What follows is absolutely real and why medical invoicing can be more troublesome than it need be.
One of my guys ran an outpatient clinic last Thursday
The clinic list arrived with me on the following Monday. There were 8 patients: 3 initials and 5 follow ups.
Within 30 minutes 7 invoices had been produced and delivered to the various insurance companies. But that final EIGHTH invoice caused significant issues. Why?
The patients insurance details had not been recorded on the clinic list.
So I rang my client’s medical secretary and ask if she knew what they were. The FIRST phone call – I’m told the patient is with insurance company A but did not know his policy number. Length of phone call: 5 mins
A SECOND phone call was necessary. This time to the insurance company. I was on hold for 11 minutes to this particular insurance company which is about normal for any insurance company. Some are 4 – 5 minutes. With some you are on hold for considerably longer. Once I got through however despite having the correct name, date of birth and postcode I was informed the patient’s policy had lapsed.
Length of phone call: 11 minutes plus 5 minutes = 16 minutes.
3. A THIRD phone call was made. This time to the patient. Answer machine so I left a message to call me back. He did. Patient confirmed it was totally the wrong insurance company. He told me the correct insurance company but did not know his policy number!
Length of phone call(s) 5 minutes
4. FOURTH phone call to the other insurance company. Placed on hold for TWENTY-THREE minutes! Finally get through and I’m advised the correct policy number etc. Invoice raised.
Total length of phone calls: 49 – FOURTY NINE MINUTES!!
There is no problem in spending 49 minutes on the phone; none whatsoever.
But just consider the problem if the medical secretary at the same time as that had patients trying to speak to her? Or she had correspondence to get out? Or she had clinics to book? She would have struggled for sure.
Finally, consider how much easier it would have been if the patient had been asked to bring a copy of their insurance details with them when they registered?
There are of course various on-line billing systems where you can look up all the details and speed things up considerably. But that is no excuse for not getting the details right in the first place. Each time and every single time.
pete@medicalhealthcaremanagement.co.uk
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