Self-pay demand is a key component of the independent healthcare market. Simon Brignall of Civica Medical Billing and Collection explains why it is important that your billing process meets the needs of the modern private patient.
The rise of the self-pay patient
Self-pay patients have become one of the most important drivers of growth in private practice. At Civica Medical Billing and Collection, we have seen a 50% increase in the proportion of self-pay invoices we raise.
Many of these patients may be choosing private healthcare for the first time, and with satisfaction and service metrics high, all the evidence show that they are likely to make recommendations to friends and family. Issues around NHS waiting lists and increased demand from wealthier older patients will continue to ensure that this demographic is a key component of independent healthcare.
Why self-pay matters commercially
Self-pay activity offers consultants greater control over revenue and cash flow compared to private insurance reimbursements, which are often tied to insurer fee schedules. Self-pay allows providers to set fees in line with factors such as their experience, patient demand and how they choose to deliver care.
If you have not updated your fees in a while, this could be a good time to conduct a review of your fee structure.
Practices in specialties such as dermatology, ophthalmology and mental health can be more than 50% self-pay, and this number can be closer to 100% with private GPs.
Meeting the needs of the modern self-pay patient
Considering the value of self-pay patients to your practice, it’s important to make sure that the billing process for these patients is managed effectively.
In our experience this is often not the case. Practices rarely offer the comprehensive range of payment options these patients need, and the chasing of outstanding debts is often sporadic. The result is that the practice accumulates a large amount of outstanding debt leading to cash flow difficulties or even worse the loss of income.
Self-pay best practice
Fees should be transparent. It is important to have a published price list and that you have notified the patient of the amount is due in advance. It is best practice to also confirm the payment options that are available as well as when payment is due.
At Civica MBC, we offer a variety of simple secure payment pathways to our clients tailored to the specific needs of their practice:
- We typically invoice patients post treatment offering 24/7 payment collection either online or over the phone via our payments team.
- Invoicing and collection of payment is also available in advance.
- Our Client Self-pay platform enables payments taken on the day.
Remember that when you are invoicing patients post treatment date, you will need to put in place a robust chase process for any outstanding invoices and ensure that this is routinely followed until payment is collected. Failure to implement this effectively is the most common reason we see practices with spiralling debt levels and issues around cashflow.
At Civica MBC, we have an average bad debt rate that is less than 0.5% and for many practices it is closer to 0.3%.
Civica MBC clients also benefit from modern payment solutions including:
- Google/Apple Pay and Open banking.
- Ability to settle multiple invoices at the same time.
- Option to add a payment link to their website.
International patients
If you are going to see a patient who is not a resident of the UK, it’s even more important to make sure that your fees, method of payment and payment date are made clear as once they leave the country it is extremely difficult to collect any monies owed.
As a rule, for most Civica MBC clients that deal with international self-pay patients we collect the money in advance of treatment to mitigate this risk.
Collection by the facility
It is increasingly common for hospitals and clinics to collect monies on behalf of their clinicians.
To manage these effectively these patients still need to be recorded, payments reconciled, and most importantly outstanding payments chased. Hospital administration can be inconsistent and service levels can suffer from staffing issues, leading to payments being delayed or missed entirely.
At Civica MBC, we raise an invoice to the hospital for your fee on our system, reconcile the payments received and liaise with the hospital finance teams to obtain any monies owed.
Insurance shortfalls
The invoicing and collection of outstanding monies from patients with Private Medical Insurance (PMI) that result from shortfalls, excesses and co-payments is something that many private practices find challenging.
Remember whatever the reason for the outstanding balance, it still falls on the practice to manage this process. Most patients do not review the terms of their insurance policy and often assume that all costs are going to be met by their insurer. So, when they receive an invoice for an outstanding balance not covered by their insurance company it can come as quite a shock.
It is important for the practice to follow up with the patient directly and clearly explain what is owed and why. Some patients may choose to contest this with their insurer believing that the PMI is liable, which is why It is important that any issues are highlighted as soon as possible to minimise delays. Once the patient accepts the debt is their responsibility then steps need to be put in place to take payment.
Next steps
The growth in demand from self-pay patient will continue to shape private healthcare. Take the time to consider if your practice is meeting their needs. Partnering with a specialised billing companies like Civica Medical Billing and Collection can offer the necessary expertise and functionality to optimise revenue collection and increase patient satisfaction
Simon Brignall is Head of Sales and Accounts at Civica Medical Billing and Collection.
