How to ensure you get paid

How to ensure you get paid

chasing-money-large

 

TopTips2Invoicing and credit control is a time-consuming task in private practice, but it is essential for obvious reasons. Yet it is the area of practice management that is most often overlooked. Jane Braithwaite reports.

Many doctors and medical secretaries are highly focused on patient care, as they should be of course, and therefore billing and collecting the money becomes the lowest priority.

It is not natural for a doctor to switch conversation with a patient from their symptoms and care plan to payment.

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.

Private consultants can sometimes struggle with the contrast between private practice and working for the NHS. It can be difficult to feel comfortable charging for your medical services after years of NHS work, which is ‘free’ to patients.

Robust credit control

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. This team will often be more aligned with the finance team and this makes total sense. But in a smaller practice, billing must be handled by the secretarial team.

It is well reported in the business world that cash flow is king, especially in the first years of a new business. 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.

Using good systems will help alleviate and automate much of the process relating to invoicing and collection. It is also key to define good processes and ensure the system is set up to support these processes.

Most private clinics will be invoicing both insurance companies and self-pay patients. They may also be invoicing embassies and legal companies.

You may already have a practice management software system in place, which could also handle billings, reminders and management accounts.

This could also make it much easier to comply with increasing requests from insurers to send billing information electronically using electronic data interchange.

Submitting invoices electronically will also speed up payment settlement, which should greatly help with credit control.

Electronic billing

chasing-moneyThe use of technology is imperative, particularly for invoicing insurance companies.

A good practice management system will link to Healthcode and allow electronic billing. All private doctors should be using this technology, as it ensures that insurance invoices are dealt with very quickly and smoothly.

A good practice management system will also ensure that invoicing self-pay patients is simple and easy.

Invoice templates can be created with pick lists of the most commonly used items. 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.

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 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 information given to patients afterwards or even following up appointments with a short email to clarify information.

If you are sending invoices to embassies and law firms for medico-legal work, these will be created in the same way as for self-pay patients, but a greater focus on chasing for payment will be needed, as these invoices often take much longer to be paid.

My advice would be to attempt to build relationships with key contacts within the organisation to smooth the way.

Reconciliation

The next step in the invoicing process is to reconcile payments received against the invoices issued. If you are using electronic billing for insurance patients, this process will be easier for you.

Insurance companies will regularly send you remittance advice notes that need to be checked against the invoices on the system.

If self-pay patients are paying by credit 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.

chasing-moneyBankers’ 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 invoice number when making a payment to ease the process.

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.

At the end of each month, a report of current debt should be produced and reviewed by key members of the team to identify and address issues early and therefore avoid that debt growing into a mountain of unpaid dues.

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 quite often this is not the case and the debt will need to be chased.

There will always be patients who do not pay on time and standard protocols to collect payment owed will need to be followed.

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 you 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. 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 chasing 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

chasing-moneyThankfully, 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. 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. Obviously, this is a last resort, but one you will need to consider.

Whether you are running a large hospital or a small clinic, you have a choice whether to handle invoicing and credit management in-house or to outsource.

In-house billing and collection

Many consultants choose to handle credit control themselves when they first start out in private practice, in partnership with their medical secretary. This can be a workable solution while the practice builds, and needs to be scal­able once the practice becomes busier.

You may need to employ additional members of staff to manage the workload. You may employ a medical secretary and a billing specialist who are able to work closely together but have 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.

There are a number of accountants who specialise in the private medical sector who could help with reviewing and recording your clinic procedures. And while this may seem expensive, it may turn out out to be a cost which repays the investment many times over.

Consultants and their secretaries often find chasing debts to be an uncomfortable task and not one that fits easily with the medical ethos.

You will need to ensure that you and your team stay informed about technological advances 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

chasing-moneyMany consultants move their entire invoicing work to an external company, which will send invoices, liaise with insurers and chase payments.

Most of these companies charge a percentage fee for the invoices they process and collect on behalf of your practice.

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.

The primary advantage to outsourcing billing and collection is that consultants can spend more time concentrating on developing the medical side of the business.

The downside is the additional cost, although this should be weighed against the potential savings outsourcing may provide. Consultants should also consider whether relationships with patients could be negatively impacted by moving invoicing to an external company. As always, communicating regularly with patients may help offset any problems.

Following the tips provided in this article may hopefully mean fewer debts are left to chase.

 

Jane Braithwaite is Managing Director at Designated Medical and regularly contributes to the Independent Practitioner Today publication.

