MHM recently completed a project for a group of private surgeons with the instruction being to find out why they weren’t getting paid.
One insurance company was particularly troublesome but an analysis of a month’s invoices soon identified why. This particular insurance company requires invoices to be sent electronically.
The “Holding” Pile
Except the invoices were incomplete. For example, the patient’s date of birth or policy number was incorrect. This will cause an invoice to fail each time.
To resolve the problem, it was imperative to make sure ALL the details were correct. That way invoices can processed and not placed in a “holding” pile. That was, so it appeared to be, the cause of the issue.
Or was it?
Lack of Communication
Medical secretaries didn’t know they responsible for getting the patient detail and both said the person who raised the invoice was responsible rather than them.
That one error had caused the practice to be short of thousands of pounds. The holding pile was not only greater than the value of average daily outpatient appointments but worse it was STILL growing.
The New Process
Skip forward a few months. The medical secretary obtains the details and checks to ensure all the details are correct. The person responsible for medical invoicing highlights each day ANY invoices which can’t be done. The holding pile is now less than 0.5%.
Overkill?
Cash input from this ONE insurance company has increased by around 160% so it’s not overkill at all.
pete@medicalhealthcaremanagement.co.uk