Welcome to September’s edition of Stay Connected.
This month we are looking at patient experience and the pivitol role it takes within a private practice.
Every practice owner understands the significance of the patient’s journey and how providing a high quality service can enhance a patient’s experience and well being. However, have you ever taken the time to thoroughly assess your patient’s journey and critically analyse whether each interaction point is optimised to its fullest potential?
Read our article below, which details strategies for delivering an exceptionally superior patient experience.
In addition, we speak to one of our clients, Nick Panay, Founder of Hormone Health. He outlines why Designated Medical has been so instrumental in guiding the practice in its patient focussed marketing strategy and how the relationship has continued to develop.
Let’s hear from Designated Medical’s Finance Director, Vicky Garbett as she answers our questions.
Q: What sets Designated Medical’s billing service apart from others?
- Our billing services are unique to Designated Medical in several ways. Our clients are only charged for paid invoices, providing cost-effectiveness and incentive for us to raise and settle invoices promptly. Payments are directly deposited into the consultant’s bank account, eliminating any delays in accessing funds. My billing team focuses on delivering a high-quality patient experience, combining expertise in medical billing with a patient-centred approach. All our billing processes are designed and managed by chartered and licensed accountants, ensuring efficiency and transparency.
Q: What support does Designated Medical’s medical billing service offer for private practices?
- Our medical billing service aims to support private practices by allowing consultants to focus on patient care while ensuring an exceptional patient experience. My team delivers prompt and accurate invoicing with effective credit control to ensure timely payment for services rendered.
Q: How does Designated Medical’s medical billing team ensure efficient billing and patient care?
- With my experience working with medical finance clients, I have developed efficient systems and processes to ensure timely and accurate billing while maintaining a high level of patient care. My team works closely with both consultants and Medical PAs to raise invoices promptly for each patient, sending them to the appropriate insurance company or directly to the patient. We send weekly update reports to keep consultants informed of progress, allowing for financial control and peace of mind.
Q: How does Designated Medical provide transparency and financial control for private practices?
- We provide weekly summary reports to our clients, offering details of all invoices raised, monies received, and the aged debt position. This allows our consultants to have complete financial control over their practice and enables them to address any problematic situations. By keeping clients informed and involving them in decision-making, we ensure transparency and collaboration in managing the financial aspects of the practice.
Q: What approach does Designated Medical take in establishing billing processes?
- We focus on establishing solid processes that ensure accurate, fast, and transparent billing for private practices. We work closely with consultants to agree on these processes, which are then handled by my team. We utilise the best available systems, such as Practice Management Systems (PMS), to manage billing processes. Integration with PMS and financial systems like Xero provides visibility and reduces the need for manual communication. We also use Healthcode for insurance company billing, automating the process for efficiency.
Q: How does Designated Medical address aged debt and reconciliations?
- My team focuses on clearing aged debt as quickly as possible, ensuring that consultants get paid for the work they have done. They also address any backlog of payments that have not been reconciled, updating patient records accurately. Our focus on processes prevents aged debt and backlogs from reoccurring, providing financial stability for your practice.
Q: What qualifications and certifications does Designated Medical’s medical billing team possess?
- I am a qualified and licensed Accountant accredited by AAT (Association of Accounting Technicians), as are the other team leaders. We design processes that simplify year-end accounting responsibilities and work with integrated financial systems like Xero. The team has expertise in GDPR compliance and security, and Designated Medical has achieved the Cyber Essentials certificate of assurance, demonstrating adherence to cyber security.
Vicky Garbett
Finance Director of Designated Medical
If you need any advice, please contact the team at Designated Medical.
The Competition and Markets Authority (CMA) Private Healthcare Market Investigation Order 2014 sets out the actions that the sector is required to take to ensure that it works competitively.
One area that the Order addresses is the requirement to provide potential users with access to independent information about the performance of those providing services, and the charges made for those services. Hospitals which admit private patients must submit information about each episode of private care to the Private Healthcare Information Network (PHIN). This information allows PHIN to publish performance measures for these hospitals in line with the CMA’s requirements. To fulfil their legal obligation, consultants must submit the professional fees that they charge to patients for consultations and procedures for each site where they practice privately. Fees need to be submitted via PHIN’s Consultant Portal.
Consultants are also invited to review and verify the data submitted by hospitals/facilities about their practice and to review patient feedback data.
What’s in it for me?
As well as fulfilling the legal duties, PHIN strongly encourages consultants to complete a profile which will be published on its website. Patients have informed PHIN that they want to see information about consultants who may possibly be able to help them with treatment or care in relation to their condition. 76% of consultants who create a complete profile (including a photograph and information about their practice) are usually viewed by PHIN’s website users. Some consultants receive many hundreds of views. There is a direct link between site views and clicks through to contact information (telephone/email) provided by consultants. The number of patients using PHIN’s website is increasing, so these numbers will only rise.
