I was at a medical conference recently and one of the speakers – a well-established consultant surgeon and an incredibly safe pair of hands – stated during his presentation that a private surgeon could not charge for inpatient care.
He may well be a safe pair of hands but on that point he was wrong.
After the conference, I had a word and said he was incorrect. It IS possible to charge for inpatient care.
I couldn’t help but suggest to him that the mere fact there was a separate code for inpatient care indicated it could be charged.
Obviously, it may well depend on the insurance company concerned. In principle, however, it is possible to charge.
I knew I was right because I’d actually charged for inpatient care for an MHM client a few weeks earlier.
And the invoice had been paid.
But he wouldn’t budge.
He was right.
I was wrong.
Skip forward a few weeks and I received an email from my consultant surgeon friend confirming that I had been right all along and he had been wrong.
Why is it sad that I had been right?
Because my consultant surgeon friend has been in private practice for well over a decade and he’d NEVER charged for inpatient care.
More significantly though, my friend had not checked each month what could and could not be charged for.
That also begged the question if the fees he was charging had been checked with the same frequency too. He hadn’t so as a favour I checked for him.
The good news is that only 3 of his fees had altered.
The bad news is that one of them had gone up £107 five months earlier yet he was charging the old and lower fee.
Thus it is important not only does a Private Consultant Surgeon need to establish what he can or can’t charge for, it is just as important to check HOW MUCH you can charge for!
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An interesting question asked by a consultant starting her own private practice.
And a question I couldn’t really answer.
What I could do was interrogate, based on a month’s worth of outpatient clinic lists for existing clients, how long established private consultant surgeons allowed for consultations.
A number of different specialisms were covered. They included: three orthopedic surgeons (one foot, one knee, one hand). An ENT surgeon. A gynecologist. A dermatologist A GI surgeon, and an ophthalmologist.
The average time for an initial consultation was 30 mins.
Some were under 20 mins. Some much longer. But the average was 30 mins. To further investigate why I asked each consultant why it took as long as it did?
And got precisely the answer I expected. Some patients required more time to examine, explain and discuss their condition than others. Not one consultant allowed a “maximum” amount of time.
When asked why, for example, they had allocated the length of time they actually had, most made the same comment. It was based on their experience together with the recommendations from colleagues whom they had asked.
To get an understanding from a private insurance perspective, I asked the same question of various insurance companies.
They too shared the view that 30 minutes was about right. All had no fixed time “allowance” for an initial consultation. Two, however, were concerned that one consultant only allowed 20 minutes for an initial consultation.
The same process was followed when the question of follow up consultation was examined.
Unsurprisingly, the time taken for a follow-up consultation was shorter.
The average time taken was 20 minutes. One consultant allocated just 10 mins; another 30 mins.
Yet across the various specialisms, the average was around the 20-minute mark consistently.
Again, insurance companies were asked the same question regarding follow-up consultations. Again there was no fixed time “allowance” for a follow-up consultation.
But the question remains for the consultant setting up her own private practice relevant. Why?
If she had allowed 60 minutes for a consultation, she would see only two patients per hour.
At say £125 per consultation, she would charge £250 per hour.
But if she allowed 20 minutes per consultation, she could see three patients each hour. She would be able to charge £375 per hour i.e. 50% more (£125/£250)
Whilst 60 minutes for a single initial consultation is most likely not required, it is the principle being looked at. The same would prove true of follow-up consultations if the fee were £95 per consultation.
Two per hour = £190 whereas three per hour = £285.
Paradoxically, I have a somewhat pragmatic view as I suggested to the consultant just starting her practice. It is highly unlikely she would have so many patients as to require the question to be investigated as we have done here.
No MHM client, I’m very pleased to say, actually cared how long the consultation took. And that is how it should be. They were only concerned with providing the best medical care and attention they can.
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A little over a year ago, a group of surgeons based in the south west of England contacted MHM. In an effort to reduce a large number of issues with outstanding self-funding debtors, they had decided to ask new self-funding patients to pay for their initial consultation in advance.
I have to say my initials thoughts were this would absolutely stop any issues with self-funders. It would do so for one very unfortunate reason. There would be no self-funders at all because they had refused to pay in advance anyway. The patients went to see other consultants instead.
And that is exactly what happened.
Hence the phone call to MHM with an instruction to establish a process whereby issues with self-funders were substantially reduced but not at the expense of turning patients away.
