A guide to the Clearing Service

We are an IT solutions provider for the whole private healthcare sector and the insurance companies are also our customers. Our aim is to produce systems to facilitate and improve the operational efficiency of administrative processes for everyone. The contracts and fee schedules that exist between insurers and healthcare practitioners are none of our business and out of our control. 

Nothing has changed. Healthcode was established in 2000 as the official clearing company for medical bills but we are more than a billing service. Over the years, our technological expertise has seen us take a leading role in developing industry coding and billing standards, as well as developing a range of specialised products and services to support independent practitioners which are available in one place on our secure online platform. These include electronic billing, clearing of electronic invoices, practice management, secure messaging and file sharing, clinical coding tools, and most recently, The Private Practice Register, where practitioners can maintain their own specialist profile and data.

Our ambition is to help healthcare professionals and organisations streamline admin processes and work together more effectively. This is the future for both the Clearing Service and for Healthcode as a technology company at the heart of the private healthcare sector and is essential to the future success of the sector itself.

The adoption of electronic billing has been a positive step for the whole sector, including practitioners.  To make it easier, Healthcode facilitates the industry by enabling you to submit electronic bills to all leading PMIs from one secure platform.  Any anomalies are flagged immediately based on the specific insurer rules, this means you or your secretary don't have to remember which insurer requires what. Not only is electronic billing more secure and more efficient than both traditional paper billing and direct email but it is better for your practice cash flow, as electronic bills are automatically validated on submission, so they are ready for processing and payment on receipt. This means the insurer receives it quicker and, dependent on the payment cycle, invoices can be paid as soon as one week.  In addition, this also benefits the patient by removing the financial stress.

Around 24,000 practitioners have an account with Healthcode and bill electronically; this ensures they can avoid delays paper billing may have such as a postal strike or other unforeseen circumstances. Our ePractice Basic plan will also include electronic billing for other types of payors to further help improve your processes.

The Clearing Service subscription is set up on a rolling direct debit basis and can be cancelled and re-subscribed at any time.  The below grid provides a snapshot of the cost by monthly invoice volume (starting with 10 invoices for illustrative purposes only). 

As these charges are associated with running your private practice they are 100% allowable as a business expense and can, therefore, be offset against tax.

The Clearing Service subscription fee includes the following functions:

• the ability to submit your invoices to multiple insurers (currently Aetna, Alliance Health Group, AXA Health, Aviva, Bupa, Bupa Global, Cigna Healthcare, The Exeter, Healix, VitalityHealth and WPA) from one secure platform
• validation of electronic invoices to Private Medical Insurers (PMIs) and other healthcare payors based on their specific rules
• rejection and flagging of invoice content where it does not meet the validation rules
• confirmation that your bill has been validated and collected by the PMIs
• data security – electronic bills submitted through Healthcode’s Clearing Service are encrypted to protect both financial and patient data 

In addition to these you also benefit from:

• Accurate and efficient: details are checked on submission of the electronic bill to ensure it meets the relevant insurer’s rules, avoiding time-consuming queries.
• Healthy cash flow: validated electronic bills are ready for processing and payment so they reach insurers’ payment cycle quicker.
• Reassurance: You know as soon as your electronic bill has been received by the insurer, because the bill status is displayed on the system.
• Free Customer support Our Customer Services team is available from Monday-Friday 08:00-18:00 or alternatively use Harley our help bot who is available 24/7 on all our main website pages.

No. Although you can continue to use the software without a Clearing Service subscription, including accessing your remittance advices, you will not be able to submit any electronic bills without it.

Yes. If you wish to use third-party practice management software you can still benefit from the Clearing Service, as long as the software is compatible. A list of compatible software systems can be found here.

Please register for a VEDA account here. Once registration is complete your user credentials along with a web services credential (if applicable) will be issued.

It is important that independent practitioners have the best possible experience of Healthcode. Firstly, that means ensuring our services are reliable, robust and secure with 24-hour data back-up and recovery. In 2019, we restricted downtime to less than 1%.

