It is a very bad idea in fact.
For example a couple of months ago – actually it was Mothering Sunday to make matters worse – a private medical consultant happily sitting at home got up to answer the doorbell.
He was not at all amused to be greeted by one of his patients standing there. The patient had called round to pay the excess off on his private medical insurance policy.
Mrs. Consultant Surgeon was, understandably so, even LESS amused.
The next day my phone rang. I spoke with a very sheepish client. For months I’d been saying he should alter the address held by all the insurance companies with whom he was recognized. It should be changed to MHM’s address for correspondence and/or remittances – no charge in either case. But he was reluctant to do so as he wanted remittances and cheques to go straight to his home.
As a result, his patient knew where to send the payment. His patient also realized this was the Consultant’s home address.
The Consultant was suitably contrite as the very issue I had flagged as potentially happening had actually happened.
A patient had gone to his home address. For all the right reasons you could argue. Nonetheless, the consultant now saw the potential for an issue.
He was seriously unhappy about patients finding out where he lived.
Sadly this is not the first time, I’ve come across this. It’s not the insurance companies fault either.
When applying for recognition by a private medical insurance company it is advisable to quote a different address from your home address. It is standard practice at MHM when we take on a new client to amend the address for correspondence etc to Hilton Hall. It doesn’t cost anything.
If it is, for example, a request for more information from the client, we scan and email the document to them. When we receive a remittance from an insurance company we scan it and send it to the consultant anyway.
More likely we need it more than they for the simple reason it will contain, where applicable, a notice of excess or shortfall and we have to action them anyway.
Make sure, however, if you do a scan and send the document, it is password protected otherwise there is a risk you could fall foul of the Data Protection Act!
Cheques are received practically every single day at MHM. They are recorded on the client’s sales ledger, we take them to the appropriate bank and pay them straight into the client’s own bank account.
The other advantage of all this is that the client has LESS to deal with. Most MHM clients have more important things to do than process pieces of paper anyway.
It’s not that difficult to amend the correspondence address for a private medical professional. In fact, it took less than one hour to get this particular client’s details changed for ALL insurance companies.
Much better than having a patient ring your doorbell on Mothering Sunday – or any day for that matter.
But at least the private consultant’s Mother-In-Law stuck up for him apparently and that did make me smile.
Read more →
Every time I give a presentation to consultants wishing to start a private practice it’s pretty much guaranteed, I’ll get asked about having a website. In particular, I’ll be asked – do I need one?
Short answer: YES!!
Ah! – Comes the response from a fellow presenter with a very well established practice – I don’t have one. I don’t need one. That may be so because he is well established. But for someone just starting out being on the private hospital’s website, just being on the PMI website or on a directory of consultants is not enough. Neither is, although still a big source of referrals, having patients referred only by a GP.
Patients are much, much more switched on these days. They will trawl the Internet looking for whom they consider being a suitable surgeon with whom to book a consultation. They may still ask their GP for an opinion. And then be concerned if the GP recommends another surgeon because the surgeon is a friend of the GP. What does the GP do if he doesn’t know a suitable surgeon? Yep – he goes to the Internet too.
The bad news is that it is not just a case of building a website. I call it the “build it and they will come” principle. Websites need to be maintained and refreshed – at least every six months. Then there is the question of social media.
MHM don’t build websites nor do we manage social media for its clients. It’s far too complicated. We just pass on the requirement to one of our partner organisations. Based on the analysis of MHM clients with a website and those without, it is pretty clear those with a website see more patients.
You sure you can’t be bothered with all this Internet stuff?? How many of you still rely on GP referrals only?
Read more →
Every so often I take a phone call from a self-funding patient. The patient requires a receipt for their payment. The patient can then re-claim the amount paid from their health cash plan provider.
For example, a patient visits a private surgeon and pays for their treatment. MHM issue a receipt on behalf of the surgeon. The patient can then claim the fee back from their Health Cash plan provider.
The Cash Plan Provider insists on a receipt as proof of payment before reimbursing the patient.
Alternatively, the patient is insured but outpatient appointments are not covered under their policy. The patient has to pay before claiming the funds back from another source.
So what are Health Cash Plans?
Health Cash Plans are designed to ease the financial burden of having such regular health checks.
They are NOT the same as a private medical insurance policy.
Well on some occasions it has indeed transpired that the patient’s private medical insurance cover does NOT include outpatient appointments. Other items may be excluded too. Instead, the patient has a health cash plan to cover the cost of their treatment.