If you’ve read previous blogs you’ll already know how to process self-funders and the major reasons behind outstanding self-funder debts.
The MHM process does not, and absolutely should NOT, suggest asking the self-funder to pay everything in advance!
It is not the way to solve the problem.
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Following on from yesterday’s post a consultant emailed me regarding his goals for 2018.
We’d known each other for a while. Indeed we had begun speaking when he had not achieved his 2016 goals. Because they were actually wishes. More money. Increased number of patients. Sadly even if they had been specific goals, the chances are he wouldn’t have achieved them anyway. Why?
In any business, 20% of what you do, results in 80 % of your profits. It does not have to be 80/20. It can be 60/40 or 70/30. But the overriding rule is that some things contribute more to a business than others. Flipping that on its head means 80% of what you are doing could only be resulting in 20% of your profits.
That is precisely what the private consultant surgeon was facing.
This consultant had private practicing rights in three different hospitals. On the two days a week he opened his clinics or attended theatre, he drove to hospital A. After this clinic, he got in his car and drove for an hour to Hospital B. Once his clinic at Hospital B was over, he got back in his car and drove for another hour to Hospital C. After that clinic he went home.
He also had a 6-week waiting time to see him at Hospital A.
At the very least, he was driving two hours each day. Once on a Tuesday and once on a Friday.
Which in my view, at his normal hourly rate of £250 per hour, equaled £500 worth of lost revenue. Twice a week equates to £1,000. Looked at another way, 20% of his day was generating him precisely ZERO.
His answer to the question WHY? was met with the standard – “that’s where the patients want to see me”
When the issue was looked at from another angle, however, it transpired the waiting list was highest at the hospital nearest to him. Hospital A. Indeed he saw the fewest patients at hospital C i.e. the one furthest away. He saw a few more patients at Hospital B than at Hospital C but nowhere near as many as at Hospital A. Hospital A incidentally, accounted for 70% of his referrals anyway.
In January 2017, he gave up his practicing rights in hospital C. Fearful of too much change – sensible man – he maintained his rights in Hospital C. The hour he’d saved by not driving to C was used to see more patients at Hospital A. The number of consultations increased. The additional revenue generated was very welcome.
Curiously such was his reputation that patients who would have seen him in Hospital C, drove to see him in Hospital A.
In May of 2017, he gave up practicing at Hospital B. As before he used his “driving time” to see more patients at Hospital A. 70% of his referrals still came from hospital A. But patients could be seen much quicker. That in itself was attracting more patients. No more 6-week waiting list because he had an additional four hours a week to see them.
By the end of October 2017, he was seeing more patients than he had seen during the whole of 2016. He was also making more money.
He had stripped out anything that didn’t contribute to revenue
His targets were more specific. He had achieved his goals. Sort of.
He did not know if he had seen as many patients as he wanted to because he hadn’t set a specific number
He also didn’t know if he was making as much as he should have been because he hadn’t set a specific target.
Which brings us neatly to 2018.
His targets for 2018 as follows:
a 20% increase in the number of consultations held in 2017
a 20% increase in revenue generated during 2017
Now he’s getting somewhere.
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Recently a family member in conjunction with her GP decided an appointment with a private consultant was necessary.
As the family member had private medical insurance through her employer, a phone call was made to the consultant suggested by the GP. It turned out although not an MHM client, the consultant practice manager and I are old friends. So I made the call myself and booked the appointment.
Came as a surprise the next day, for my family member to announce the insurance company had called. They wanted her to see a different consultant. My family member quizzed them for an explanation. Eventually, she was told the second consultant didn’t charge as much as the one she wanted to see. Not a good thing to say. My family member insisted – and had to seriously insist at that – in seeing the consultation of her choice. I quickly found out how much the second consultant charged for an initial appointment. It was indeed less.
Nonetheless, the appointment with the first choice consultant happened and the medical issue resolved.
Two weeks later a letter arrived from my family member’s insurance company stating the consultant had been paid. However, there was a shortfall as the 1st consultant’s fee was higher than that of the second consultant and my family member was required to pay the difference.
The fact that my practice manager friend is pulling her hair out at the moment with the increases in shortfalls she’s seen this year whilst relevant, is not the point.
The point and the stark reality is that the insurance company were using finance as criteria upon which to base the decision which consultant one of their policyholders (my family member) went to see.
And that, I’m sorry, is NOT right.
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Many times I come across a consultant who is having problems getting paid by self-funding patients.
