An MHM client recently performed a certain surgical episode. The surgery was something he’d done many, many times before with invoices being both sent and paid by various insurance companies.
Pretty standard stuff in other words.
One particular insurance company paid £349 for the procedure. Before sending the invoice I’d checked per normal that this remained the correct fee. It did.
When the remittance arrived from the insurance company I was therefore most puzzled to see the fee had been reduced by £105. It was not a shortfall. It was not an excess. The fee itself had changed to £244. So I re-checked the fee. Sure enough the correct fee was £349. How strange! Then I noticed something.
The anaesthetists fee was £244.
So I called the insurance company concerned and explained my predicament.
The phone went quiet for while but then the insurance company came back on the line and said the immortal “Ooops – I think we got that one wrong”
The surgeon had been paid the aneathetist’s fee and the aneathetist had been paid the surgeon’s fee. No problem, the insurance company can reverse both entries and pay the correct person the correct amount in the next payment run.
MHM had been doing its job – and this is the serious lesson from the tale – always check you have charged the right fee BEFORE you send an invoice and then check you are actually PAID the right fee when funds arrive.
So the MHM client is a happy MHM client.
At least he was until I told him.
It would appear after that particular day’s theatre, he had gone for a bite to eat with the aneathetist concerned. Pleading poverty, the aneathetist had persuaded the surgeon to pay for lunch.
I couldn’t help but smile.
pete@medicalhealthcaremanagement.co.uk
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