When it comes to charging for procedures & consumables, medical professionals often fall into two camps – those who have put a system in place that ensures they are charged for, & those who simply write them off as the cost of doing business. If you are in the latter camp then you may not have thought to calculate the implications of this business decision & the actual impact it is having on your bottom line. 

In 2015, Healthbridge surveyed a cohort of General Practitioner (GP) practices in a study to measure profitability. What was found was that certain consumables were often under-claimed or not claimed at all, & that procedure lines were often missing. This had a huge impact on these GPs’ bottom line & the profitability of the practices. So before you write-off consumables as negligible, consider the findings of the case study – summarised below– to help you make an informed decision for your business. 

There appears to be two main reasons why routine procedures & consumables are not charged &/or claimed:

• Not knowing which codes to use. When practice staff aren’t sufficiently trained or practitioners don’t have codes on hand, claiming can be time-consuming & frustrating. 
• Concerns about cost implications for the patient. A number of doctors are reluctant to charge for consumables & procedures because they worry about the financial impact on their patients. This being said, many of these doctors have not calculated the impact that absorbing these costs has on their practice & their ability to keep their practice running at the top of their license.

Fixing the problem

Taking an example from one GP who participated in the study, Healthbridge could determine that the most common procedure he did not claimed was ‘urine test.’ Similarly, the most missed consumable was ‘Voltaren injection.’ Per item, these are small amounts of money – almost negligible until they’re calculated over time.  

By assessing the most common type of claims submitted by this GP & others, Healthbridge developed unique claim templates that made it simpler & easier to include procedures & consumables in claims. For the GP in the example above, once ‘urine test’ & ‘Voltarin injection’ was automatically included in his claim templates, it amounted to additional revenue of approximately R9 000 & R8 400 respectively in 2015.  

Making the switch to customisable claim templates meant this doctor grew his overall bottom line by just over R80 000 for the year. Simply by charging for otherwise missed procedures & consumables. 

The most commonly overlooked procedures & consumables

Below are some of the most used procedures & consumables based on Healthbridge claims data from 2021. You may recognise many of the line items – do you overlook them too when it comes to claiming? 

*Unit prices are based on the average values Healthbridge doctors received for these procedures & consumables.

Bottom-line

Given the economic times we live in, you might feel inclined to exclude the cost of procedures or consumables to alleviate some of the burden on cash-strapped patients. On the other hand, protecting your practice’s cash flow & revenue is equally as important to stay in business & provide quality health services to those same patients. It’s therefore important to claim in full for your services & associated costs. And by using customisable templates, you negate the admin burden on yourself & your practice staff because codes are automatically included without needing to search for the correct codes. 

For more information about how you can improve your practice’s profitability by using the right practice management software, click here.