If you get the basics right many problems with getting paid don’t happen.
The basics mean the absolute minimum and mandatory requirements in order to present an account for your services. The basics are:
Patient’s full name.
What is their full address?
Do you have the postcode.
Patient’s date of birth
The name of their insurance company
The policy number of their insurance company
A pre-authorisation number issued by the insurance company
A Correct CCSD code
Make sure you have the right fee for that Code
But it doesn’t stop there.
Your invoice must also always have:
Your name and address
The Consultant’s provider number
A unique invoice number
The date of the invoice
The date of the treatment/consultation
The right CCSD code
A value!
14 points.
But if you don’t get all 14 you make it harder for the insurance company to pay you.
Where do you get the above data from?
If you are practicing from a private hospital all this data will be recorded on the patient’s registration form.
If you are operating from some other private consultation facility, make sure you do ensure the details are obtained.
If you are invoicing electronically, its pretty much standard that you MUST have the above data. The same is also true if you are dealing with a self-funding patient or you have to collect a shortfall/excess amount from a patient.
In other words, you are going to need all 14 pieces of data.
Therefore it makes more sense to get them right the first time.
But have a guess at what are the TWO major reasons an insurance company does NOT pay your invoice?
1. you haven’t sent one (crazy but true)
2. you haven’t included the right information.
pete@medicalhealthcaremanagement.co.uk