The dedicated Consultant team at PHIN offers virtual sessions to consultants to cover the following topics:
· Logging onto the portal
· Viewing your practice report
· Verifying your data for publication
· Submitting and approving fees
· Reviewing patient feedback
· Creating a profile about you
The Team is always happy to help with any queries and the booking of virtual sessions and can be contacted via email: consultants@phin.org.uk or by calling 020 3143 3177.
Welcome to March’s edition of Stay Connected.
Here at Designated Medical, we are delighted to announce the launch of our new website with a new community hub section.
The brand new community hub we have developed, along with a whole host of content rich blogs and articles that we hope, will be of so much benefit to you and your practice.
Please register for our Designated Community Library, it is free and easy. Once registered you will be able to access our community content which is essential reading for any private practice. With more content like the blog below we have so much information ready and waiting for you, and more and more content added each month.
This month we hear from one of our clients about the accountancy service we provide for him and how this helps his practice. We are also highlighting exactly why marketing for your private practice is so important.
We are also looking at the thorny subject of call answering and how that can impact your practice. Our Managing Director, Jane Braithwaite looks deeper into this issue and highlights some important factors to consider.
Originally published in Independent Practitioner Today in March 2023, our Managing Director Jane Braithwaite summarises the ten main considerations to ensure your group has maximum potential for success.
What makes a successful group? The guidelines for creating and maintaining a successful group reflect similar ones that would be set for any team of people working together.
Undoubtedly, a successful group is one motivated by the shared core values of its members. When your group shares the same sense of purpose, they celebrate and champion each other, creating a culture of excellence within the business.
1) Agreed goals and objective
When the group was formed, the group members agreed on the group’s goals and objectives. Each group member documented this agreement in writing and signed to signify their understanding and commitment. This important document is referred to as their contract and they took advice from their accountant and lawyer to ensure all eventualities were catered for. This activity gives the group clear direction and a common aim to work towards collectively. When any change is made to the group – for example, a member leaving or a new member joining – the contract is updated to reflect this. Clearly defined goals enable everyone within the group to maintain a clear vision of what the group is aiming to achieve.
2) Leadership
A group is usually a partnership where all members are of equal standing. But a successful one will have nominated one individual to act as the group leader or managing partner. This is often the group founder, the person who originally created the concept of the group, or it may have been a joint decision, choosing the individual with the greatest leadership skills. The leader is trusted and respected by the group members and encourages everyone to work collaboratively. The leader also encourages a positive work environment and work ethic. Ultimately, the leader is required to ensure good decisions are made in a timely manner. This is especially important when consensus cannot be reached promptly.
3) Communication
Every month, the group members meet to discuss the performance of the group. They communicate openly with each other, sharing their thoughts, opinions and ideas and they take time to consider what others have to say. On a daily basis, the group members are open and honest in their communications, highlighting concerns or issues and enabling them to be addressed before they become bigger problems. Everyone trusts one another and feels able to speak up. This continuing open dialogue helps ensure that conflict is mostly avoided, but when conflict does occur, it is handled professionally.
4) Clear responsibilities
Everyone recognises that running the group is equivalent to running a business, which brings additional responsibilities. The group has identified the relevant management roles and responsibilities and has allocated these fairly across the group members. Everyone contributes their fair share towards the workload of running the group and each individual understands their responsibilities and where they fit in with the overall running of the business. This helps to prevent overlap, miscommunication and misunderstanding. They take ownership of their area, are committed to their work and they care about the success of the group overall.
5) Clearly defined financial model
When the group was formed, its financial model was clearly defined and described in the contract that each group member signed. Each individual has clarity on how their financial rewards will be calculated and, therefore, clearly understands how their work contributes to their financial success. Rewards are fair and unbiased and represent the hard work and contribution made by each individual. The agreed financial model is motivating and increases job satisfaction. The agreements made were realistic and expectations were met. It was understood that, like any business, the group would take time to establish itself and the financial rewards may take time to build. The group regularly discusses and reviews financial performance throughout the year to ensure a clear understanding of progress made and how this impacts each individual to avoid any surprises at year end.
6) Decision-making
When important decisions need to be made, the group members can openly discuss their views and contribute to making the best decision for the group overall. When there is disagreement, the group members actively listen to each opinion and aim to compromise to reach an agreement. When needed, the nominated leader of the group can make the decision, and the group members respect and support the decision. A lack of decision-making can be damaging. It is critical that people communicate their concerns, have a clear vision of where they are headed and make decisions. Not everyone may agree on the decision, the tactics or how to work together, but still the team must make a decision and move forward.
