Numerous times I’ve said it is vital a clinic list be checked to confirm all outpatient appointments have been invoiced. The same goes for surgical episodes. It is one of the very first things to look for when you review the process of a private medical practice.
It is not a faultfinding exercise. It is not a witch-hunt. The blame game is of zero interest to me. I’m more interested in getting it right.
The only goal in my world it is to ensure that the consultant surgeon gets paid the maximum he or she can for her professional services.
That starts with making sure an invoice has actually been raised. If an invoice has not been raised then it is absolutely guaranteed, he will NOT be paid the maximum. He or she won’t get paid anything. Obvious really.
And that is precisely what happened recently when I started working for a surgeon in the North of England.
Standard procedure – I random sampled outpatient clinics. I also random sampled surgical episodes. 25 outpatient appointments and 25 surgical episodes taken from 10 different dates picked at random over a 90-day period. 50 invoices checked for fees and confirmation the invoice had been really raised. The fees were perfect. But the results confirmed 2 missed outpatient charges and a single surgical episode hadn’t been charged. That was enough to require I checked the last three months in total.
Sure enough there were more.
Whilst there were the two outpatient appointment that hadn’t been invoiced (£95 each) on one specific day no invoices had been raised for the consultant’s work in theatre: £1,284. Two months after that the same thing had happened for another day. This time the value was £1,367.
£2,841 worth of work the consultant had not been paid for. All because he hadn’t charged for the work.
So I charged them and they were all subsequently paid. Happy days!
But how on earth did that go unnoticed??
Most people say we “should” do something. For example: we should check at the end of the day start or the next that all invoices have been raised. “Should’ never is enough.
Instead try we “MUST” check at the end of each day or the start of the next, that you’ve raised all the invoices.
Then each month I recommend you MUST check the consultant’s diary (not the clinic or theatre lists) against what has actually been invoiced. If you find a problem, you will have spotted it within a maximum of 30 days. Then you can do something about it.
But it’s not a witch-hunt and a blame culture is boring. In any event, in the real world, busy people make mistakes.
This is what I do. I process numerous clinic lists each week. I raise an invoice for each outpatient appointment on each list. I draw a red line through each appointment after the invoice has been raised. Therefore a missing red line means I can immediately tell if I’ve missed one or there is an issue meaning I can’t raise an invoice just by looking at the clinic list. The same with a theatre list. Once everything is invoiced I draw another red line from corner to corner across the whole page.
It is not a case of I should do it; I MUST do it. And it means 100% of outpatient appointments are invoiced. I do the same with theatre lists.
At the end of each month, I check with the medical secretary that the consultant’s diary agrees with the number of outpatient clinics I’ve invoiced and how many days he was in theatre that I have invoiced. Thus there are NO gaps. In the unlikely event (twice in the last 6 years) I spot something, we action it immediately.
All because “should” has been replaced with MUST.
Must was worth £2,841 to this particular client don’t forget.
You MUST check!