Of the circa 690,000* bills submitted to Healthcode each month a proportion fail because they are missing important information or contain inaccuracies. In this blog, we highlight the most common reasons.
Here are the main categories of failures that can cause your bill to be rejected at the validation stage:
- Patient insurance details
- Controlling specialist
- Procedure code
- Service date
- Service item provider number
However, some of the failures are due to things such as codes not being mapped or the practitioner’s recognition not being updated by the insurer which will need to be followed up with Healthcode or the relevant insurer.
Failed bills are frustrating but they have more serious implications for you and your organisation as payment delays can have a serious impact on your cash flow and limit your working capital. What's more, submitting an invoice which is incomplete, inaccurate or months old can make you seem disorganised or unprofessional.
The first step to creating bills that are fit for purpose is to include all the information the recipient needs about what they are being asked to pay and why. We recommend the following is included on all invoices as best practice:
- About the invoice - invoice number and data
- About you - full name, provider number, specialty, billing address, payment details
- About the patient - patient name, date of birth, insurance company, policy number, address, where applicable diagnosis code and description, plus lead practitioner's name and provider number
- About the treatment - the type of care delivered, date of treatment, service delivered, procedure code, total amount
Invoice templates which meet these standards are available to download here. They can be used for invoicing organisations, insurers or self-paying patients.
*Figures based on bills sent via third-party software users only