There are certain details, which the invoice sent to the insurance company, must show. Otherwise, you may not get paid.
Minimum Requirements
The layout must include the following:
Patient full name, patient complete address (including the postcode!!), patient’s date of birth, policy number and pre-authorisation. Yet many times the consultant fails to add ALL these details to the invoice and complains when he is not paid on time.
One area often overlooked and a source of delayed or non-payment is the coding of the surgical episode. The place to find a medical code is the CCSD website. Find the code and make sure it is clear on your invoice.
Whilst consultations are easy [20300 for an initial and 20310 for a follow up] coding for a surgical episode is a precise science. Yet the CCSD website will immediately show you the right code to use.
Remember the pre-authorisation mentioned above?
Generally speaking, the insurance company will give the patient the pre-authorisation number and a CCSD code that relates to a specific episode and/or consultation. In other words, the correct code against which to invoice anyway.
Additional Requirements
There are other areas of course. For example, the invoice should show your provider number or at the very least your GMC number. Plus, if you really want to upset your accountant forget to give each invoice a unique invoice number. It does happen would you believe. My favourite is a client who had previously sent invoices out without the word INVOICE on them. He couldn’t understand why he wasn’t getting paid.
Always consider instead the layout and content of your invoice from the point of view of the company to whom it is intended.
Make it easy for the insurance company to immediately identify their insured patient in other words and the likelihood of prompt payment increases dramatically.
Where do you find all this?
All the information required to submit an invoice for payment can be found on the hospital registration form.
If the information is NOT there, you will inevitably have problems with your medical invoicing!
pete@medicalhealthcaremanagement.co.uk