What you Should know before selecting a practice management provider

By: Healthcare Solutions  06-02-2011
Keywords: Medical Practitioners


What you should know when selecting a service provider:

Many medical professionals make use of practice management firms or bureaus, but very few practitioners actually know what to look for when selecting a service provider.

Other practitioners have concerns and reservations in this regard; below we clarify general misconception whilst highlighting some of the real risks of other practices & procedures, or the lack thereof being applied in the industry.

1.    Are my funds accessible, secure and accurately accounted for?

Best practice as applied by us:

·         A separate account is created – ensuring accuracy, fluency and accountability;

·         The practitioner is given access to the account and authority of pre approved scheduled payments – ensuring accessibility, security and transparency;

This system thereby enables the management of all funds due to a specific practice in a separate account per practice. This enables the accurate monitoring of payments and claims, ensuring the effective collection of short and non-payments.

What to look out for:

·         A consolidated account;

·         Not having access or authorisation abilities to your own funds;

·         Collections taking place on currently liable amounts;

·         External collections agencies collecting prematurely but also in a consolidated fashion which compromises ability to allocate funds accurately.

2.    How regularly can I access my funds?

Best practice as applied by us:

The separate account per practice enables regular weekly payments or on request.

3.    How efficiently are MY claims handled to ensure quick turnaround times?

Best practice as applied by us:

Electronic submission is critical to achieve quick turnaround times, and do we address this as follows:

·         by supporting all major software we seamlessly integrate with any practice for efficient claims submission;

·         we also supply software and training to capacitate the practitioner to capture their claims to enable submission.

We handle manual capturing of claims by capturing it electronically to ensure efficient submission and monitoring.

What to look out for:

Manual submissions by service providers which enables human error to creep in, also compromising submission times, monitoring and accuracy.

4.    Impact on my patients?

Best practice as applied by us:

The supply of healthcare services to the public is a highly personal service; we appreciate this and ensure that parties are treated in a professional manner, and are not harassed, as this could lead to tension in the doctor patient relationship.

This notorious balance can only be achieved when the correct steps are taken prior to a claim becoming a problem, such as debit order facilities and payment undertakings by patients.

What to look out for:

Debt collection orientated service providers, rather than debt management providers.

5.    How do I ensure my service provider is reputable?

Best practice as applied by us:

The medical financial sector is relatively new in South Africa in relation to developed countries such as the United States, Australia, New Zealand and Europe. The latter has regulatory bodies in place to govern providers, which in turn shows the trend South Africa is moving towards.

We feel it is important that the service provider and the resources are registered at professional and/or regulatory bodies; we are registered at:

·         PASA (Payment Association of South Africa as mandated by the South African Reserve Bank)

·         SAICA (South African Institute of Chartered Accountants)

·         Law Society of the Northern Provinces

·         PSSF (Payment System Stakeholder Forum)

What to look out for

Service providers whom are not registered at any professional bodies and neither have any employees that are registered at any professional body.

6.    What about hidden costs?

Best practice as applied by us:

When a provider supplies services under the flag of the National Payment System (NPS) as enforced by the Payment Authority of South Africa (PASA), no hidden costs are allowed to be charged on the collections account and set-off against it.

Directive 1 of 2007 as issued by the South African Reserve Bank (SARB) states that no set-off of funds is allowed for when collecting funds from a third party on behalf of a beneficiary.

What to look out for

The common practice in the healthcare industry is to set-off claim submission costs, admin fees, etc from the amount collected. As stated, this is not allowed, and should extra costs be invoiced separately to the client. This also leads to amounts being claimed without the necessary consent.

Always ensure that these amounts are billed separately. This will ensure that you know exactly where and how your money is being managed.

7.    What are the terms?

We strictly act in accordance with the contractual terms in the contract we supply to you. The South African Reserve Bank requires any party handling payments on behalf of third parties to have a contract with that person, normally regulating the manner in which payments are received, termination clauses, obligations and so forth.

What to look out for

Always ensure that the contract allows for normal termination, and will not put you in a position where you need to pay cancellation charges or penalties.

Always ensure that the agreement you have covers all the services you applied for. Some services are governed by providers, such as debt collectors, and should these services be governed by a separate agreement, stating its separate fee structure.

The same applies to the sale of debtor books to providers. The danger exists that you are liable for any funds paid to you, and not collected from medical schemes or patients by service providers or credit providers. The shock of noticing that you are indebted to them for hundreds of thousands of Rand is a reality many medical practitioners in South Africa are currently faced with.

Keywords: Medical Practitioners

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