3rd Party Invoicing - Work Cover / TAC etc

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  • Updated 2 years ago
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We run an 18 physio clinic, and see lots of work cover and other 3rd party compensable patients. As these are generally linked to common insurance companies / government agencies, we recently transferred all our patients to 'linked' 3rd party billing settings. This is great as it groups all patients linked to a common 3rd party biller. BUT.....

We recently did our regular end of month invoicing run for all these linked 3rd party biller groups, and we have had a unpleasant response from some employers/ insurance companies, saying that while all the relevant information is on the invoice, the individual patients within the linked group need separate invoice numbers (preferably on a separate page per person). This is because even though it is a common biller (and payer, ie. the insurance company), the individual invoices need to go to particular case managers within the insurance company to be approved for payment 1st. So therefore all the common people linked to the biller on one common invoice doesn't work.

Does anyone have any insights around how to bill 3rd party compensable patients - ideally using email integration, which was the main idea behind linking 3rd party patients in the 1st place (as well as more effectively track where longer term debt is within our outstanding payments).

Ideally, I would like to be able to get our Front Desk staff to easily generate and email an invoice to the insurance company at the time a patient is seen. This is what another newer clinic of ours does (we use Cliniko for that clinic), and there is a super easy way to do this which works brilliantly. 
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Liam James

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  • Frustrated

Posted 4 years ago

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Josie Tropeano, Product Manager

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Official Response
We don't recommend that you use the 'Linked' 3rd party billing function for all your Workcover/TAC clients as a matter of routine.  This function should only be used when dealing with entities such as employers that self-insure, nursing homes, sporting clubs and families that prefer 1 consolidated invoice. Most insurers will require an individual invoice per patient.

Sorry for the bad news but you are going need to set them back to 3rd party "individual" billing.
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Liam James

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That's extremely frustrating, as I spent a lot of time discussing this on the phone with the help/support team, and we came up with this solution. I took our admin team a lot of effort to change them all over, and now we will not only have to change them back ,but also clean up the mess of our May invoicing (ie. cancel all issued invoices, and re-send them all). Would have been very helpful to know that it's not recommended, prior to doing this!!! 
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Liam James

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Is there any way of tracking common 'individual' 3rd party billers when generating outstanding payment reports, as this was extremely helpful for our accounts staff when calling insurance companies to chase outstanding debt - in that she could list a group of names all linked to the common insurer, and get updates on all in one hit.
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Josie Tropeano, Product Manager

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Please contact our business care team tomorrow during business hours and we will be happy to review your recorded conversation with our support team to try to work out what happened. www.smartsoft.com.au/support
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In Stride Health Clinic

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I end up sending invoice by practitioner to the third party.  I have a workcover email template set up that automatically adds the client name and claim number.  It might mean some accounts I sent 2-3 different emails for the same client but still quicker.

If you are sending on the day- each time the client is seen.  It would be just as easy to send this way as they can only see one practitioner per day.

At the moment they don't have a billing account email address link so you would need to readdress the email each time (if the client has an email for themselves - you don't want to overide it).

I have set up orgnanisational accounts on the Frontdesk to resolve this issue with the 3rd party email address.  But when sending the email you would still need to change it to 3rd party email before sending.

Its a few steps but I find it works and saves on postage.

Sharon