This is often followed by a reference to numerous reminders and sometimes even final demands being sent in vain to the patient. Despite all this, no payment has been received and the invoice remains outstanding. I’ve always found this curious as I have very few problems with self-funding patients.
The reasons my clients don’t appear to suffer as much as their colleagues are threefold.
Firstly, I make sure the invoice that is sent out is absolutely correct. The address is verified with the post office (the address and the postcode is checked against the Post Office “Postcode finder”). This is free and saves me worrying if the details are correct.
Secondly, if the invoice is unpaid after a set length of time I telephone the patient.
Thirdly and finally, I take debit card payments for my clients.
None of the above are exactly rocket science but if you strip down each stage you remove many of the reasons for a self-funding patient not to pay.
If you take each, in turn, starting with validation of the address, this removes the potential for the invoice to be returned undelivered. For example: how confident are you the address quoted is 100% complete and accurate? There are many occasions when an address has been shorted or a digit incorrect used in a postcode. It takes all of 30 seconds to check everything is as it should be. If it is NOT, then the opportunity to get it right presents itself. If you send an invoice out incorrectly addressed, and believe you me I’ve seen.
Permit me to give you an example of something that was actually mailed to me and never delivered recently because the postcode was wrong. It was a digit out. That doesn’t seem to be much of a mistake but it was enough to cause a failed delivery. The first I knew about it was when I called the sender to ask where the expected correspondence was. How many self-funders are going to call and ask where the bill is? Some might but good luck expecting that to help reduce the number of outstanding invoices for self-funding patients.
The second is perhaps the most important of them all.
By actually speaking to the patient two things are pretty much going to happen. You are either going to get paid or you are going to find out why the invoice hasn’t been paid. For example, the patient will either agree to pay there and then or, as in the latter case, explain they are insured, thought the payment would be taken from the debit card swiped upon registration or some other reason. It doesn’t really matter what the reason is. What matters is that I’ve been able to identify a problem. And then sort it.
Sorting it brings us neatly to the third reason my clients don’t suffer from excessive issues with self-funding patients. I take debit and credit card payments for them.
There is a freephone number on the invoices I send out to use if the patient wants to make a card payment. Or in the event, I have to speak to a patient I always ask for a card payment. 99.9% of the population have debit and/or credit cards. Thus the patient is encouraged to clear my client’s account whilst on the phone. Of course, there may be issues such as the patient genuinely believes the hospital have taken payment or the patient wants to check something. Not a problem with any of that save it needs resolving within a maximum of 36 / 48 hours because my client hasn’t been paid.
None of the above is bullying or harassing the patient; quite the reverse in fact. It confirms not only is the consultant a professional but he/she has an equally professional administrative function within the practice.
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Since private medical insurance first began, the number one route by a patient to a consultant surgeon has been the patient’s GP.
Most time the patient will follow the GP recommendation but what if they don’t?
What does the private patient look for in a consultant surgeon?
Ease of access is the most often quoted reason a patient chooses a specific consultant. This is a logical progression from why the patient has private medical insurance originally – because he/she wishes immediate access to a consultant surgeon. Allied to this is the location of the consultant surgeon.
But how does the patient narrow down the search if there are many consultants in a geographic area all of whom are easily accessible?
The patient will look for recommendation from friends and colleagues who have been patients of the consultant.
They will almost certainly check the internet for the consultant’s website. That said, it is not unusual for the patient to check the website only AFTER making an appointment. Further still there is a gender divide with almost 95% of female patients looking at a consultant surgeon’s website but less than 50% of male patients.
However, the story doesn’t end there.
Empirical evidence confirms the first impression of a patient when he/she contacts a Private Medical Practitioner is a big influence on whether the consultant is actually engaged.
It is perhaps significant that one MHM client insists the telephone is answered within 3 rings and enjoys an extremely busy initial patient schedule. A second uses an answering machine service but consequently has a much lower number of initial patient consultations.
So, the patient is looking for ease of access to the consultant, a good reputation and to be managed by the Practice extremely professionally.
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Ever considered what is the most often quoted reason for non-payment by a patient of their excess to the consultant surgeon?
The same reason is quoted over and over again. It’s not “I haven’t got the money” nor is it “I didn’t realise it was so much, Not even “The invoice must have got lost in the post”.
Actually it is…
“I’ve paid it because when I registered at the Private Hospital, they took a swipe of my debit (or credit] card and the fees are taken from that”
That is often quoted to me. Twice last evening in fact.