7) Consistent standards of patient care
The group members share a common view on the level of care that their patients should receive and aim to deliver a similar patient experience. When the group was formed, the clinicians discussed their views on patient experience and agreed on standards of care that the group would commit to delivering and they adhere to these expectations daily. This enables them to feel comfortable referring their patients to their colleagues within the group for additional treatments and to care for each other’s patients during periods of absence and holidays. When a patient complaint is made, the group reviews the complaint together and investigates the causes openly and honestly. There is no blame, so the discussion focuses on how to manage the situation to achieve the best outcome for this particular patient and how to learn from this event and improve processes to prevent a recurrence. All group members commit to continual learning to ensure their knowledge is up to date. They share their expertise widely within the team and aim to enhance everyone’s skill sets.
8) Organised, disciplined and well-managed
Each clinician professionally manages their own practice. The administration is well managed and patient communication is exceptional. The business itself is also run in an organised and disciplined manner. Each group member manages their responsibilities diligently and delivers their work to the agreed deadlines. Each group member is respectful of others by attending meetings on time and submitting their contributions on time. Regular meetings are held to ensure everyone is on the same page and deadlines are being met,
9) Supportive
The doctors perform well as a team and the group exhibits a collaborative work environment. Each group member has a positive attitude and work ethic, and the group is efficient and productive. No single individual dominates discussions and each person has an equal opportunity to be heard. The culture of the group is supportive, with each group member actively supporting others when needed; for example, when one individual is under pressure with their workload or facing a difficult clinical decision. Each clinician has different expertise and experience, utilised across the group through collaboration. This diversity is respected and embraced to offer patients the best possible care.
10) Enjoyment
Within a truly successful group, the doctors enjoy their work and they enjoy working together, having a sense of achievement and of fun. They enjoy the company of their colleagues and value their discussions, both clinical and business related. Positive relationships built across the group help create a relaxed environment and reduce conflict. The group members have constructive chats about work-life balance and they encourage one another to maintain a healthy balance, recognising this helps prevent burn-out and ensures they are all able to perform to the best of their abilities.
Jane Braithwaite
MD of Designated Medical
If you need any advice, please contact the team at Designated Medical.
Originally published in Independent Practitioner Today in February 2023, our Managing Director Jane Braithwaite gives her advice on how to attract the right partner to join your practice.
Our group is working very successfully, and we would like to attract a new partner to join us. How do we find the right person and ensure the group continues to thrive?
Firstly congratulations on founding a thriving group where the partners are working well together and the practice is growing. The decision to recruit a new partner is usually driven by an increased patient workload that needs to be shared by a greater number of doctors and this is a great position to reach. Another reason might be that one partner wishes to reduce their workload, which will need to be picked up by a new partner.
Whatever the reason, recruiting a new partner often comes with some anxiety. When a tightly bonded group works successfully together, there is an understandable concern about introducing a new person to the group and potentially changing the group dynamics.
An ideal group is formed when all the partners have aligned goals. When the original group was created, discussions were likely held to identify common goals and objectives. These goals may relate to the practice’s growth and utilising complementary skillsets to offer patients a wider range of services. There may also have been a goal to create economies of scale and reduce the costs of running individual practices by sharing the overheads.
Running a group is effectively managing a business, and the current partners will have agreed responsibilities for the various business functions, including finance, marketing and medico-legal responsibilities.
One of the most challenging aspects of running a group is ensuring all partners are satisfied with the financial arrangement. While most doctors do not enter the profession purely for monetary rewards, they expect to be rewarded fairly for the work done and the expertise provided to patients. On day one, the group agreed on how finances will be managed, which will be important when recruiting a new partner.
In most cases, the group will have created a contractual agreement to state the objectives and goals of the group, clarify responsibilities and expectations and describe the financial model. If this is not the case, it would be wise to do this before embarking on the recruitment of a new partner, forming the basis of a new partnership agreement to reflect the expanded group. The partners themselves can produce this, or you may prefer to engage professional support via your accountant or a legal advisor.
Describe your ideal partner
A new partner can expand the group in more ways than pure size. Rather than just co-opting the first consultant that has the right experience and shows an interest, it is wise to consider what skills and knowledge would complement your own. Is there special training or background that may help the group expand revenues and offer new services to patients in the future?
There is a job description for most jobs, defining the role itself and objectives, and also clarifying terms and conditions. When looking for a new partner, a good starting point is to build a job specification based on your ideal worldview of the right person for your team. The specification will include the expertise and skills required, possibly similar to the current partners or possibly with a different and complementary set of skills. Also state the group’s objectives, goals and aspirations so that you can assess if your new partner is a good fit in terms of their own ambitions. For example, if your goal is to continue the group for the next 10 to 15 years and a prospective partner plans to retire in 2 years, there may be a better fit.