Secondly, customers who need to contact us are entitled to expect a professional and responsive service. In this respect, we will invest significantly in technology the first step being Harley the help bot who is on hand 24/7 to support customers with their queries. We are also expanding our customer service team, who on average deal with 5,000 calls a month.

For ePractice

To request a login, please complete a user login request form here.

When completing the “role” field, you will need to select "Other (find with SiteID)" and enter the Site ID, which is the 7-character account number starting with HC. You will need to repeat this process if you need login access to other sites.

For third party practice management software (VEDA)

To request a login, please complete a user login request form here.

Follow these steps to complete the form:

• Role field: Select "Other (find with SiteID)" and enter your 7-character account number starting with HC
• Access Levels: select HC VEDA
• Select Basic Billing Access

Once we have received your form, we will issue your user credentials to enable you to log in to your account.

Other methods of invoice submission also have issues. For example:

• By post you will need to factor in the costs of the materials (paper, envelope, printing ink, stamp/franking) and the admin time taken to get it ready (folding and putting into the envelope, adding the stamp/franking) and take it to the post box. If the invoice never gets to the insurer you have no way of tracking it and no recourse to recover it and you will not know until you realise that the insurer has not paid you. Depending on how robust your credit control procedure is, this could be weeks or months after you initially posted it.

• By email, if you are not using an encryption service to send an email and if someone, who is not the intended recipient, intercepts and opens it, this counts as a data breach as your invoices will not only contain the personal details of your patients but also health information which means it is “sensitive” under the UK’s data protection legislation. In addition, sending encrypted emails could also cause problems at the insurance company as they may not use the same system or their internal servers could block them.

Using both these methods does not ensure that your invoice meets the validation rules and you will not find out whether it has been rejected until the insurer has manually processed it and you are informed of the outcome on your next remittance advice.

Healthcode was established and continues to exist to drive operational efficiency across the industry; profit maximisation has never been the main purpose of the business. We made our Clearing Service available free of charge to independent practitioners to ensure they could reap the benefits, including efficiency savings, better cash flow and reassurance of data security compliance and back-office support i.e. technology and data security upgrades are carried out behind the scenes at no extra cost to you.

Historically, Private Medical Insurers (PMIs) have borne the cost of the clearing of medical invoices as well as it being funded by Healthcode through other activities. Although, PMIs will continue to pay for the clearing of medical invoices, increased customer and billing volumes means we have now reached the stage where a free service to practitioners and clinics is simply no longer sustainable. The pricing model we are introducing has been designed to be the fairest to most of our customers.

The Clearing Service will offer you peace of mind - it's more secure than post or unencrypted email, it will provide visibility the insurer has collected the invoice, and you continue to benefit from quicker payment as it reaches the payment cycle quicker. 

The Clearing Service subscription fee includes the following functions:

• the ability to submit your invoices to multiple insurers (currently Aetna, AXA Health, Aviva, Bupa, Bupa Global, Cigna Healthcare, The Exeter, Healix, VitalityHealth and WPA) from one secure platform
• validation of electronic invoices to Private Medical Insurers (PMIs) and other healthcare payors based on their specific rules
• rejection and flagging of invoice content where it does not meet the validation rules
• confirmation that your bill has been validated and collected by the PMIs
• data security – electronic bills submitted through Healthcode’s Clearing Service are encrypted to protect both financial and patient data 

In addition to these you also benefit from:

• Accurate and efficient: details are checked on submission of the electronic bill to ensure it meets the relevant insurer’s rules, avoiding time-consuming queries.
• Healthy cash flow: validated electronic bills are ready for processing and payment so they reach insurers’ payment cycle quicker.
• Reassurance: You know as soon as your electronic bill has been received by the insurer, because the bill status is displayed on the system.
• Free Customer support Our Customer Services team is available from Monday-Friday 08:00-18:00 or alternatively use Harley our help bot who is available 24/7 on all our main website pages.