Sometimes it can be confusing why an invoice is declined for payment.
The patient arrived for her consultation. She brought her pre-authorisation number too.
An invoice for her consultation and the investigatory procedure was raised.
We were expecting a £200 fee for the consultation and a £75 for the procedure.
Instead, payment was made for the procedure only. Thus the phone call to the insurance company.
The invoice was NOT declined because the insurance company had decreed a consultation fee could no longer be charged at the same time as the procedure.
Nor was it as stated on the remittance that the episode was within 6 months of the previous treatment date.
It was because the patient’s policy did not cover consultations.
There are a number of policies out there like this. Other than asking the patient, they cannot be identified until payment is made.
In any event, the £200 consultation fee was the patient’s liability.
What was more relevant is that the issue was identified and actioned.
Shortfalls/excess can easily build up. Then they are a problem.
When MHM are contacted and asked to report on the performance of a practice, shortfalls/excess are consistently in the top three problems.
Thus MHM was, having checked it all out and sent the invoice to the patient, delighted to be told a few days later the client had received the £200 by BACS into her bank account.