Billing rules to ensure your practice recovers

Billing rules to ensure your practice recovers


Billing rules to ensure your practice recovers 

Implementing these ten simple billing rules will mean your practice is best positioned to recover from the impact of the Coronavirus. Simon Brignall has suggestions for independent practitioners to put in place

TO SAY that Covid-19 has had a detrimental impact to the independent healthcare sector is an understatement. Private consultants, GPs and clinics have seen a loss in income that varies depending on their specialty and patients treated.

To ensure this impact is minimised over the medium to long term, it is important that practices are best positioned to take advantage of any recovery. Here are ten simple rules to put in place to achieve this goal:

1Make sure you spend as much time as possible focusing on your core skill set: treating and looking after patients

It seems obvious, but it is important to prioritise seeing and treating as many patients as possible, as the shutdown means there will be a pent-up demand for your services.

If you and your secretary can focus on the medical side of the practice, this will increase the revenues for the practice, because you are focused on what you do best rather than spending time on tasks that can be delegated.

Running a private practice is not easy and many tasks do not fall naturally into a consultant’s skill set. Take stock and consider what elements of your practice could be outsourced – enabling you to generate that all-important cash flow.

2Make sure your work is invoiced as soon as possible

As things open up, most consultants will naturally try to see as many patients as they can to make up for lost income and deliver urgent care to patients who need their services.

It is important that this work is invoiced as soon as possible to derive the benefit of this activity and to make sure you are not just storing up problems for the future.

Remember, some major insurers now enforce time limits for submitting invoices and if you miss the deadline, they will not pay. Late invoices indicate poor service to patients and are a major contributor to their dissatisfaction and lead to bad debts.

Delaying the patient’s awareness of a shortfall means that the patient assumes the invoice has been settled, which can lead to disputes over the bill.

Late invoices sent direct to patients can be ignored if they think you are not serious about wanting payment.

3Take this opportunity to review your fees

It is important to regularly review your fee structure and thus, if it has been a while since you have done so, use this time to review your rates for consultations and procedures.

I still come across practices that have not reviewed their prices for years and sometime decades.

If you bill your procedures to insurance guidelines, make sure your price list is still current, because these constantly change and are not often communicated clearly. You could be charging less than you could or more than you should. Practices still make wrong assumptions, leading to issues with insurance companies, delays in payments and losses in revenue.

4Review the way your work is being billed to ensure you are compliant with the regulations communicated monthly from the Clinical Coding and Schedule Development Group (CCSD)

If you are taking the time to review your fees, this would also be a good time check that you are abreast of the CCSD’s monthly changes and establish if/how they affect your specialty and possibly your income.

Practices commonly make billing errors through being unaware of the changes and so it is important to establish what rules each insurer adopts, as each insurance company can choose their own variants.

5Make sure that your price policy is clear and that your patients are notified of it before commencing treatment

This should be second nature, as a clearly defined, well documented, and communicated price structure and a patient registration form is vital in a modern practice.

It will ensure no room for ambiguity by laying out responsibilities for payment of your medical invoice, leading to fewer delays in getting your money.

Remember, fee and payment terms transparency is a key require- ment of the Competition and Markets Authority.

6Ensure that your practice has a robust chasing process in place for outstanding invoices

The current crisis has highlighted the need to have strong procedures in place to resolve aged debt.

These procedures need to be applied on a consistent and continual basis to result in benefits to the practice. This will ensure these invoices are fully paid and improve your cash flow.

The vast majority of calls we have received during the crisis have been from practices with issues in this vital area, meaning they continued to run high levels of bad debt. Almost every practice that joins Medical Billing and Collection (MBC) has an outstanding backlog of invoicing going back years.

Debt levels can typically be over 20% of turnover and sometimes have reached 50% of annual turnover and I have seen this increase over recent months. On average, we achieve bad debts of less than 0.5%. This is a huge difference.

7Make sure you are aware of any bad payers so you can better police them more effectively

Visibility around problem payers means you can request the patient settles any outstanding invoices before you allow them to make their next appointment.

If you do not do this, you will end up regularly throwing money away by adding to the problem.

When we take on a practice’s backlog of outstanding invoices, there are often patients who have built up debt over years, yet the practice has continued to see them despite never being paid.

8Ensure you have key management information on your practice to allow for informed decision-making

It is quite common for me to speak to a consultant who has no or minimum access to up-to-date accurate data on their practice. All practices should know where patients are coming from and how their patients break down in terms of volume of insured, self-pay, medico-legal and international patients.

It is also good to have information about patient activity. Consul-tants should have access to reports that show their monthly revenue, payments received and the breakdown of any outstanding invoices.

Without this information, it is difficult to understand which direction your practice is going and it is quite easy to come to the wrong conclusions. This is more important than ever as practices recover from the current crisis.

At MBC, we provide all the above data online 24/7 to assist you in the running of your practice.

9Put in place a robust secure IT infrastructure to deal with the practice’s administration

This often is a common weakness in many practices and is generally only highlighted when it is too late.

Enjoy the peace of mind that your business is on a secure platform that meets General Data Protection Regulations and that your data is secure. A wide range of options can facilitate this, so it should not be difficult to implement.

10Consider whether now is the time to join thousands of other doctors who have outsourced this crucial element to a professional billing company

Most consultants find the billing and collection side of the practice a challenge to manage and that weakness can result in unnecessary and often consistent financial losses.

Outsourcing could be the best decision you make this year to guarantee your practice is ready to face what lies ahead with a cost structure correlated to received income.

Simon Brignall is director of business development at Medical Billing and Collection