How to establish a billing system

New consultants in private practice need to get well organised to ensure they receive their pay. Garry Chapman sets out some vital steps to take

Three years on from my Independent Practitioner Today article about consultants in private practice needlessly losing revenue I have to report it remains a big problem.
I visit practices on a daily basis and see it first-hand.
Now, I understand that the first priority for the consultant is the care of the patient and that this should always be the case.
But unless the consultant takes a long, hard look at the way the practice functions in terms of the billing and collection services, then they may not survive in private practice to treat the patients.
During the recent credit crunch and downturn in the economy, making sure that your finances are in order has become even more important.

Costs still rising
Many consultants are either billing less year on year or are, at best, standing still in terms of revenue generated, but they are finding the costs of running the practice still rising.
The market has also shrunk during this time with approximately two million people falling out of private healthcare over the past four years.
On top of this, the CCSD coding structures have also changed during this time and that has reduced the number of multiple codes that can be billed together.
As we all know, some private medical insurers have also reduced the fee reimbursement for many CCSD codes, which ultimately leads to reduced revenue for doing the same level of work.
Taking the above into account the focus must be on:

  • Making sure that invoices are raised in a timely manner;
  • Ensuring that every procedure is billed correctly;
  • Invoicing with correct codes for each private health insurer;
  • Collecting the money in a timely fashion to avoid bad debts.

We are constantly surprised how rare it is to find these fundamental business practices being carried out within the medical practice.
The reason we know this is because the majority of our clients are coming to us in various states of financial distress.
Some have huge backlogs of outstanding debts which quite often go back years.
Others have clinics that have not been billed for many months.
Some are years out of date with their fee levels and, in the worst case scenarios, there are doctors who have all of the issues described above.

Why does this problem exist?
That doctors are not getting paid all that they are entitled to can occur for a range of reasons.
Everything being left to the secretary is a common cause. The secretary, who is often the busiest person in the practice, is frequently expected to be a medical secretary, receptionist, personal assistant, sales ledger clerk, and insurance guru as well as a debt collector.
The individual with the combined skill set required to complete all of these tasks, as well as fit them all into a working week, is either a very rare breed or simply does not exist.
It is an impossible task for one person to cope with once the practice grows exponentially from what is typically a slow start.
In our experience, as the practice continues to grow the secretary is so busy dealing with the medical side of the practice that the billing and collection is the area that is most frequently neglected.
Running a practice over the last few years has changed dramatically and the administrative burden has grown during that period, meaning that the problems I identified in 2009 have only become worse – leading to more examples of consultants losing money.

Garry Chapman is managing director at Medical Billing and Collection

Go down to bottom and follow steps 1 to 5
Phone: 08456 00 54 22

Select ‘Specialists’ at the top / Select ‘Specialists recognition’ on the left
Go down to the bottom and select which specialty / Select ‘Application form’
Phone: 01892 504038

Go down to the bottom under ‘Medical Provider Resources’ and select ‘Apply for Provider recognition’ / Select which specialty Select Next
Phone: 01823625170
Standard Life Email name, address, specialty and contact phone number to They will then send you the application form.
Phone: 0845 6023453

Select registration form (PDF)
Phone: 0800 1583333

Bupa International
Go to the very bottom: under ‘Working with Bupa’, select ‘For providers’ / Under Administration, select ‘Working with Bupa’, then select
‘Apply to become part of our medical provider network today’
Phone: 01273 323563

Select ‘Healthcare Providers’ / Scroll down to ‘Provider application’
Phone: 01475 492222

Pru Health
Email name, practice address, speciality, GMC number, contact telephone number and fax number to info@pruhealth., they will then confirm registration by phone or email.
Phone: 08000 929400

Exeter Friendly
Select ‘Documents’ / Select ‘Forms’ / Go down to ‘Other’ and select ‘Application for Specialist / Registration (Word document)’
Email form to
Phone: 0300 123 3203

  • 01494 763 999
  •   Medical Billing & Collection
         Connery House
         Repton Place
         Buckinghamshire HP7 9LP

More than Just a Billing Company