When it pays to remain up to date

Garry ChapmanUncategorized


When IT pays to remain up to date

In today’s world, we are surrounded by technology and, without realising it, we use information technology daily in almost every part of our lives.
This could be driving to work using the satnav, reading the newspapers on our tablets and watching TV/films via satellite/PC/smartphone.
We also use our smartphones to communicate via email or text, booking our holidays online, reviewing customer comments to decide which restaurant to choose and even having the ability to control our finances online.
In the medical world, IT has been a major driver in improving treatment in a host of ways across a variety of specialties and, in the last ten years, this has increased dramatically.
This has been through improved scans/MRIs, robotic surgery, enhanced echocardiographs, better drugs and a plethora of equipment which has enabled better diagnosis.
All of these tools have improved the ability to offer a level of care which once would have been beyond the medical world’s wildest dreams.
With all of the above IT being used on a daily basis, I wonder why, from an administrative perspective, most of the medical world lags behind the rest of the commercial world.
The biggest example is the lack of a core central system for patient notes for the entire UK. It seems ridiculous in this day and age that the patient’s notes, for the most part, are still on paper.
In the 1970s, motor manufacturers used to communicate with their suppliers regarding receiving orders and supplying remittances electronically via an electronic data interchange (EDI) system to facilitate better service levels and reduce costs.
Compare this to the medical world today, where millions of invoices are sent from practices up and down the country to the private medical insurers each year by post. They are then still assessed manually before being inputted into their respective systems so that it can be processed for payment.
The cost of having these manual systems in place is becoming increasingly prohibitive for both the practice and the insurer.
Something has to change.

Mandatory change
I believe that, in the near future, there will be a big push from the major private medical insurers (PMIs) to reduce the cost per invoice transaction by enforcing the use of electronic billing, enforcing payment by BACS directly into the consultant’s bank account and emailing remittances.
While these facilities are currently available – dependent upon the PMI – to every practice, it is not yet mandatory. This is what I think will change: in order to do business with the PMI, each consultant will have to commit to operating electronically.
One insurer already has specific wording that relates to this in its contracts with consultants, but, as yet, it is not enforcing it.
For the majority of consultants, using IT is not necessarily the problem, but implementing these sophisticated systems within the practice can become a challenge on many levels.
There are a plethora of administrative solutions on the market and deciding what particular systems
best suit their needs to cover all the administrative functions is not an easy task and can become very time-consuming.
Each consultant will need to consider how best to deal with this and when they should start the IT review process to make sure they are in the best possible position should they become forced to adopt electronic working.
I see many practices that have their entire billing process on Excel spreadsheets, with the invoices created via a Word document.
They do not even have a basic accounts package that they use.

Dangerous practice
This is a perfect example where the use of IT is not ideal and is actually quite dangerous. If the hardware crashes and the files get corrupted, then the entire billing system could be lost, with all the implications that would have on lost revenue.
Another example that I see on a regular basis is where the practice actually uses an electronic system connected to the PMI’s so that they are actually doing electronic billing – but it is only part of the solution.
They do not have a robust system to deal with the remittances and then, where appropriate invoicing the patients with the shortfall and excess amounts. A number of consultants have joined us where they were using the above solutions and had recognised the pitfalls of them.
One option available to the practice is to consider outsourcing this critical area to an organisation that can do this on behalf of the practice, not just now but on an ongoing basis so that they have the responsibility to cope with the inevitable changes that will take place. This will be potentially easier for the organisation to deal with due to economies of scale.

Core infrastructure
At Medical Billing and Collection, we have used IT as the core infrastructure of our business and have continually invested in our own state-of-the-art software which means we are able to provide medical billing direct to patients and insurance companies electronically.
This includes sending invoices electronically to the major PMIs via their EDI system, having the ability to receive the remittances electronically, having the ability to email invoices directly to the patient as well as receive payment from them by debit/credit card online 24/7, which reconciles the payment against the outstanding invoice automatically.
When we are chasing payments, the chase letters are also sent automatically by email direct to the patient containing a link to our payment portal. Our clients also have access to our system online and we can also communicate with them via email and text directly from the software.
Whatever decision the consultant makes, I believe reviewing the IT strategy within the practice should be taken at the earliest opportunity so that they can decide if they need to change any aspect of their IT administration functions. If they do decide to make changes, then deciding the time-scale could be critical. It is important for patients to be able to trust health providers and this is a reflection of both the clinical care and service they provide.
Getting this wrong could be costly from both an investment perspective as well as a potential loss of revenue, should they not be able to transact with a particular PMI.

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