What administrative and management responsibilities would you expect your new partner to take? This might be an excellent opportunity to review the administrative workload of the current partners and share the burden more fairly. You may also have new initiatives you wish to explore, and your new partner could take the lead.
If some of the workload could be managed without the direct input of a consultant, you could employ staff, for example, a nurse or HCA, to undertake tasks on your behalf. This can help ensure that your limited time is spent on activities only you can perform. If you do not currently employ clinical staff, advice is needed to ensure that you are providing a service that is safe and well-supervised including the provision of training and professional development.
You may also explore outsourcing more of the administration and management tasks to an appropriate specialist company. For example, your bookkeeping could be managed by an expert in this field with the added benefits of bringing their skills and experience into your business.
Finally, and very importantly, you must clarify the financial model offered to your new partner. Be clear and transparent. Refrain from the temptation to oversell the arrangements. It is far better to attract the right person with an honest and realistic plan than deal with disappointment later in the process.
Once complete, your job specification will provide you with a valuable tool to share with potential partners and also for you to use when shortlisting and interviewing.
How to find your new partner?
You are effectively undertaking a recruitment exercise; therefore, drawing from recruitment consultants’ and headhunting firms’ processes and models makes sense. Not all of the standard procedures will be appropriate and you will need to adapt them to your circumstances, particularly how publicly you want to share your plans.
Your first task is to attract potential candidates for your role. A recruitment consultant would advertise the role on various recruitment sites and invite interested parties to apply. This general approach may not sit well with you if you wish to proceed slightly under the radar, but there may be some associations that you are a member of that would be able to share your role in a professional manner.
A headhunter takes a more proactive, but discreet, approach than a recruitment consultant and would research potential candidates and contact them directly. This may align more closely with your preferred style, but it will require an investment of your time. The starting point is identifying the individual candidates who might be a good fit for the role and contacting each one to explore the opportunity.
As with most things in life, word-of-mouth recommendations are usually best, and so it would be sensible to discuss your plans with colleagues who might know of a consultant who would be interested. Make the most of your own personal networks and utilise professional networks that you are a member of.
Once you have a number of potential candidates, you must make a shortlist of two or three individuals with whom to explore the opportunity in greater detail. Creating the shortlist is an activity in which all the current partners should ideally be involved. Reflect on the job specification you created initially and take both a logical and an emotional approach to your decision making. Consider how well each individual matches the job specification, ranking each person, but also consider your instinct regarding who is the best fit in terms of aspirations, style and character. Your new partner needs to be a good fit in terms of skills, expertise, and personality.
The next stage is the interview stage which should be a face-to-face discussion, with one or more of the current partners. This meeting should be relaxed and open to allow both sides to determine if there is a good fit. This is a big decision for everyone involved so allow time after the meeting for everyone to reflect before agreeing on the next steps. You may need a second meeting before a decision can be reached.
Thinking back to our specialist recruitment companies, they would request references. Whilst doing this might be considered unseemly, it would be perfectly acceptable to talk to colleagues who know the person well to gain as much background information as possible.
Finally, you have identified the right partner for your group and wish to offer the role to your chosen partner formally. Congratulations. The role can be offered verbally but also confirmed in writing, subject to the agreement of the Partnership Agreement. Be prepared for some negotiation and agree between the current partners on what aspects of your offer you are prepared to move, if needed.
Revised Partnership Agreement
Once your new partner has accepted the role, a contract must be signed by both parties in the form of a revised partnership agreement. As mentioned earlier, the partners can produce this or you may prefer to ask a specialist such as your accountant or a lawyer to draft the agreement for you.
Good communication is key to the success of any group. Diarise regular partner meetings on a monthly or quarterly basis and ideally face to face, at least for the first few months You may also choose one partner, in particular, to act as a mentor to your new partner, at least for the first six months. This could include monthly one-to-one review meetings, which provide an opportunity to review progress and for both sides to raise any concerns and address any issues.
Remember it is normal for a new group to experience some challenges in the early months as described very helpfully in Tuckman’s stages of group development. Bruce Tuckman first published his model in 1965 and described the forming-storming-norming- performing model. His opinion is that it is necessary for all teams to work through every stage of the model, so prepare your group for the storming stage and embrace it positively.
Jane Braithwaite
MD of Designated Medical
If you need any advice, please contact the team at Designated Medical.
Recruiting the right Medical PA for your private practice is important. You need to find the right person with the right skills but most importantly the right person for you and your patients.
