Group Practices

We have dealt with Group practices for many years and now have over 20 Groups as part of our client base so we are very familiar with the administrative problems that can occur within the Group practice structure. Our service removes the enormous administrative overhead that groups have to deal with and we have highlighted how we can assist with the main issues.

One of the main issues relates to ensuring that all monies received end up in the right bank accounts. A large part of this is due to the way that Insurance companies only pay into the nominated consultant’s account so when a Consultant works inside a group as well as having a practice outside the group then it can be an administrative nightmare for both the group and the consultant’s individual practice. Through our reconciliation process we can keep track of both where the money should be going and where it ends up so that any adjustments that need to be done are notified in a timely manner.

Another major issue is where the practice has its own provider code and everything is billed under the practice code. A common administration problem is where the Insurance companies pay the wrong invoice to the wrong provider code and they end up paying the consultant and not the practice or vice versa. Although we cannot stop the insurance companies making mistakes; we can administer this issue because we invoice against each provider within the group albeit under the practice code and when we reconcile we can identify any overpayments or recoups that need to done between the practice and the consultant.

Another problem groups can experience is dealing with the multiple price structure that can exist with consultants charging different prices for different insurance companies for the same code. This has become more prevalent in the last few years with new consultants having to adhere to the new price lists released by BUPA and AXA. We can set up the pricing for each consultant that exists within the group on our software so that it becomes an automatic process and not subject to human error. This leads to fewer issues with the insurance companies & patients resulting in a better service being provided within the practice and ensuring that payment is not delayed.

One of the biggest issues that groups have to deal with is the volume of transactions that take place within the group, the more successful the group the bigger this issue can become. The volume of phone calls from patients, insurance companies, clinic bookings, hospitals etc can result in the billing being delayed as the patient takes priority. This delay can lead to greater bad debt as not only does the billing go out late the practice often runs out of time to chase the outstanding invoices. When groups join us they find that the additional time that they get back from not doing the billing means that they can actually provide a much better level of service to the patient which in turns assists in the growth of the practice. On our part no matter how much volume is generated by the practice we can direct as much resource is required in order to ensure that all aspect of the billing process is carried out on time and efficiently resulting in a much better cash flow combined with bad debts of less than 0.5%.