The business of getting in your fees
Making the switch to outsourcing your billing is a big step for some private doctors. Independent Practitioner Today’s Leslie Berry quizzed Medical Billing and Collection’s Garry Chapman – who has 20 years of experience in the industry – about how the process works
Berry: What would you say are the main benefits that outsourcing the billing brings for doctors?
Chapman: Bad debts reduced to less than 0.5% and an increase in net income of up to 25%.
And the consultant-patient relationship is kept purely at a medical level, which ensures that the relationship is not tainted in any way with the commercial aspects of their medical condition.
Berry: So what is the set-up process?
Chapman: We use a software package that has been designed specifically for our business where we ‘create’ the doctor’s practice and set up the appropriate rules that apply to it.
We have a contract and a set of forms to notify the insurance companies that we act as that practice’s billing provider.
Once these are signed, then we can start working on behalf of the practice. How long that takes is down to the practice, but it can be as short as one day.
When a client joins us, we place them in ‘intensive care’ to ensure we capture all the nuances of the way the practice operates. Communication
between our organisations is monitored very closely.
Our approach is proactive to ensure the bi l l ing runs as smoothly as possible and we put procedures in place to stop problems occurring.
Once the practice is ready to come out of ‘intensive care’, it is assigned with an account manager who will be responsible for all aspects of the billing and collection.
This means that they get to understand the business of the practice, ensuring both continuity and good communication.
Berry: If a consultant has a backlog of debt, do you chase?
Chapman: Almost all of the consultants who join us have a backlog!
So I’d say we have become very experienced at dealing with any size of outstanding amount of money that a practice has.
We have an established way of dealing with all the outstanding invoices and chasing them in an appropriate and sensitive manner.
And, of course, we liaise with the practice if any queries arise. Once the chasing process starts, it continues to a conclusion.
Berry: How does the billing process actually work?
Chapman: The billing information can be sent to us in a variety of ways. These include email, post and fax and can be by spreadsheet or direct from the practice management software the practice uses.
We always aim to raise the invoice the same day that we receive the billing information.
This ensures there is no delay in the payer – be it insurer, embassy,
solicitor or self-pay patient – processing the payment.
You will find each payment company has different payment terms. These are pre-set on our software which means we can chase any late payment of the money as soon as possible.
The pricing is pre-set into the software per payment company as per the instructions of the practice so that it is priced correctly.
Any billing information which cannot be converted into an invoice for any reason is stored on our software until we receive the correct information. This ensures nothing is missed.
Berry: How do you reconcile the payments?
Chapman: We aim to get all insurance payments made directly to the practice bank account by BACS, with the remittance advice being sent to us where it is reconciled on our software.
Any cheques we receive made out to the practice from any payment company or self-payer are accurately recorded before sending the money direct to the client or their bank account.
Any money we collect on behalf of the client, such as credit or debit card payments, will be transferred electronically to the practice bank account.
Berry: How does the collection process work?
Chapman: Having achieved bad debts of under 0.5% across all our clients, I’d say very well! It is extremely robust. Of course, we have to be extremely sensitive due to the nature of our market.
One of the reasons we achieve such low rates is that we have the ability to accept payments by debit or credit cards at no additional cost to the practice.
We will always consult with the practice on a case by case basis if there are any issues or reluctant payers.
There is also an option of sending invoices to debt collectors, which is included in our fees and managed by us.
Berry: How do you get the money to the doctor’s bank account?
Chapman: Where possible, all monies paid to the client will be by BACS, direct to the practice account from the insurers. Money we receive on behalf of the practice will be transferred direct to the practice account on a weekly basis every Monday.
Any cheques received made out to the practice can either be sent direct to the practice or their bank on a weekly basis.
Berry: What financial reports do doctors get?
Chapman: Our practice management module allows them to have online access to a wide range of financial and management data relating to the practice.
This includes aged debt information, bank reconciliation information, billing and payment analysis, patient activity data, referral analysis, location breakdown, insurance breakdown and fee analysis.
This data can be viewed online as well as downloaded into a spreadsheet. And some reports can even be set up to be sent directly to practices by SMS and or email on a weekly basis.
Berry: So how long have you been working with independent practitioners?
Chapman: We are celebrating 20 years in business this year and since our inception we have grown every year through achieving some exceptional billing outcomes for clients.
We have never employed a salesforce and our growth has come through referrals by word of mouth and has resulted in a client base numbered in the hundreds.
Our clients are spread across the entire UK, as our service does not depend upon the location of your practice, although the majority of our clients are based in London.
Berry: Can doctors get other services from you?
Chapman: Yes, we offer advice on all commercial aspects of the practice as well as the billing process, including medico-legal terms, patient registration forms and many other aspects. We are now sending out periodic emails to keep our clients up to date with what is happening within the private medical market as well as providing one-to-one advice as required.
Berry: What do you charge?
Chapman: We have a set-up fee of £250 and our fees are charged as a percentage, but are based only on what we collect and not what we invoice. Our fees are variable, based on the way a particular practice operates and take into account the size of the practice.
Berry: Do you have any experience of billing for clinics?
Chapman: We have clinics as part of our client base, so we have experience of how they operate and the way that the facility fee works. So we are in a position to offer billing advice in this area as well as setting our fee structure so that the client does not pay our fee on consumables.
Berry: How does your service work for a group practice?
Chapman: We have over 20 groups, so we are very familiar with their administrative problems.
I think our service removes an enormous administrative overhead that groups have to deal with relating to ensuring that all monies received end up in the right bank accounts.
A large part of this is due to the insurance companies only paying into one account, so when a consultant works inside a group as well as having a practice outside the group, it can be an administrative nightmare for the group – and the consultant.
- 01494 763 999
- Medical Billing & Collection
Buckinghamshire HP7 9LP
More than Just a Billing Company