Be on top of the form to avoid fee shortfall

Garry ChapmanUncategorized

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Be on top of the form to avoid fee shortfall

If more private consultants used a patient registration form, they would have fewer fee problems, says Garry Chapman

In a commercial environment the ‘terms and conditions’ describe how the company will conduct its business with its clients, and they can also be part of a contract. For private doctors, the equivalent is the patient registration form.
Where possible, we recommend that a practice has a set of words which describe how the transaction between the patient and the practice will work in relation to its pricing and the payment of any treatment provided.
This wording can either be on the headed paper of the practice or it can be emailed to new patients when they book an initial consultation. The important thing is that, to avoid any ambiguity, the patient is made aware of the information before treatment commences.

The small print
In our experience, when a patient has private health insurance, many of them immediately think that all the costs of the treatment are covered, when, in reality, there is a cost element that the patient has to pay in most cases.
The vast majority of patients have health insurance through their companies, so most of them are unaware of the small print of their own policies, which typically leave them with a shortfall.

This can be for many reasons and I list the main ones below:

  • They could have an excess on the insurance policy for the first part of the treatment;
  • They could have exceeded the benefit limit of the policy;
  • They could have a policy which is called co-share, where they have to pay a percentage of each invoice.


The patient registration form should also inform the patient if the practice has any other commercial terms, such as charging for consultations that patients do not attend where they have not been cancelled in advance or cancelled at the last minute. These, of course, are often referred to as DNAs (Did Not Attends).
But another area which often needs clarity is if the practice charges for items that are typically not covered by the insurance companies.
This can be items such as writing prescriptions or performing phone consultations. All of the above need to be incorporated into a patient registration form, as well as any other commercial considerations particular to the specific practice – such as charging for domiciliary visits.
If you have a website, I would also encourage you to have the wording published on it as well. I have given an example of a form on the right. Feel free to use it as a template.

Garry Chapman is managing director at Medical Billing and Collection

PATIENTS COVERED BY MEDICAL INSURANCE
This is a private appointment and your insurance provider will be contacted for payment. Should they not cover the full amount of your treatment, you understand that you are responsible for settling any outstanding amount.
It is your responsibility to obtain authorisation from the insurer prior to treatment. Therefore, you authorise the consultant to submit claims relating to your treatment direct to your insurer. Quotations can be provided upon request.

SELF-PAYING PATIENTS
You understand that this is a private appointment and you are responsible for all charges. Payment may be requested in advance if full costs are known, or immediately after your treatment. Quotations can be provided upon request.

FEE SCHEDULE
Our fee schedule is typically met by the insurance companies.
However, as there are so many different policies in existence, it is the patient’s responsibility to establish if their own policy will cover both the treatment and the costs of the treatment and identify if they will incur any shortfall.

OR

Our fee schedule is not always covered in full by the insurance companies, as we have our own price schedule which is the same for all our patients, However, as there are so many different policies in existence, it is the patient’s responsibility to establish if their own policy will cover both the treatment and the costs of the treatment and identify if they will incur any shortfall. We can provide quotations upon request.

PLEASE NOTE
If you fail to attend an appointment without providing notification of at least 48 hours by phone or email between Monday and Friday 9am-5pm, you will be charged a cancellation fee of XX% of the consultation / procedure fee.

The consultant’s fees are completely separate to the invoices you may receive from the hospital for tests or procedures carried out.
Our fees for the following items are not typically covered under the insurance policies:

  • Home visits £xx
  • Phone consultations £xx
  • Prescription charges £xx

  • 01494 763 999
    info@medbc.co.uk
  •   Medical Billing & Collection
         Connery House
         Repton Place
         Amersham
         Buckinghamshire HP7 9LP


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