Private Patient Retrospective Invoice Review

Retrospective Invoice Review to identify on average a 20% uplift on private patient revenue.

The Liaison Retrospective Invoice Review can assist Trusts with their savings targets to generate real refunds to Trusts. On average, the review identifies a 20% uplift on private patient revenue which can be offset against Financial Targets.

We agreed to complete a sample exercise as a ‘piece of mind’ exercise for a Trust that had spent almost 12 months reviewing the processes and procedures of the Private Patient Department; focusing on pricing, billing and income generation in general.

The Trust has approximately 400 NHS beds, 7 main theatres and 2 day theatres and offers a wide range of private treatments, surgeries, medical consultancy, therapies and outpatient services.

To demonstrate our uniqueness in the market, we compare PP recorded data with numerous other NHS reports in order to identify additional anomalies and calculate accurate invoicing; increasing revenue.

Our contractual arrangement with a client in relation to the Retrospective Invoice Review ensures that we only charge fees once savings identified are realised i.e. a Trust is in receipt of additional income. This was a ‘win win’ situation for this particular Trust as the changes they had implemented could be measured and monitored without incurring unnecessary fees.

The Outcomes

33% of Trust Private Patient revenue provided for Audit.

24% potential increase in revenue from audit findings.

78% of audit sample with revenue query.

92 patient episodes analysed.

72 surgical episodes with procedure query.

58 episodes without accommodation charges.

£65k potential revenue not billed.

£38k value of procedure related queries.

£21k accommodation not charged.

The Benefits

The sample exercise identified:

Extra Income

Including under charged income to insurance companies (estimate at over £190K per annum)

Complete Gap Analysis

Identifies areas where Trust makes consistent errors in charges, to recommend improvements

The next phase of the work with this Trust includes a full retrospective invoice review to realise savings on the full in-scope period. Further, we anticipate becoming a long term partner with the Trust to proactively monitor and audit charges to Insurance Companies as well as provide additional consultancy services in the following areas:

Best Practice Methodology
Price Benchmarking
Profit & Loss Compliance for Private Patient Benchmarking

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