Why is it always being quoted and should you be suspicious when its said to you?
In answer to the first question, it’s because the patient assumes the bill for your professional services will be “sorted” by the hospital. They genuinely don’t realise that the transaction is between them and you as the Consultant. Clearly the above statement may not be applicable if the patient has purchased a “package” with the Private Hospital.
In answer to the second part of the question, you should not be suspicious.
This is not to suggest the fault lies with the reception staff at the private hospital in any way.
Recently I went with my own partner to a private hospital and as she checked in, it was very clearly explained that her debit card swipe covered the hospital fees if there were any. There was even a sign up to that effect on the wall in front of us. So my partner, as with all private patients, should realise what is covered by the swipe of their debit or credit card.
Yet a few weeks’ later when the invoice arrived from the consultant surgeon she saw, my partner said to me something was wrong.
The hospital had taken a swipe of her card when she attended the consultation. I explained most likely WHY she had received an invoice from the consultant. She, nonetheless, insisted that was wrong because her debit card had been swiped by the hospital. This despite it being explained when she registered what her debit card would and would not cover.
Quite rightly, she called the consultant’s secretary (not an MHM client by the way!) who explained the situation and payment was made by debit card immediately.
Thus he most often quoted reason why payment for an excess invoice has not been made.
“The hospital took a swipe of my debit card when I registered”
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One of the most common remarks I hear from my guys is the number of patients they see in the NHS. They literally have patients queuing up to see them. Such a comment is normally followed by the opposite when discussing a private practice.
This, for me, confirms the absolute difference between the public and private sector.
In the NHS, a consultant surgeon does not have to do much in order for patients to be delivered to them.
In the private sector, the opposite applies.
In the private sector a consultant surgeon, because fundamentally a private practice is a business, MUST attract a patient. He must engage in pro-active marketing.
He must ensure it is known his practice is there. First of all, however, he must comprehensively understand WHY a patient is choosing to go private. It is not merely the case of a patient wanting to be seen private because he or she has private medical insurance.
It is understanding WHY the patient has private medical insurance. I, for one, dispute it is because private care is better than NHS care.
More likely it is because the private patient wishes to be seen quicker.
Even so, a consultant surgeon MUST engage in marketing.
If the patient can be seen at the private practice quicker than at an NHS location but the patient is unaware the private practice exists then all bets are off.
Therefore a marketing plan of some description is an integral part of a private consultant surgeon’s business plan.
And therein lies the reference to the first and absolute cultural difference between an NHS practice and a private practice.
In an NHS practice, patients will be delivered to the consultant surgeon without him even asking.
In private practice, patients will not just be delivered. They have to be attracted to the practice or more accurately to the business.
Note the use of the word BUSINESS for a private practice is a business.
This is not the time to discuss which marketing strategies will and do work best for a private consultant surgeon. This blog is more concerned with highlighting that due to the differences between the NHS and the private sector, a private consultant surgeon has no choice but to have a marketing strategy.
Just as a consultant must have a robust infrastructure to support the business (secretarial support, invoicing, banking, etc), it is equally as important to have a marketing strategy.
Look at it this way, if any business does not have a regular number of customers or clients (in the case of a medical practice PATIENTS) then inevitably the business will not succeed.
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There are only 24 hours in a day. That much is certain.
All of my guys are incredibly busy. I’m amazed at the volume of work they get through in a single day. They are either on-call, doing a ward round or in theatre. Then they have to see their private patients. That explains why most of them call me either very early in the morning or in the evening. One prefers a Saturday morning. It doesn’t bother me. It’s my job to fit in around them and make their life easier.
Recently however I was asked to review the private practice of a consultant who was having serious difficulties generating any cash into his practice. And following my question to his long suffering medical secretary, it didn’t take long to establish why. The question was: what is the biggest problem you have this week. The reply said it all:
“I never get a response to the queries or receive the information I need after I’ve asked Mr Surgeon. He always seems too busy to deal with the things I need”
The situation was despite leaving messages on his phone or emailing him, seldom did Mr Surgeon respond. He was too busy. Yet most of the information the med-secretary needed was fundamental to generating cash into the practice. For example: two clinic lists a week ago (result: no invoices sent out) or remittances from an insurance company (no idea who had or hadn’t paid) or the post Mr Surgeon picked up and put in his bag one day last week (it had cheques from patients in it)
So I sat down with Mr Surgeon and asked him what he thought about it. His response was a classic: “I just don’t have time to deal with all that. My private patients are paying to see me so they must come first”
I agree with him but sadly therein lies the cause of the issue.
