Most MHM clients ask us to look at self funders when we start looking at the amount of money owed to them. Self funding patients are also a very common reason MHM is called in the first place. With the self-funding market increasing therefore, it is important to understand the major reasons self-funders can – if you let them – be a problem.
What are three most common reasons a self-funder hasn’t paid and has become a problem instead?
The first issue is always the same. When the patient is contacted as a self-funder, he/she claims never to have received an invoice originally. Whilst this is obviously easy to rectify (send them a copy!) how many medical professionals are 100% certain the invoice was sent in the first place? Obviously some self-funders will be naughty so to speak but generally speaking they will pay if sent an invoice.
So the first common reason is the self-funding patient hasn’t been invoiced. Any consultant surgeon must be confident invoices have been raised and sent to the patient. Sadly numerous times, we are told invoices are raised only to discover they have not been raised. That is why it is vital to check the clinic list and be 100% confident everything has been invoiced. We do it the old fashioned way – because old fashioned works! We take the clinic list and draw a red line through each appointment and write the invoice number we’ve produced against the patient’s details. Its old fashioned. Its simple. But it works. It also applies to insured patients of course.
The second issue concerns the use of debit or credit cards. In 99.9% of cases when a patient arrives at a private hospital he/she will be asked to provide a swipe of their card. Sadly on numerous occasions, the patient is unaware that the card only covers the hospital fees. It does NOT cover the consultant’s fee. Numerous times, the patient remains unaware the debit card they’ve passed to the hospital does not cover the consultant’s fees. The MHM solution is when the patient first makes contact with the consultant, he/she is advised the card swipe will NOT cover the consultant’s fee. This should be followed up by a note on the consultant’s invoice to the patient stating: This invoice is NOT covered by any debit / credit card details you may have provided to the hospital.
The second common reason – the patient thinks they have already paid
The third issue is the easiest of all to resolve. On frequent occasions a self-funding patient has called upon receipt of the consultant’s invoice to say they are actually insured. This must be addressed immediately because invoicing the wrong person is absolute insanity. The cause is a failure at the patient’s initial point of registration to ensure the correct details are taken. This goes straight back to how the patient is processed at the point of registration.
The third common reason therefore is a major failure in the consultant’s registration process. This simply must be addressed and not left to chance. If this stage is 100% correct, many problems are not allowed to occur.
If the above three items are correctly managed and a firm process put into place to manage the minority of self-funders who don’t pay, the number of outstanding self-funding invoices drops in most cases by over 80%.
Three basic simple steps in managing the process of a self funding patient that sound unimportant but for a consultant surgeon they are definately not unimportant if you want to keep self funding patient outstanding accounts to a minimum.
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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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