Your Medical PA will act as an ambassador for your private practice and will take responsibility for the overall patient experience. The right person will make a significant contribution to the success of your practice and so it is important to choose very wisely.
Workplace
One of the most important factors today is where your Medical PA will be based. Do you plan to have a virtual Medical PA who works from home, or do you require your Medical PA to be office based within your consulting rooms?
Most Medical Secretaries have now had the opportunity to work from home and they have loved it, so returning to an office-based role is less appealing to them. For those who will consider an office-based role there is demand for a higher salary to compensate for the additional time, cost and stress associated with commuting.
If your preference is for office based, then it is worth considering if you can offer some kind of flexibility, for example, part time hours, or a hybrid model with the week split between office and home.
Employment model
You will also need to decide on your choice of employment model. Do you plan to employ a permanent member of staff, contract someone on a self-employed basis or subscribe to a Medical PA service. Each model has pros and cons as follows.
Permanent Employment
The benefit of employing an individual to work directly with you is potentially a greater sense of belonging and loyalty to your practice. As an employee your Medical PA may feel a greater sense of being part of your team.
If your Medical PA is your fist employee you will need to register with HMRC and take responsibility for payroll, National Insurance and potentially provision of a pension.
You will also have responsibilities as a line manager for the health and safety of your employees and for ongoing management.
Your Medial PA will be entitled to a holiday allowance of at least 20 days plus bank holidays and you will need to arrange cover for these holiday periods.
If your practice is full time, based within your own consulting rooms, and office based then employing your Medical PA will probably be your favoured option.
Self employed
There are many Medical PAs who have set themselves up in a self-employed freelance capacity and this may be an option for you to consider. They generally have a great deal of experience working in private practice and have decided that they would prefer to work for themselves, based at home and to avoid commuting. You will benefit from their wealth of experience and limited responsibilities as you are not officially employing them.
You will normally pay an hourly rate for your service and your Medical PA will be responsible for handling their own tax and national insurance.
Your Medical PA will choose how much holiday they wish to take, and you will not pay for the holiday time although you might feel it is fair to do so. It is important to ask a prospective self-employed Medical PA what arrangements they have in place to cover your practice when they are on holiday or if they are unwell.
One word of warning about the self-employed model is IR35 and its implications. IR35 refers to UK tax legislation introduced in April 2000, which is designed to make sure contractors pay the right amount of income tax and National Insurance contributions (NICs). Currently the IR35 rules do not apply to small businesses but they do for medium and large companies. Your self-employed Medical PA is most likely to be considered as being outside IR 35 which means they are not considered to be your employee. Contractors operating outside IR35 are responsible for making sure they pay the right amount of tax outside the PAYE system.
Medical PA Service
A Medical PA service is different to recruiting either a permanent employee or a self-employed Medical PA in that you will receive a service which means you limit your responsibilities hugely and this can prove to be very beneficial.
Your Medical PA service provider will provide you with a nominated Medical PA who works with you and your patients and becomes the face of your practice. Your Medical PA will be available during normal working hours to answer your patient calls, book patient appointments and undertake all the normal tasks for you.
You will pay for the time your Medical PA works specifically for you and usually you will be charged an hourly rate for this. You will receive a monthly invoice and so there is no need to worry about payroll and HMRC responsibilities.
Your Medical PA will probably have one or two other clients to fill their working day so they will have other priorities, but the benefit to you is that this can be a very cost-effective solution.
You service provider will also manage holidays and sick leave so that you don’t need to worry about any of the logistics.
Job description
If you plan to employ your Medical PA then you must create a job description, but it is a good idea to spend some time articulating your expectations in writing which ever model you are planning to use.
A job description clearly states the essential requirements of the job describing the main duties and responsibilities and the skills required to perform the role. There are numerous job description templates online that you can use to help get you started.
Ideally you would share your job description with all potential candidates for the role so they can determine if they are a good fit. The job description will also be valuable when managing performance in the role.
Salary
Deciding what salary to offer to a Medical PA is a complex decision and the market has changed a great deal since the Covid pandemic. Most Medical PAs would prefer to work in a virtual role, based at home, and those who are looking for office-based positions will expect a higher salary to compensate for commuting costs and time.
A good place to start checking for information to help you decide what salary to offer is Indeed, the recruitment website. They offer information on the average salary for various professions, and you can also check out other current job adverts to get a guide.
Finding the right person
Finding the right person is the greatest challenge. It is a good idea to ask your network of colleagues for any recommendations and also to keep you in mind if they hear of a Medical PA looking for a new role.
You can engage a recruitment consultant to help manage the process for you and this is the best option if you have limited time. It is important to choose a recruiter who has direct experience of recruiting Medical PAs in private practice. You will normally be charged a percentage of salary and the terms will provide some back up if your new candidate does not work out in the first three months of working in the role.
