Maximizing Medical Aid Claims

Today’s health care environment is increasingly fast paced, and many doctors and dentist are having difficulty in keeping up since medical aid claims are not what they used to be. On top of this many health care practitioners are feeling squeezed in a financial sense: very busy, but decreasing cashflow.

On the one hand we have a depressed economy which results in increasing numbers of patients defaulting on the medical debt. They are forced to accepting more responsibility fo levies and co-payments, while medical aids are denying claims due to restricted benefits.

One the other hand we have a draconian statutory environment with government hell-bent on creating an environment that seem onerous and scary. Today’s private practitioner is faced with seeing his or her passion for healing people focused almost exclusively on keeping the door open. That said, there are some pretty interesting solutions being thrown around by medical representtaives and others on the fringes of, but with a vested interest in the industry.

One of these is the idea of expanding services or “diversifying” what a doctor or practice can offer their patients. The idea is deceptively simplistic and attractive especially since private practices are experiencing a reduction in revenue from conventional family practice, consultations or procedures. It is hoping to escape the clutches of medical aid claims by expanding offerings of ancilliary services that may not be medically indicated, but more focused on elective ‘self-care’, hoping that medical service providers can create additional income streams. Facilities like aesthetics and rehab centers are examples of this trend.

A solid foundation is what your practice should be built on

Before you think about adding on products and services to bring in more fees and revenue, it’s perhaps more pertinent to examine whether your practice is collecting as much revenue from billed services as is possible. Experience has shown that many practices are sub-par compared to certain benchmarks. This means you may actually be losing a whole lot of money, or as we would say leaving money on the table. And without your even being aware of it, you may in fact be jeopardizing the bottom line of your. To a large extent, what underpins this problem often has to do with inadequate administration, insufficient staff training, problems with routine medical aid claim denials, and shortcomings in patient collection strategies or bad debt collection.

In order to really succeed in today’s private health care environment, you need to invest in good core management before branching out to other avenues or auxiliary services. This means taking a hard look at the fees you bill for consultations, procedures, injections and consumables each day, and how much of fee income is ultimately deposited into the practice’s bank account. And of course how much is written off as uncollectible. A good many practices will find that there is a significant potential to get more cahflow from existing medical aid claims without expending energy and diluting focus into expanding the practice. That’s a win-win for almost all independent practices.

Candidate Ideas for Diversification

There are certainly instances where a medical practice can benefit from either expanding services or partnering with other allied professionals. Creative liaisons and local allied practice collaborations can give your practice more visibility in the community your serve and hence a fuller patient appointment book.

However, unless you’re actually collecting all of that fees being generated off your letterhead, you may still end up struggle financially. Time take a look at whether to bulk up in-house patient financial strategies or outsource some of your medical aid claims administration to a competent third-party firm that can help you do more with less.