MHM recently completed a group of consultants with a remit to investigate why they were not getting paid.
One insurance company was proving to be particularly troublesome. An analysis of a month’s invoices soon identified why for particular insurance company requires all invoices to be submitted electronically.
Except the invoices were woefully incomplete. For example, the patient’s date of birth or policy number or pre-authorisation was incorrect so each and every time the invoice failed.
To resolve the problem, it was imperative to make sure ALL the details are correct. That way invoices are correctly processed and not placed in a “holding” pile. So that was the cause of the issue.
Or was it?
Medical secretaries thought the receptionist was responsible for getting it right. The receptionist thought the medical secretaries were responsible. Then they both said the person who raised the invoice was responsible.
In reality nobody was making sure the data was right.
The result as a pile of meaningless rubbish.
The spat was costing tens of thousands of pounds and the holding pile was not only greater than the value of average daily outpatient appointments. Worse it was also STILL growing.
Skip forward a few months. The receptionist obtains the details and checks them. The medical secretary ensures all the details are recorded on patient records accurately and checks them again. The person responsible for medical invoicing highlights on a daily basis ANY invoices which fail. The holding pile is now less than 0.5%.
Is this overkill?
Cash input from this ONE insurance company has increased by around 160%. It’s not overkilling at all.
And all have realised a little pre-emptive medicine has stopped rubbish in = rubbish out issue.
pete@medicalhealthcaremanagement.co.uk
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