Welcome to the first edition of the Industry Insights newsletter


With the help of our skilled data analysts, each month we'll explore emerging trends in the private healthcare market that will help doctors better understand and prepare their practices for this ever changing environment.

This month we explore General Practitioner (GP) practices' claiming behaviour across 2014.

GPs are changing the way they send their claims

Towards the end of the year GP practices sent significantly more claims while patients were still at the practice (we refer to this as 'Send Now' behaviour), with a peak in October. The reason for this spike seems to be financial. Most patients' medical savings accounts (MSA) start running out in the last quarter of the year, meaning that more patients become personally liable for settling their accounts. Accordingly practices' collection efforts increase on a comparative scale.

Why Send Now reduces risk of potential bad debt

It's logical to assume that practices want to find ways of managing this increased risk of potential bad debt. We believe that implementing the Send Now claim behaviour is one way of avoiding this risk and more practices are realising this. A claim sent while the patient is still in the practice results in an immediate response from the medical aid, detailing what will be covered and how much must be settled by the patient. With this information, practices are informing patients before they leave the rooms of any possible liable amounts - because the sooner a patient is informed of any possible liable amount, the more likely they are to pay.

Pilot study launched to test hypothesis

We tested this hypothesis in a pilot program where 42 practices were selected to participate. These practices were chosen due to their low Send Now behaviour patterns. To demonstrate the benefits of Send Now behaviour, their processes and the set-up within the practice were adapted to allow claims to be sent while the patient was still at the practice. Furthermore, the behaviour was monitored for a 4 week period.

Overall, the Send Now habits of the practices changed significantly and this behaviour has remained ongoing across the majority of participants. In particular, one of our most impressive practices who adopted the entire process of Send Now, together with the collection process, achieved around 66% reduction in his book debt.

As the trend indicates, there seems to be a similar motivation that practices in the wider market have cottoned onto and have subsequently started changing their claiming behaviour. Interestingly the trend of Send Now behaviour was consistent across all provinces and all specialities including Dentists, Specialists, Optometrists and Auxiliary practitioners.

Click here for more tips and tricks on how you can adopt a similar process within your practice.

Watch this space to see if 2015 holds similar trends.


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