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How does your practice grow?

How does your practice grow?

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TopTips2Jane Braithwaite’s latest article in her series about managing your private practice puts the spotlight on the broad area of business development.

 

We often see or hear the term ‘business development’, but it is little understood and often it is confused with sales.

Well, I see business development as all the activities that lead to developing your practice or clinic in terms of growth and expansion.

Anyone who has their own private practice or medical company will understand that the healthcare landscape changes all the time.

To grow and develop, we need to change with it. One of the key reasons for business decline is a failure to spot change and exploit the new opportunities that change offers.

Business development is broadly considering what we need to do to ensure we have insight into upcoming markets, services and/or technology that could make an impact on our current businesses.

This month, I am going to explore the various options that are open to all of us and I hope one or more of these ideas resonate with you.

Developing and growing your practice or clinic further might mean offering additional services to your existing patients or looking at new channels to appeal to a new set of patients for your existing services. It might be a mixture of both. In either case, there are numerous options.

Expensive overhead

top-tips-jigsaw-smallPerhaps there is a complementary aspect of healthcare that your existing patients would appreciate. You could enable this by inviting another practitioner to make use of your facilities.

Physical consulting space is an expensive overhead and it is always wise to consider how you can make better use of the space you have in a way that might complement your practice. Do some market research or competitor research to find out what your options might be.

You may feel there is an opportunity to grow by servicing a wider geography. Could you add another clinic at a hospital in a different location, if your schedule allows?

It might also be worthwhile considering different age groups and identifying the differing needs of each group. Consider the age range of your current population.

If the patients at your clinic tend to be 40-plus, do you need to review your marketing activities to attract potential patients below the age of 40?

A good understanding of the different requirements of differing age groups will assist you when it comes to marketing your services at a broader age group. Perhaps the message to younger patients is about preventive healthcare rather than specific treatment plans.

New offerings

Technology now offers us different ways to communicate with patients and this may enable new service offerings such as telephone, email or skype consultations.

Embracing these technologies may allow you to offer more frequent support to your current patients and allow you to reach patients who are unable to see you in person. There are several very successful companies offering only ‘virtual’ consultations.

There may well be a greater opportunity for doctors who are able to offer both face-to-face and virtual services in a complementary manner.

Regardless of how you decide you should develop and grow your practice, there are numerous ways in which you can ensure you meet your objectives.

Networking wins

top-tips-jigsaw-smallOne of the main ways to identify and research new opportunities for business development, and to progress them, is to invest time in networking.

It’s a core part of business development, as leveraging relationships is critical to success. How do you maintain relationships with patients, staff, suppliers, organisations, the local community, hospitals and other doctors?

Traditional networking is about communicating in person with patients, colleagues, suppliers and peers. There are numerous events that provide such opportunities and often provide valuable opportunities for education and reflection.

Do you arrange regular events at your practice and invite your own contacts to attend? This requires a real investment in time and effort, but can provide valuable opportunities for referrers, patients and prospective patients to get to know you.

You will also get some valuable feedback this way – people are far more forthcoming in person than on a feedback form.

Networking these days also includes your online network. Your practice may have several different social media channels that allow you to communicate with a wider audience. The most personal networking tool is probably LinkedIn.

It’s a valuable tool, especially for keeping in contact with your peer group. Most people check LinkedIn at least once each week to accept connection requests and check on messages, but you could maximise its power by contributing to conversations daily so that your name comes to mind at the right time.

Presenting at conferences and events only suits certain individuals, but if this type of activity appeals to you, it is a powerful way to reach a far wider group of people. If presenting is not especially attractive to you, then perhaps publishing articles is more realistic and enjoyable.

Powerful communication

top-tips-jigsaw-smallVideo is a very powerful way of communicating with your audience. Like presenting, you will either love it or hate it, but it is a very wise investment. Ideally, you would create regular videos, upload them on You Tube and link to your website. This is an area that is going to grow and grow in popularity.

Healthcare marketing is rapidly becoming more focused on digital, but still relies significantly on print advertising. Whether you’re handling your own marketing or outsourcing it, you must be clear on what your audience and goals are before starting.

Without an awareness of whom you want to reach and what you want to achieve, any money spent is wasted.

You also need to bear in mind the guidelines issued by the GMC and the BMA around ethics and confidentiality when it comes to marketing your services.