But unlike full-blown insurance cover, the patient is required to pay the charges they have incurred. They then re-claim the payment from the Health Cash Plan provider.
And that’s why they require a receipt.
Thus it is important to understand what a Health Cash Plan is and how it may compliment a private medical insurance policy.
Read more →
Reading Matthew Syed’s latest work reminded me of something I’m conscious of when I look at the business performance of the private medical practice.
One definition could be the ability to look at a situation and almost have a sixth sense of the cause of the problem. For example just this week I looked at a pile of rejected invoices and knew immediately why they had been rejected.
I didn’t have to ask why.
The specific insurance company they were destined for always uses numeric reference numbers ONLY.
Those rejected contained letters. But the international division of that insurance company always proceeded their reference numbers with letters.
Nope. Experience had taught me to spot that.
I’m told by one of my clients the technical expression for having such an almost sixth sense about something is called “expert induced amnesia”
The knowledge over time has moved from the conscious part of my brain, the explicit, to the implicit part of my brain.
And that got me thinking about how and what I look for when considering if and how a practice can improve.
The “what” is always the same. For example:
That is not the same as asking what the number is. It is “do you know how much?”
I’m not really interested in what the actual number is.
Instead, I’m interested in knowing if the business KNOWS!
If the answer is “don’t know” that tells me there is a lack of management controls which sets the direction and scope of the assignment.
However, if the answer is yes but the number is at the end of the last financial year that tells me something else.
Very occasionally I hear “yes; its £x,000 as at the end of last month”
If there is no regular and timely basic management information being produced, the likelihood of significant process errors being made increases too.
And that is precisely what I found when I took on my most recent client.
No timely, accurate management information was being produced.
This was because the process of invoice generation and cash receipt allocation was not being completed.
That immediately led to another question: why not?
Yet paradoxically, the concept of “meaningful patterns” can be said to fly in the very face of my training and subsequent application of scientific management.
I’m looking for patterns which will point me in the areas of possible improvements.
Actually, it doesn’t fly in the face of my training and application of scientific management at all. And it doesn’t really matter if it does.
What matters is that areas for improvement are discovered. And then acted upon?
What is really interesting is the reaction from a practice principal when an error is found.
To me its an opportunity to put it right and ensure the error is prevented from happening again.
Sadly, however, some reactions don’t exactly proceed that way.
Significantly though, those that follow the path of “opportunity to improve” do see an increase in their cash flow.
Read more →
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.
Read more →
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.
Read more →
Ever thought what is the most often quoted reason for non-payment by a patient of the excess?
The same reason is quoted over and over again. Its 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…
“But when I registered at the Private Hospital, they took a swipe of my debit (or credit] card and the fees should have been taken from that”
Why is this always being quoted and should you be suspicious?
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, you should not be suspicious.
This is not to suggest the fault lies with the reception staff at the private hospital.
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 only 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 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, she said to me something was wrong, as the Hospital had taken a swipe of her card when she attended the consultation.
Quite rightly, she called the consultant’s secretary (not an MHM client by the way!) who explained the situation and a BACS payment was made same day.
It does demonstrate however, the most often quoted reason why payment for an excess invoice has not been made.
Read more →
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 to 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 almost certainly will check the internet for the consultant’s website. That said, it is not unusual for the patient to check the website AFTER making an appointment. Further still there is a gender divide with almost 90% of female patients looking at a consultant surgeon’s website but only 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.
Read more →
The argument if a private patient should be allowed at an NHS location is not the debate here. For one thing, the debate would require a substantially longer blog article than space will allow!
This blog instead seeks to answer the patient’s question of “ Can I be seen privately on the NHS?” And the answer is YES.
There are many, many NHS facilities at which private patients may be seen.
Known as PPU (Private Patient Units), these units in the NHS offer a greater choice to those patients wishing to be seen privately. What is interesting is that the prices for an NHS Private Patient are often very competitive when compared with a private hospital.
Do not assume though that only self-funders can be seen at a PPU. In reality, most PPU are recognised by the Private Insurance Companies and often will arrange for their account to be sent direct to the insurance company.
However some policies – see an earlier blog – will restrict access to certain hospitals of the insurance company’s choice.
But in answer to the real life question asked by a patient of an MHM consultant surgeon client, YES a patient can be seen privately at an NHS location.
Read more →