If you want to manage the recruitment process yourself (the DIY approach) then you will need to set aside time to manage the process.
The DIY recruitment approach
1. Job advert
Your first objective will be to advertise your role and you should look to websites such as Indeed to help you do this. You can place your job advert on Indeed and use their recruitment system to help you shortlist candidates, arrange interviews etc. There are also skills tests that you can introduce as part of the application process.
2. Promotion
If you are using social media channels such as Facebook, Instagram, and LinkedIn you can promote your job advert here to drum up more interest and this can make a huge difference.
3. Interviews
Once you have attracted a few candidates you will need to work through them and create your shortlist of those you want to offer an interview. I would recommend an initial video interview prior to offering the opportunity for a face-to-face interview.
4. Offer letter
When you have found your ideal Medical PA, you will need to formally offer the role in the form of an offer letter. In practice you will probably offer the position verbally either in person or by phone, but the letter formalises this.
Your employment offer letter expresses your intent to employ your Medical PA and should contain a brief summary of the main terms and conditions of the position. This will include details of start date, salary and benefits. You may make your offer contingent on certain conditions such as acceptable references and if the candidate does not meet these requirements, you are able to withdraw the offer.
5. References
In most cases it is advisable to ask for two references and, in a practice regulated by CQC this is essential. You may also need your Medical PA to provide a current DBS certificate (Disclosure and Barring Service).
6. Employment Contract
Your employment contract is your detailed offer of employment to follow the initial offer letter and must be signed by both employer and employee.
If this is your first employee you would be well advised to consult an HR specialist or employment lawyer to help draft your contract, although there are numerous template contracts available on the internet.
7. Start Date
Hopefully day one is the beginning of a long and successful employment that works well for you, your patients and your employee.
If your Medical PA is your first employee then you will need to consider your responsibilities as an employer including health and safety etc, but also in terms of HMRC and payroll.
Welcome to December’s edition of Stay Connected. With Christmas upon us, we would like to wish all our clients a Merry Christmas and Happy New Year. Thank you all for your loyalty this year and we look forward to working with you in 2023.
In this month’s newsletter, we are looking at Accountancy and self-assessment, breaking down how to fill in your self-assessment tax return.
Following on from that, if your tax forms are something you would rather outsource, we are looking at our top tips for choosing a new accountant.
And finally, we are delving into the world of new patients and the best practice on how to attract new patients.
Best wishes,
Designated Medical Team.
When you are establishing your new private practice, how do you ensure you set yourself up for success? It is hard to step back from your day-to-day activities and invest time in your new practice. Making sure your prospective patients receive the experience and environment you want to deliver, and they expect, requires careful thought and a solid strategy.
Your passion, values and vision are at the heart of why you are making this leap into private practice. So, how do you ensure these are understood and communicated to all your stakeholders, including potential referrers, and patients? Practically, have you covered all the elements to ensure your practice is ready to be launched to the public and your referrers?
The overarching desire is to attract new patients and referrers to your practice, but competition is fierce and with the increase in self-pay patients due to the post pandemic NHS waiting lists, your practice needs to be better than your peers to make sure you are forefront of mind and delivering an exceptional patient experience.
This is where Designated can help. Our team of experts can support you with your business strategy and plan for your practice. Utilising our experience in the industry along with our own service background, the team can help you to identify the strengths in your plans, and pinpoint the weaknesses, creating an opportunity to highlight and rectify any problems before they become ingrained.
Understanding you and your private practice
To really understand your clinic and aspirations, and for Designated to provide a comprehensive report of recommendations that identifies your ideal patients and referrers and ensures your brand messaging and values are communicated to all of your audiences and stakeholders – we recommend starting with our Designated Business Strategy Project.
This is based on a set of strategic questions which will identify your aspirations for your clinic across our private practice/clinic areas of expertise – Marketing, Accountancy, Patient/Referrer Experience, and Practice Management and processes.
From this process we can provide you with our observations and recommendations/guidance to help build your business plan and establish your new private practice.
Areas we cover:
- Business objectives
- Vision, Mission and Values
- Service offering
- Key target audience – patients and referrers
- Reputation – Marketplace perception – how do you want to be identified?
- Competitors
- Patient experience
- Practice Management
Tough read
We will be honest in our views, but these will come from experience and the will for you and your new private practice to succeed. Some of our observations may be a difficult read as it will enable you to uncover gaps that you were completely unaware of. The process and findings can feel quite personal as your new practice is your passion and vision. The key is to thoroughly evaluate the results and make changes to your plans where necessary.
