An MHM client held one of his twice-weekly outpatient clinics recently. Nine patients; so there should be NINE invoices.
Except there are only EIGHT?
Quick look at the list indicates one of the patients is designated as inclusive care; no invoice required. But hang on a second, an invoice was raised for a surgical episode recently for this very patient and sent to an insurance company for payment. Indeed its been passed for payment already.
How can the follow up be deemed inclusive care if the surgical episode was chargeable to an insurance company? Generally speaking, it can’t.
Simple explanation. The patient had been incorrectly designated as inclusive care for this clinic. Once the error is corrected, there are NINE invoices. Happy days. After all its only one episode
Make that mistake only once a week for a single month and you potentially loose over £500.
And that is why MHM checks the clinic list is right each time and every time.
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A question we were asked very recently. One in fact we are asked frequently!
There are a few very simple reasons why on-line invoices are not being accepted – the details being submitted are incomplete and/or the details being submitted are wrong.
MHM is a big fan of electronic invoicing and uses it wherever and whenever possible. But it does depend totally on one item – absolute correct data. For example: if you try and invoice electronically you will almost certainly be asked to state the patient’s date of birth and the patient’s postcode. If either is incorrect or is missing then you will NOT be able to invoice. This in fact goes back to a consistent requirement of making sure you or your secretary obtains the correct details. Let’s put this in perspective. In 2014, MHM was asked to review the billing of a large private medical practice. The issue was the practice was owed significant amounts of money and could not get paid by one specific insurance company who insisted invoices should be sent electronically. MHM reviewed 100 invoices all of which had failed to be accepted electronically. In well over 60% of the cases either the patient’s policy number was missing or date of birth was missing or the patient’s post code was missing / wrong. The practice manager responsible for this had, to resolve the problem, decreed the invoices should be sent in paper form instead. A clear case of mistaking movement for action! The insurance company concerned, remember, had stated invoices should be sent electronically and ONLY electronically.
There is no such thing as a quick fix to this. Indeed a quick fix – such as sending invoices in paper form instead – often leads to even more problems as it does not resolve the cause of the issue.
MHM suggested going forward ALL patient details were captured correctly and the data verified with NO exceptions. We then took the “old” invoices and corrected / completed the data.
Within 4 months the average monthly cash flow into the practice had increased from around £120k a month to £260k a month.
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I was literally 70% through billing for a client’s clinic lists from last Friday. Eight separate patients and a mixture of initial and follow up consultations.
All was going well until I noticed the details of one of the patients on the clinic list were incomplete. The only solution was to speak to the patient’s insurance company. I need accurate data to bill effectively and efficiently. So I called the insurance company but like many when you call them you join a queue and have to wait.
So far I’ve been on hold for 16 mins.
Yet this problem could have been so easily avoided if the correct details had been taken down and checked. The problem was the policy number had not been recorded, as it should be.
Just got through and it transpires the date of birth is also wrong. The patient was born a year earlier than stated on the clinic list.
Three observations really:
The insurance company may well clear and pay the invoice even if the details are incomplete and/or incorrect, there again they may not.
If the details had been checked originally before the clinic list had been produced, none of this would have been necessary and the invoice would have been processed for payment much quicker.
Finally, if your med-sec is handling your billing, whilst he/she is on the phone for 20 mins to an insurance company she’s not actually talking to patients and booking them in or typing your letters. Indeed patients can’t call her because she’s on the phone sorting out issues such as the above.
So it’s taken around 20 mins to sort this one single issue and that is what can take up so much time!
How many times have I said most clearly: INVOICE RIGHT = GET PAID RIGHT??
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