I very recently wrote about this issue and have been asked if the increase was just a blip and possibly “one of those odd things”???
The Real World
Therefore auditing the work of the same consultant surgeon I wrote about in mid-February:
Week commencing Monday, March 24th and ending Friday, March 28th he saw 18 patients. Total invoices sent to various insurance companies came to £2,200.
The insurance companies subsequently advised 21% or £460 would be subject to shortfall/excess. February the same number was 23% or £575.
Therefore the consultant is now required to collect £460 from the March patients with the balance of £1,740 being paid by the insurance companies.
Why?
Some consultation fees were declined completely. Others were only partially paid with the balance deemed “shortfall” or ‘excess” i.e. the £460 is due from the patient(s). If this week is taken as a norm and multiplied by 48 (assume the consultant has 4 weeks holiday each year) –
He will undertake just under £106,000 worth of outpatient consultations throughout 2014.
He will be left with around £22,000 worth of shortfall and excess fees to collect.
Even if we apply the same criteria as employed previously and assume only 50% of shortfalls/excess will remain unpaid. Whilst that’s still £11,000 even though it has dropped from the original Feb calculation which projected £13,000 it hasn’t moved that much.
Incidentally of the original £575 worth of excess/shortfalls for Feb only £50 remains unpaid.
Now what?
But now is the time to start thinking about what is happening to your practice because £11,000 is one HUGE perspective more so as surgical fees continue to be reduced by the insurance companies.
pete@medicalhealthcaremanagement.co.uk