It is common in my world to be presented with a number of unpaid invoices. The remit is to go get paid for them. That I can do.
But it depends?
If they were raised in the first place that is.
If they have NOT been raised it is much more difficult.
I’ve done it many times. It’s not without its difficulties though.
Self-funding patients normally express amazement that they haven’t been invoiced.
More than a few have put forward the view they thought they would have been invoiced ages ago.
Some have even said they’ve called the consultant surgeon’s secretary to ask where the invoice was and still nothing has arrived.
There is a very simple remedy to this problem.
Send the invoice.
Insurance Companies
What is much more problematic is the same issue with a private medical insurance company.
This is especially true where, as part of the consultant’s recognition criteria, the insurance company insist all invoices are submitted within 6 months of the episode date.
It matters not one jot whether the episode was surgical or a consultation.
The invoice must be submitted within 6 months of the date.
End of.
This is precisely the situation I faced late last year when reviewing the billing process of a northeast based ENT surgeon.
She had just over £4,250 worth of invoices for a single insurance company that had NOT been invoiced.
They were all way over six months old.
Worse still they added up to just over £4,250.
The Six Month Rule
The wrong solution to this is to ask the insurance – politely or forcefully – to accept the invoices even though they are so “old”.
Most likely the private medical insurance company won’t agree to even look at them.
It is irrelevant to blame the insurance company.
A complete waste of time.
The correct solution is to consider HOW this situation had been allowed to happen.
In other words, be much more concerned there is not another £4,250 worth of surgical episode or consultation that hasn’t been invoiced. Hopefully, the value will be less but you need to check.
In most cases, there will be uninvoiced outpatient appointments. Sometimes entire surgical procedures have not been invoiced. In all cases, you need to find out.
You should also make sure a robust process is in place to prevent this from happening again. How?
How to stop it
The simplest of daily or weekly routines. The sanity check.
Using one of my current clients as an example, I know he holds two outpatient clinics per week and is in theatre once a week.
Therefore I should see two clinic lists and a theatre list every week.
If I don’t, I call his secretary.
Sometimes, I’ve only received one clinic list because there was only one clinic. Other times though, there were TWO clinics but she has forgotten to send me the 2nd clinic list.
Sometimes he hasn’t returned the clinic list.
The important point is that we know about it and make sure the discrepancy is sorted.
A very simple sanity check will prevent a build-up of uninvoiced appointments or surgical episodes. But do not think this is a “should” check.
Close the Circle
hen each week, ALL MHM client’s get a spreadsheet. ONE document. All they have to do is check, the clinics have been invoiced. Surgical episodes are on there too.
This is very much a “MUST” check.
If you don’t, it is so easy to end up with £4,250 worth or surgical episodes or outpatient appointments that you can charge for but will almost certainly be refused for payment by the insurance company.
Then you may have to contact your patient and explain due to your own poor administration the patient must settle your bill.
I have no issue doing this even for we are where we are. I have to say in most cases the patient is not at all impressed!
It’s so much easier not to put yourself in the position in the first place by performing a sanity check each week.
pete@medicalhealthcaremanagement.co.uk