Curing doctors’ money malaise
Consultants are facing a multitude of problems when it comes to medical billing and collection. Independent Practitioner Today asked billing expert Garry Chapman to keep a ‘warts and all’ diary of the issues he encounters in a typical working week. Here is his report
It is an early start to the week for me with a trip to the south coast for a 7.30am meeting with an orthopaedic surgeon and his secretary.
He had been referred to me by several of our clients who work in the same specialty and geographical location.
The surgeon explains that, as the practice has expanded, they have struggled to cope with the workload and the debt had continued to grow. They were also having problems dealing with the private medical insurers on their complex operations.
I explain how we could assist the practice on all aspects including taking over the process of liaising with the insurers for their complex operations which would allow the secretary to have the time to carry out all her other important tasks. I leave at 9am with all the paperwork signed, so that we can start working for them at the end of the month.
In the late morning, I arrive at our office where I have a management meeting with our general manager and his management team to review the previous week’s operation and discuss any key issues that have arisen since.
Today, the major talking point is the letters being sent out by both Bupa and AXA PPP to consultants in the UK regarding reducing consultation fees and procedure code fees.
After agreeing a way forward, we send out a broadcast message to all our clients instructing them to contact us before responding – should they receive a letter – so that we can explain what the financial implications are to their practice and what options they have available.
I then have an internal hand-over meeting with the account manager who is going to be working with the new practice that signed up this morning, so they can have everything set up ready.
I leave the office mid-afternoon to go to one of the major private hospitals to have a review meeting with a client.
We review his pricing structure which has not changed for many years and he decides to leave the prices where they are.
I then present him with his billing reports which show him that since he has been with us, he has billed over £1.3m and we have written off only £743.
Needless to say, he is extremely happy with our service and continues to recommend us to his colleagues. I head for home – it’s time for responding to the emails.
In London all day today. The first meeting is with an anaesthetist who called me last week.
I meet him at 9.30am. He explains he has been doing his own billing for 20 years but has reached the point where he is finding it very difficult to keep abreast of all the changes taking place on the insurers’ pricing structures and chasing the ever-increasing shortfalls that patients have to pay.
He states that he was recommended to MBC by a colleague and after looking at the testimonials on our website, he recognised a number of his colleagues using our services.
I explained how we work and that our service is tailored to the needs of the individual consultant, which he was very happy with. He decides to go ahead and start using our services straight away.
It’s been a good start to the week with two new consultants joining us.
I pick up a voicemail message from a surgeon expressing an interest in our services, as he had been recommended to us by his anaesthetist.The week just got better.
My remaining meetings today are review meetings with some of my existing clients. The first is with one of our physicians and is relatively quick, as she is pushed for time because she has an emergency.
We agree to monitor her practice closely over the next few weeks, as she has just changed secretary so wants to make sure her clinic information is still coming to us regularly.
My second meeting is with one of our surgeons who is thinking about reducing her NHS practice and growing her private practice. We discuss what her timetable is in doing this and work through some options for her to consider before making a final decision.
I agree to provide a report which breaks down where her patients are coming from and to introduce her to a company that could build her a website if she choses to take up that option.
Before I start the last meeting of the day, I finally connect with the surgeon who left a message earlier in the day. We agree a date for next week to meet and discuss his requirements in further detail.
My final meeting of the day does not happen, as upon arriving at the hospital, I am informed that the consultant has been delayed in theatre and will re-arrange for a future date. I head home to respond to my emails received today.
Another early start as I head off for a golf day. I am very happy to receive the invitation, as there will be a lot of consultants attending, so it should be a good chance to network. I speak with a number of people who may well be in touch, so it is worthwhile attending, but – alas – my golf is poor. Considering I am a high handicapper, that’s no surprise.
I head home after lunch to change into a suit and tie, as I am presenting at an event in the evening for consultants who are new to private practice.
The seminar is due to start at 6.30pm, but we eventually begin at 7pm due to some late arrivals. There are five other presenters and all aspects
of running a private practice are covered from billing and collection, marketing, website design, software through to accountants’ services and tax advice.
All the presentations are well received and everyone comments on how useful the evening has been. The majority of doctors attending are either just starting out or have been in private practice for between one and two years.
I leave the event at 9pm and head home with several people stating they want to meet in the near future. So a good end to a long day.
In the office today with various internal meetings. The bank manager is coming to see me for our annual meeting and I am meeting with our software company to review some functionality changes we are considering to enhance our service.
I also have several second interviews lined up, as we are recruiting for more account managers to handle the growth we are experiencing.
All the meetings go well and I sign off on the software development work and the bank manager leaves after giving us a glowing tribute.
We have agreed terms with two of the candidates and they can both start in a month’s time, so it has been an excellent day. I leave the office at 4pm to attend a dinner at the Royal Society of Medicine in London.
It is attended by 11 others: a mixture of consultants, GPs and people from other companies who work in the private healthcare space.
After a delicious meal and excellent company with some lively debate about the insurance sector, I head home at 10pm.
It’s an early again, as I have a meeting in Manchester with a dermatologist who found Medical Billing and Collection on the internet and then spent some time looking at our website. He was sufficiently impressed to want to have a meeting. I arrive at 10.30am, 30 minutes early, as there was no problems with the traffic. For a change, the M6 is fine.
Fortunately, the consultant is able to see me early and he explains he has several issues regarding his billing and collection. These include having a large backlog of outstanding invoices amounting to over £100,000.
His wife has been doing the billing, but is finding it harder and harder to cope with as the practice grows and she is also looking after the children at the same time.
I explain how we can help him collect his backlog and also how we could work with him in the future. He is particularly impressed with the fact that we only charge on what we collect and not what we invoice.
He says he will talk it over with his wife and come back to me next week. I thank him for his time and leave Manchester at 11.30am hoping I will have the same fortune with the traffic on the way home.
No such luck. I’m back working through admin in the early evening when the dermatologist I met earlier today rings to say his wife is very happy and relieved to hand over the billing. He wants us to start as soon as possible.
After a busy and successful week, it’s time for a cold glass of something nice.
Garry Chapman is managing director at Medical Billing and Collection
- 01494 763 999
- Medical Billing & Collection
Buckinghamshire HP7 9LP
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