Below, I have highlighted some important marketing areas to keep in mind, but it’s important to get a full assessment of your marketing needs, as every business is different.

Business website

I suspect that anyone reading this has a website of some description, but is it doing a good job for you? Is your website helping you to reach your desired audience? Once potential patients visit your website, do they follow through to book an appointment?

A website should not be a static tool but should evolve and change over time to better suit your purpose. For a start, any website which isn’t enhanced for mobiles is not going to appeal to users – you may lose them before they have got past the homepage.

Does your website allow users to book an appointment online? If competitors have this option, so should you.

What capability do you have to record testimonials from your site or include reviews from other sites such as Trustpilot, Facebook or Doctify?

Patient reviews are key to build your reputation, and therefore your business.

Finally, a key way for new patients to find your website is a Google search, but this relies on your site being optimised for search engines (SEO).

Many people think that SEO is a one-off activity, but it’s best to review every six months to make sure that your brand is still appearing near the top. This is where it does pay to hire an SEO expert, as it’s a science which relies on many factors and changes often.

Business blogs

One of the main factors which affects SEO is ‘freshness’ of content – a website which never changes will not score highly and won’t appear on the first page of results. This is one of the reasons why so many businesses embrace regular blogs.

Blogs, if marketed properly and consistently, can attract new patients. But this is if they’re written to add value for the reader, rather than simply advertise the business.

One of the most successful blogs written for my business, Design­ated Medical, was about the EU’s General Data Protection Regul­ation. It contained helpful information for our audience and brought new visitors to our website. It wasn’t about the services we offer or salesy in any way. Writing content which is valuable for your audience is key for blogs.

Are you using GMB?

Don’t forget about Google My Business, which is an excellent – and free – way to boost your business online. GMB is basically your business profile on Google, where you can add your opening hours, photos and short posts.

It’s also where you can respond to Google Reviews. It’s quick work to set up your GMB profile, but well worth it to control your image on the biggest search engine.

Social media

Social media marketing is a very cost-effective marketing method, and for most private doctors it can be a very successful way to grow networks and attract patients.

As before, knowing your audience and goals is essential to make social media work for you. If you’re looking to establish more business connections or thinking of branching out to other markets, LinkedIn will be a key platform for you.

Twitter also works very well in terms of business relationships, as it’s more conversational and ties in well with events. Facebook is ubiquitous for businesses but using its low-cost, super-targeted advertising is the key to success.

You can also get impressive reach via free Facebook events listings. Finally, Instagram can work very well for beauty and aesthetics clinics, with image-driven high engagement.

 

Jane Braithwaite is Managing Director at Designated Medical and regularly contributes to the Independent Practitioner Today publication.

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Designated Medical are GDPR Ready!

Designated Medical are GDPR Ready!

Our commitment to GDPR

Introduction

The European Union has taken a monumental step in protecting the fundamental right to privacy for every EU resident with the General Data Protection Regulation (GDPR) which will be effective from May 25, 2018. Simply put, EU residents will now have greater say over what, how, why, where, and when their personal data is used, processed, or disposed. This rule clarifies how the EU personal data laws apply even beyond the borders of the EU. Any organisation that works with EU residents’ personal data in any manner, irrespective of location, has obligations to protect the data. Designated Group, including Designated Medical is well aware of its role in providing the right tools and processes to support its users and customers meet their GDPR mandates.

Designated Medical’s Commitment

At Designated Medical, we have always given our clients and contacts’ the right to data privacy and protection. We have never relied on advertising as a means to generate business and we have never sent direct advertising to our contact database, and never will.  This means that we have no necessity to collect and process our contact database’s personal information beyond what is required for the delivery of our services and to ensure we optimise how we can help and support them.

Over the years, we have demonstrated our commitment to data privacy and protection by meeting the industry standards for data protection. All client sensitive data is saved in an encrypted storage facility which is tightly regulated.  We have also made significant investment into our IT infrastructure and we recognise that the GDPR will help us move towards the highest standards of operations in protecting customer data.

How is Designated Medical preparing for GDPR?

We have reviewed all our data and touch points where we collect data and have ensured that we are fully compliant by the time the regulation comes into effect.  Designated Medical also understands its obligation to help clients and contacts get ready for the big day and has published useful information to assist them in the process.