The reason Mr Surgeon is having difficulty generating the cash is due to him not dealing with such issues as the missing clinic lists or not passing over remittance advices.
Mr Surgeon needed to make very sure, the support facilities of the practice were dealt with. The word “support” suggests these things can be demoted to a “Too busy to deal with that and they are not that important so I’ll deal with it later” category.
Sadly they can’t.
Eventually they catch up with you. In the case of Mr Surgeon, they were the reason he was struggling to generate cash into his practice.
Mr Surgeon is a very safe pair of hands and the patients love him. He’s a nice guy too. But he needed to change ONE SINGLE THING in the way he works. He needed to put aside no more than 30 minutes every week to make sure he’s covered all his administration too.
So he did.
And within a month Mr Surgeon was pleased to see not only more cash coming in to his business but that he wasn’t being chased by his med-sec so often.
In case you are wondering why I don’t have such issues with MHM clients its because every single week my clients take their post or clinic lists etc scan them to me and promptly proceed to forget about them thereafter.
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A shortened version of a recent conversation with a well established private consultant surgeon.
Very recently one of the major PMI players announced a further reduction in payable fees. Definitely applicable to newly recognised consultants in January 2015, the fee reduction does not apply to those recognised previously. Ot at least it didn’t.
But it does now.
The immediate retort from another very well established MHM client was to pass any reduction on to the patient. That’s all well and good but not if she is fee assured with the insurance company concerned. I actually checked just to be sure. Yep; if a fee reduction is passed on to a patient by a fee assured consultant, the consultants recognition may be put at risk.
None of the above means MHM agrees with insurance companies reducing fees – even though market forces may on occasion be the root cause of such reduction. By all means argue with the insurance company. And I already am.
But…don’t rely solely on that argument and assume the argument fees should not be reduced will be successful. It might. There again it might not.
Instead make sure you are charging the very maximum you can. Make sure you are charging for everything you do. If the surgery takes twice as long as expected, request an uplift fee. If a double consultation is required, charge for a double consultation. Its not as difficult as you may think it is.
And don’t forget to do a sanity check each month. If you think a 20% reduction in fees is bad, consider the 100% reduction if you fail to charge an entire consultation.
Whilst the question of where fees will go will be considered in future blogs, its important before even thinking about your fees to make absolutely sure you are charging the right fee already. You’d be surprised how many aren’t!!!!
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This specific issue comes up frequently when MHM is asked to review the outstanding accounts of a private consultant surgeon.
There are two reasons normally why the patient believes the hospital have taken payment for the consultant:
To overcome this, MHM recommends the client’s invoice bears the message “payment of this invoice is not covered by any debit / credit card details taken by the hospital” To further help prevent the issue arising, MHM recommends that when the patient makes the booking for the initial consultation, he/she is told an invoice will be sent to them after the consultation.
Over the last year, twice MHM has amended the surgeon’s invoice to include the above sentence. In both cases, the number of outstanding self-funder invoices reduced.
To resolve this issue MHM contacts the patient and request they check what was and what was not covered in the package. Payment of the surgeon’s initial consultation fee soon follows as the patient agrees the initial consultation fee is not covered. BUT again when the consultant’s secretary confirms all items with the patient, the patient should have been advised the initial consultation was not covered.
Actually, on this specific point why has the patient been advised the invoice for the initial consultation is still outstanding if appropriate.
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Some consultant surgeons aren’t fully familiar with the fees paid by different medical insurance companies for the same surgical episode. Consequently, they actually undercharge without even realising it.
Surgeon A is an ENT consultant surgeon. He performs an E1910 on two different patients. He bills both the patient’s insurance company £1,600 each. No problem except Patient ONE’s insurance company fee structure is £1,600 for an E1910.
Patient TWO’s insurance company fee structure is £1,945 for the same E1910 episode.
Surgeon A has therefore by invoicing Patient TWO’s insurance company £1,600 i.e. the fee he gets from Patient ONE’s insurance company undercharged by £345
Surgeon B is a gynaecologist but has the same issue.
He performs a Q0800 on two different patients who are insured by separate insurance companies. He invoices both insurance companies at £636 each. Save Patient ONE’s insurance company’s fee structure is £636 whereas Patient TWO’s insurance company’s fee structure is £800.
