Keep taking these tablets
The ten commandments for billing and collection Make sure the people you rely on in your practice are following these essential rules to keep your payments coming in. Gary Nials lays down the law
1. Thou shalt send invoices out promptly. The sooner you get the invoice sent, the sooner it will be paid. Ideally, you should aim to get any invoice sent the same day of treatment or once aware an invoice is due.
2. Thou shalt keep a record of every invoice sent. It is imperative that you keep a record of invoices sent so you can track them. Once payment has been received, it is also crucial that you mark them as paid, otherwise you will waste time chasing them. This will also look unprofessional on your part.
3. Thou shalt ensure patient contact details are taken on first appointment. The best time to get patient contact details are when they arrive for their first appointment. This is also the time they most expect to be asked. Phone number and email are crucial – especially for following up with payments. A good policy is no details, no appointment.
4. Thou shalt ensure procedures are recorded by relevant CCSD code. Insurers use codes for re-imbursement purposes, so it is crucial the correct CCSD (Clinical Coding and Schedule Development group) code is attached to any procedure. Also be aware CCSD codes change monthly and insurers apportion different prices to different codes. (See page 34).
5. Thou shalt ensure you have correct Letters of Guarantee (LOGs) for embassy patients. Embassies are very clear that they want a letter of guarantee (LOG) attached with any invoice.
If you have an embassy patient, make sure they have the LOG and check the details are correct in terms of consultant name, treatment and dates.
If not, receiving payment will be a big problem, so you really should re-arrange the appointment and insist they bring a LOG.
6. Thou shalt carry out bank reconciliation every Monday. Quite often, there are payments that hit your bank account with multiple payments included in it. While it is time-consuming, you must stay on top of this process of checking what invoices the payment is for – otherwise you will waste time chasing invoices that have already been paid. I suggest your relevant staff set aside time each Monday to look at the previous week’s payments.
7. Thou shalt be certain to invoice excesses and shortfalls for insured patients promptly. Once you have carried out bank reconciliation and become aware of any shortfalls or excesses to be billed for insured patients, make sure these are sent to the patient promptly. The same principle applies as per the first commandment.
8. Thou shalt ensure your terms and conditions are clear to patients. Clearly state on your patient registration form – as well as your website – what your terms of business are. This is another reason you should make sure you keep a record of when the invoice has been sent. If unpaid invoices break your agreed terms and conditions deadline, make sure you keep chasing them – which should involve a phone call, not just an email or letter. See that those working on this in the practice inform the doctor(s).
9. Thou shalt chase outstanding invoices on a regular basis. It is not enough just to send invoices and expect them to be paid. You need to chase invoices regularly and systematically and ensure that payments are recorded. If invoices have not yet been paid, this should become obvious in your system with some flagging format such as colour coding of green when still outstanding, black when paid and red when overdue.
10. Thou shall ensure staff inform the doctor(s) of late payers and problem invoices. Remember, you have to pay tax on invoices raised, not payment received. This increases the importance of systematically sending and then properly chasing your invoices. Even with this, there still might be non-payments for various reasons. If staff think the practice might need to consider writing an invoice off, they should let the doctor(s) know so it can be discussed. Better that way than leave it to chance. Especially as you can get the tax back if you do decide to write it off.
If you cannot manage all of the above, then you need to decide what action to take and consider whether you should outsource this crucial element of your practice to a professional billing company.
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