance policy details and authorisation number. 

It can also have disclaimers such as the patient liability discussed above.

8 Have a DNA policy

Did Not Attends (DNAs) are a frustrating fact of life. Some practices we partner with minimise this by asking us to collect money up front for new patients, especially for international patients.

It is important that you decide on your DNA policy and what charges will be applicable if a patient does not turn up or provide adequate notice of cancellation. 

Remember, you need to ensure any potential charge is clearly detailed to your patient as part of your terms and conditions. By having a policy in place, you then have the option on whether you choose to enforce it or not.

Take a time-out to review 

9 Review your fees regularly 

I know from the many conversations I have had over the years that this has always been something that appears to give consultants the most stress. 

It is a very difficult area, both within the insurance market as well as the self-pay sector.

In our experience, consultants typically do not set their prices effectively because they have not done enough research when initially conducting this exercise or because it has been many years since they last looked at them. 

10 Do an annual assessment

Make a habit of annually reviewing your practice, because fees are not the only thing you should examine. 

Access to accurate practice data detailing your activity at the various locations where you practise, or the type of patients you are seeing, allows you to spot trends over time and adjust accordingly. 

It is easy to make assumptions about your practice that do not reflect its true position. This may lead you to open another clinic at a popular location or add functionality to better support a rise in self-pay activity you are seeing.  

Our reporting dashboard at MBC provides reports on the type of procedures a practice is conducting and can track GP referral data. 

This allows a practice to engage with its referral network about new or popular treatments that will benefit their patients. We also conduct a practice review as part of our on-boarding process.

If any of these topics have highlighted areas of concern, I suggest you take steps to address to them.

Simon Brignall (right) is director of business development at Medical Billing & Collection, which is celebrating 30 years of partnering with consultants in private practice