Surgeon B, by using the fee structure for Patient ONE only, has undercharged by £164
Both carry on billing not realising that the fee depends on whom the patient is insured with. And different private medical insurance companies publish different fees for the same surgical procedure.
To illustrate we checked four different medical insurance companies this afternoon in order to confirm the fees for an E1910. The fee were £636, £676, £775 and £800. We then turned to Surgeon B and the medical code of Q0800 and found the fees were, dependant on which medical insurance companies we checked, £636, £676, £775 and £800.
Don’t set fees at the level published by a single insurance company.
Check which fee is paid by which insurance company for the same procedure. Don’t assume they are the same because they may not be. A published medical fee for the consultant surgeon can and does alter not only between private medical insurance companies but can also alter over time. In every single case, it’s always worth checking the fee structure paid and not assuming it is the same across all private medical insurance companies.
Normally, of course, the medical secretary is assumed to know who pays what. But to expect an already overworked medical secretary to check each time before she bills is, in plain English, not really an option.
Invoice for two different codes in the same surgical episode incorrectly and it’s easy to get into even more trouble. For example Insurance Company X may allow 100% of the higher value code and 50% of the second but Insurance company Y may allow 100% of the first but only 33% of the second. Imagine what happens if all episodes are billed at 100% and 33%. Immediately you’ve lost 17% of your second fee.
It’s even more fun when careful attention is not being paid and 100% of the LOWER value fee is claimed and 50% of the HIGHER value fee, as well as both fees, being lower due to the insurance company the patient is with.
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Monday morning comes round all too quickly and its time to invoice last week’s clinics.
This is a good example of not paying sufficient attention to the clinic list. It almost cost the consultant £50. The patient was marked down as a follow-up. An invoice for £100 was required for the patient’s insurance company.
According to MHM, the consultant had never seen this particular patient before. A quick phone call established that this was actually a new patient so a £150 invoice was required for an initial consultation and not for a £100 follow up.
Who was responsible for making the mistake isn’t really the driver. It is important of course but mistakes happen. Of more importance is having a process to identify and correct the error. before it costs you £50.
All you have to do is outsource the invoicing to someone who checks absolutely everything.
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Just taking ONE client as an example.
Week ending Friday, February 14th: out of 15 consultations, 4 (four) came back with excess/shortfall deductions totaling £575. So for a total of £2,500 worth of revenue from outpatient consultations £575 or 23% came back short. Looking back to the same week in 2013, the number of shortfalls/excess were roughly half this.
The question as to why this is happening is not the concern. The concern is what are you going to do about it. If 23% continues the downside and potential loss to the consultant is significant. There is only one real way to resolve this issue. Phone them!
Sure you can write letters and even email but nothing gets a response like a ringing telephone. Most patients are unaware of the issue but some think this is an issue between them and their insurance company. In other words, the patient thinks they need to pay the insurance company. They think the consultant gets paid in full by the insurance company. There are variations on this but the crucial point for the consultant is not to establish why; its to ensure he recovers the shortfall/excess efficiently.
But if telephoning the patient is the most efficient way to tackle the issue, it does not automatically follow its the easiest. It has to be done professionally and with due diligence. The long-suffering med-sec really won’t have the time to do this as professional and caring as she undoubtedly is. I promise you faithfully, she won’t want to phone patients for money and will be thinking this is the least enjoyable part of her job.
There is an alternative though: do nothing. Some patients actually will pay but this assumes they a) are aware of the shortfall/excess and b) make it good straight away.
What if they don’t?
Assume it’s not £575 or 23% a week or £27.6k a year (£575 multiplied by 48 – not 52 weeks as you will have 4 weeks off a year). Assume instead its 10% for 24 weeks (i.e. roughly half of the current numbers) and allows for some patients paying without being contacted.
The potential losses for the consultant, in this case, reduce to £13,800 per annum. That’s a chunk of change in anybody’s book still.
What’s significant is that at a number of client meetings recently I’ve asked what the client considered the biggest threat to the practice during 2014. Most popular was a further reduction in private insurance fees. That may indeed turn out to be a big problem.
But at this point, empirical evidence suggests its potentially leaving the back door wide open so to speak and enduring £13,800 worth of potential losses right off the bottom line.
I’d be really interested to hear from anyone who is seeing an increase in shortfalls etc and their views on remedies.
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