The process will broaden your view of your plans for your practice, who your new patients and referrers are and how to find them and steer you away from assumptions.
If you would like to find out more about our Designated Business Review, please do get in touch:
Invoicing and credit control in private practice can be a time-consuming task, but it is essential for obvious reasons, and yet it is the area of practice management that is most often overlooked. Knowing how to invoice effectively can streamline this process and improve financial management.
Doctors and medical secretaries are quite rightly highly focused on delivering the highest quality patient care, and therefore billing patients and collecting the money owed becomes the lowest priority.
It is not natural for a doctor to switch conversations with a patient from their symptoms and care plan to a discussion about overdue invoices. Likewise, a medical secretary has often chosen to work in the field of healthcare due to a desire to care for patients and is less comfortable handling the billing side and chasing money.
Private consultants can sometimes struggle with the contrast between private practice and working for the NHS and it can feel uncomfortable charging for your medical services after years of NHS work, which is ‘free’ to patients.
But managing payments and debts is crucial for any business and you will not thrive or grow as a private consultant without a robust credit control strategy from the outset.
In a bigger clinic or hospital, there is often a department that handles invoicing and billing, and this team will often be more aligned with the finance team, and this makes total sense.
In a smaller practice, billing must be the responsibility of somebody within the practice team and I will refer to them here as the “billing manager”.
It is well reported in business that cash flow is king, especially in the first years of a new business and this is just as true for a consultant working in the private world as it is for a clinic or hospital.
Delays in receiving payment can put a great deal of strain on cash flow in a private medical practice and we need to ensure this is avoided.
Systems and processes
Using good systems will help alleviate and automate much of the process relating to invoicing and collection. It is also key for your billing manager to define good processes and ensure the system is set up to support these.
Invoice templates with a professional layout can be created by your billing manager, with pick lists of the most commonly used treatments. Invoices can be sent to patients via email or by post if preferred, but I would use email as widely as possible to reduce costs and eliminate delays.
Most private clinics will be invoicing both insurance companies and self-pay patients. They may also be invoicing embassies and legal companies.
A good practice management system (PMS) will offer the functionality needed to handle the creation of perfect invoices, patient reminders and management accounts. Most will also integrate with a good finance system such as Xero to ease booking and accountancy for the practice.
The use of technology is imperative, particularly for invoicing insurance companies.
The PMS will also make it much easier to send invoices electronically to insurance companies, using the Healthcode system. Submitting invoices electronically will also speed up payment settlement, which should greatly help with credit control.
A good practice management system will link to Healthcode and allow electronic billing. All private doctors can use this Healthcode, and it ensures that insurance invoices are dealt with very quickly and smoothly, but there is a cost for doing so and some practices avoid using it for this reason. The alternative is to send your invoices directly to insurance companies.
My instinct is that it is cheaper overall to use Healthcode when compared to the additional cost of sending and chasing invoices with each individual company.
A good practice management system will also ensure that invoicing self-pay patients is simple and easy with various payment options, including the option to send a payment link to patients and allow online payment.
Insurance shortfalls
Shortfalls from insurance payments will need to be dealt with in the same way as self-pay patients. It seems that many aged debts are due to a lack of transparency over insurance shortfalls.
Patients simply are not aware that their insurance will not cover the entire cost of the consultation, treatment, or procedure. This could be remedied by improving communications with patients.
It might mean incorporating a short discussion about payment in the consultation itself, reworking the written payment information given to patients prior to their initial appointment and/ or following up appointments with a short email to clarify information.
If you are sending invoices to embassies these will be created in the same way as for self-pay patients, but a greater focus will be needed. Prior to an appointment with a patient sponsored by an embassy, it is imperative to have a letter of guarantee from the embassy which guarantees they will cover the costs.
Without this letter, getting paid will be much harder. Even with a letter of guarantee, some embassies are notoriously bad at making payments to the point that some doctors will not treat their patients.
You may also be invoicing law firms for medico-legal work, and again these are raised in the same way as a self-pay patient. Most law firms have robust payment processes in place, but your billing manager should be ready to chase if needed.
My advice with both embassies and law firms is to attempt to build relationships with key contacts within the organisations to smooth the process.
Reconciliation
The next step in the invoicing process is to reconcile payments received against the invoices issued. The invoice payment methods may be different but the reconciliation process is the same. Payments are allocated against the specific outstanding invoices. If you are using electronic billing via Healthcode for insurance patients, this process will be easier for your billing manager.
Insurance companies will regularly send remittance advice notes that need to be checked against the invoice details on the system, but you can also view live updates via Healthcode.
If self-pay patients are paying by credit or debit card, the payments should be marked as paid on the day payment is made. There is nothing worse than chasing a patient for payment when they have already paid.