We have thoroughly reviewed GDPR requirements and have put in place a dedicated internal team to drive our company to meet them. Some of our ongoing initiatives are:

  • Identifying personal data – All our data is categorised and integrated with our marketing systems to ensure consent and accessibility.  We  have invested in systems to ensuring accuracy and control of data across all systems.
  • Providing visibility and transparency – The most important aspect of GDPR is how the collected data is used. Designated Medical’s key role is to provide our clients and contacts (the data subjects) with the access to effectively manage and protect their user data. Designated PA has contacted each and every contact allowing them access to opt in and out and update their personal information.
  • Enhancing data integrity and security – Data privacy and data security are two sides of the same coin. As our clients tighten their data security measures, Designated Medical would like to extend a helping hand and have a team of marketing experts who can assist with GDPR compliance.  We have invested heavily in our IT infrastructure to ensure we maintain a high level of security and integrity.
  • Portability and transferability of data – GDPR gives data subjects the right to either receive all the data provided and processed by the data controller or transfer it to another controller depending on technical feasibility. With this new right in mind, Designated PA is able to export data at an individual level as required.

What does this mean for our clients?

We understand that meeting the GDPR requirements will take a lot of time and effort. And as your partner, we want to help you make your process as seamless as possible, so that you don’t have to worry about compliance and can focus more on running your business.  If you need assistance with implementing processes that are GDPR compliant, get in touch and our team of marketing experts can assist.  The Information Commissioner’s Office (ICO) have a self assessment tool for businesses which is definitely worth a read.

What should you do to be GDPR-ready?

If you are just getting started with GDPR compliance in your business, here’s a quick to-do list to keep in mind.  The ICO have also produced a 12 step process to preparing for the regulation here.

  • Create a data privacy team to oversee GDPR activities and raise awareness
  • Review current security and privacy processes in place & where applicable, revise your contracts with third parties & customers to meet the requirements of the GDPR
  • Identify the Personally Identifiable Information (PII)/Personal data that is being collected
  • Analyse how this information is being processed, stored, retained and deleted
  • Assess the third parties with whom you disclose data if
  • Establish procedures to respond to data subjects when they exercise their rights
  • Establish & conduct Privacy Impact Assessment (PIA)
  • Create processes for data breach notification activities
  • Continuous employee awareness is vital to ensure continual compliance to the GDPR

Are you GDPR ready?

 

Useful Information:

12 Steps to take now

Guide to General Data Protection Regulation

Key Definitions of GDPR

Data Protection Self Assessment Toolkit

What is a bookkeeper?  and why you should hire one.

What is a bookkeeper? and why you should hire one.

That pile of receipts and invoices is getting bigger AND you haven’t updated your cash flow spreadsheet in 2 months!  You know roughly where you are financially with your business but how do you get a clearer, accurate and more up-to-date picture? Most SME’s live and die by their cash flow so employing effective bookkeeping and accountants is invaluable to the overall growth and stability of your business. What is the difference between a bookkeeper and an accountant and which one is the right one for you?

Accountant vs Bookkeeper

An accountant will generally look at your ‘books’ on a quarterly basis and advise on VAT, Corporation Tax owed and other such legal requirements for your business.  As well as classifying, reporting and summarising financial data. A bookkeeper will work on day-by-day basis recording financial transactions chronologically and advise on any cashflow problems or late payment invoices and in some cases, can help with classification and financial reporting.

Most business will really need both services, but often they only engage an accountant largely because they feel they can handle the day to day activity themselves but also to help reduce costs. But is this a sensible decision?

Business owners are so busy running their business, that the task of recording of financial transactions and performing a reconciliation get left to the end of the quarter when the VAT return is due. That also means that for much of the time their view of their company’s finances is several weeks out of date. Some business owners get so behind that their accountant is brought into clear the backlog and this can be a significant expense as it’s not the core business of an accountant to handle this type of work.

At Designated Bookkeeping, we would strongly recommend that all business owners employ a highly trained bookkeeper as soon as they are able to afford to do so. A good bookkeeper brings two distinct advantages: –

  1. Relieves the pressure on the business owner to manage the day to day finances freeing him/ her up to grow their business
  2. Ensures financial control with accurate up to date data.

For more information on our bookkeeping services please visit: designatedbookkeeping.com/ or call us on 02079521460.

Engage. Share. Connect. The Elixir June 2017

Engage. Share. Connect. The Elixir June 2017

The Elixir June 2017 is out NOW!  … read our latest interview with Andrew Vallance-Owen, Chairman of PHIN, check out our new online health checks and social media services, not forgetting all the latest events to add to your diary and news from the DMed Blog.

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