Many MHM clients have asked what I think the future holds for their fees?
A number of private insurance companies have reduced fees for consultations and for surgical episodes over the last few months and years.
One insurance company, for example, dictated newly recognised consultants must accept lower fees than their colleagues who had been recognised some years earlier. It was inevitable that at some point the previously recognised consultants would be asked to accept the lower fees too. And that point was reached recently looking at some of the emails forwarded to me.
No – I refuse
Certainly, the more established consultants can and have tried to refuse acceptance of the new fees.
Some have accepted the new lower fee but decided to pass the difference between the old and new fee on to their patient as a shortfall. Their solution has been problematic. The refusal has often been met with the threat of de-recognition by the insurance company concerned.
I know of one consultant surgeon who instructed “gap” invoices should be sent to the patient. An invoice for the difference between the old, higher fee and the new, lower fee. He wasn’t an MHM client otherwise I would have told him what was likely to happen.
The act of issuing an invoice and passing on a shortfall by a fee assured or fee guaranteed consultant will and has resulted in the same de-recognition scenario.
Market Forces
Whilst MHM never has and never will be in favour of constantly reducing consultant’s fees, the often quoted insurance company argument of fees being dictated by “market forces” is both mischievous and, in some cases, wrong.
And if somebody else tells me the Covid-19 pandemic has forced all insurance companies to re-examine their fees, I’ll scream. Covid-19 is nothing to do with it!!
But we are where we are.
Higher fee not being charged
What is disturbing though is when MHM talks to new clients the number of cases where the maximum correct fee has not been charged. More specifically, where a lower fee has been charged that the insurance company was happy to pay.
Insurance companies do have a habit of reducing fees.
But they increase fees too.
Certain surgical fees have gone up recently. Fees should be checked very regularly to make sure you ARE charging the right fee.
So, what next for a private consultant’s fees?
The assumption has to be that pressure on fees to reduce will continue.
Nonetheless, the assumption the private consultant is charging the right fee in the first place should and must be challenged for you may, in fact, be undercharging.
pete@medicalhealthcaremanagement.co.uk