Bankers’ Automated Clearing Services (BACS) payments will need to be reconciled with bank statements and that is a harder task than it sounds. Encourage patients to quote their unique invoice number when making a payment to ease the process and ensure accurate payment details are provided.
Payments should be reconciled regularly so that you have an accurate picture of your current debt. I would suggest that a reconciliation is done at least weekly.
Your billing manager should circulate a monthly finance report to the practice team showing the total amount of invoices raised and invoices paid during the previous month. Most importantly the report should also track aged debt levels. It is always best to address issues early and therefore avoid aged debt growing into a significant number.
Credit control process
Each practice needs to define their credit control process. An invoice sent to an insurance company or self-pay patient may be paid promptly, but often this is not the case and the debt will need to be chased based on the invoice due date.
There will always be patients who do not pay on time and standard protocols to collect payment owed will need to be created and followed by your billing manager.
A robust monitoring system must be in place so that you can keep track of reminders sent. This can be managed within your practice management system.
A good practice management system will allow you to set up a process for chasing debt, but your billing manager will need to define the parameters. You can set up standard template letters to be sent after certain periods of time.
The time allowed may differ depending on your practice, for example, you may feel that patients should be allowed a month to pay before receiving their first reminder.
This might be the case in a practice where you are seeing the patients regularly and have every confidence that they will pay at their next appointment. In another practice, you may want the reminder to be sent seven days after the initial invoice.
Reminder letters
You can set up a series of reminder letters to be sent by email to patients to chase their payment. These letter templates must be created and while the first might be a very gentle reminder, the third reminder needs to be a little sterner.
Eventually, someone will need to pick up the phone to chase payment and that is not a task liked by most. If a patient is ignoring your letters, then a phone call may be just what is needed to prompt payment.
Again, you need to decide at what stage this occurs. Do you wait one month or three months before taking such a step? What feels right in your practice?
Debt collection
Thankfully, most patients do pay what is owed, but there will be a small percentage who ignore emails, letters, and phone calls.
You need to be clear on how you will handle this.
You may also want to consider requiring payment in advance for certain treatments or consultations to avoid potential issues with unpaid invoices. Are you happy to accept a certain percentage of non-payment and simply write this off?
Or do you want to take this further and involve a debt collection agency to recover what is owed from the patient? Obviously, this is the last resort, but one you will need to consider.
Whatever you decide, it needs to be stated in your terms and conditions provided to your patient when they book their first appointment.
In-house billing and collection
Whether you are running a large hospital or a small clinic, you have a choice whether to manage invoicing and credit management in-house or to outsource to a specialist company.
Many consultants choose to handle invoicing themselves when they first start out in private practice, in partnership with their medical secretary. This can be a workable solution in the earliest stage, while the practice builds, but care needs to be taken to ensure it is scalable once the practice becomes busier.
You may need to employ additional members of staff to manage the invoicing workload. You may employ a medical secretary and a billing manager who are able to work closely together, but both have clearly defined roles. As always, effective, and clear procedures need to be in place from the very start.
It is imperative that administrative and financial processes are reviewed regularly and documented to avoid key person dependency. You do not want to find yourself in a situation where someone is sick and no one else knows how the systems and processes work.
Consultants and their secretaries often find chasing debts to be an uncomfortable task and not one that fits easily within the culture of a healthcare company.
You will need to ensure that you and your team stay informed about technological advances and best practices for invoicing so that you and your patients can benefit from them.
On the positive side, handling invoicing in-house means that you have complete control and can feel comfortable that every communication with your patients is made by a member of your team.
Outsourcing invoicing
Many consultants, clinics and hospitals engage an external specialist billing company to manage their invoicing and payment on their behalf. Most of these companies charge a percentage fee for the invoices they process and collect on your behalf.
They can also chase aged debts and provide a variety of management reports such as insurance breakdowns and bank reconciliation information.
Some firms have their own custom software for this, while others integrate with industry-standard practice management software. It is always better to use standard systems to avoid being tied to one company long-term. It is good practice to keep your options open.
The primary advantage of outsourcing billing and collection is that consultants can spend more time concentrating on their patients and developing the medical side of the business. It is also hugely reassuring to know that such an important aspect of your practice is managed by a team with expertise and the value of this should not be underestimated.
The downside is the additional cost, although this should be weighed against the potential savings outsourcing may provide. For most organisations the cost is less than the money that can be lost due to bad debt recovery.
Summary
Following the tips provided in this article will hopefully mean you now know how to invoice your patients to ensure you get paid and can establish an excellent invoicing and credit control function for your practice resulting in fewer debts.
If you need any advice, please do contact the team at Designated Medical.