Shortfall Collection Service from Healthcode and patientzone

Published: Thursday, 20 January 2022 15:52

When The London Clinic implemented a new automated hospital Shortfall Collection Service from Healthcode and patientzone, they found the ‘extra pair of hands’ made light work of the credit control and collection process.

The customer

The London Clinic is the UK’s largest independent charitable hospital with a strong reputation for world-class medical expertise, technologically advanced facilities and high standards of personalised care. It specialises in cancer therapies, general surgery with a focus on digestive diseases, and musculoskeletal conditions.

The hospital receives more than 120,000 patient visits annually to its facilities on Harley Street and Devonshire Place which comprise 234 beds, 10 theatres, a pathology laboratory, an endoscopy unit, a radiology unit, dialysis and a 13-bed intensive care unit. Its team of 900 clinicians are assisted by more than 1,200 clinical and non-clinical support staff.

Established in 1932, The London Clinic was granted charitable status in 1935. A Board of Trustees oversees the organisation to ensure it is financially secure in a competitive marketplace and able to meet its charitable objectives. “As a charity we have a responsibility to provide value for money and make a surplus because we reinvest this in things like research, clinical trials and the running costs of a major hospital,” explains Denise Turner, the Head of Billing and Credit. “It’s important that The London Clinic is able to make every penny count.”

The challenge

A significant number of the London Clinic’s patients are funded by five major private medical insurers (PMIs) who are billed electronically using Healthcode’s Clearing Service. However, a significant number of these remittances are subject to shortfall amounts because the patient’s policy does not cover the total cost of treatment. This means the hospital must collect the outstanding amount from the patients themselves in order to balance the books, a time-consuming and sometimes difficult task for the hospital’s accounts team.

“The need to collect a large volume of shortfalls obviously stretches our capacity,” notes Denise. “It can also cause issues with patients if there is a delay before we are notified of a shortfall and we have to go back to the patient several months later and present them with a bill.”

The solution

Fortunately, there was a more efficient technological solution close at hand. The new Shortfall Collection Service from Healthcode and patientzone was developed to automate the time-consuming process of identifying and recharging shortfalls and then give patients (and other payors) a convenient and secure way to settle their account online.

It works like this:

  • When an insurer pays a provider invoice which has been submitted through Healthcode’s Clearing Service, it also sends an electronic remittance to the provider.
  • Healthcode uses their newly created integrated code set, Industry Standard Shortfall Codes, to automatically scan these electronic remittances and identify shortfalls with patient liability.
  • Healthcode applies the patient’s details and passes a collection instruction to patientzone.
  • patientzone issues a hospital branded collection notice via email or text message. The notice contains a unique link to the patientzone platform.
  • The patient uses the link to securely access the patientzone website and pay the balance due. There is no additional charge for them to use the service.
  • Once the money has been collected, patientzone sends a receipt to the patient and notifies Healthcode.
  • Healthcode provides an electronic remittance to the hospital so the transaction can be closed.

The pilot phase

The London Clinic was first in line to pilot the shortfall service. Denise worked closely with the development team to ensure the service ran smoothly, all major insurers have now been introduced to the platform.

“From our side it was quite easy,” she remembers, “we told them what we wanted and Healthcode and patientzone worked together to deliver those enhancements. For example, the patientzone service was effectively a messaging service but we wanted there to be further communication if the patient did not respond. In response to this feedback, the team introduced automatic payment reminders for unpaid shortfall bills so we now have a complete credit control cycle built into the system.

“We also had some patients contact us because they weren’t sure whether the email or text they had received was bona fide. In response to this feedback, we tweaked the branded message that went out to patients so they could be confident it wasn’t a scam or phishing.”

The benefits

Following the successful pilot, The London Clinic has fully implemented the Shortfall Collection Service and Denise is pleased to have an efficient and effortless way to manage these payments.

To date, several thousand shortfall invoices have now been processed with outstanding success for The London Clinic through the Service, boosting hospital funds for running costs and reinvestment. From Denise’s perspective, the operational advantages have been clear and she also notes that the service has been good for patients too.

“The key benefit has been timeliness,” she explains. “As soon as the payment was shortfalled, the patient was automatically contacted and that was quicker than in the previous manual system because we didn’t have the capacity. It’s been like having an extra pair of hands. And for the first time we were able to give patients the option to pay online and not have to worry about calling us to pay by credit card or arranging a bank transfer. With patientzone, they now have an easy and secure way to view their invoice and correspondence from the insurer and then settle the bill there and then. While it’s early days, Healthcode and patientzone made it easy for us and I’d recommend the service to other hospitals.”

Further information

patientzone charges 2.5% +VAT commission when the bill is paid and deposits the money in the hospital’s account each week, considerably less than the expense of setting up a merchant account and paying credit card processing fees. Branded automatic payment reminders are charged at 10p +VAT for electronic messages and 55p for paper reminders.

To find out how the Shortfall Collection Service can help your organisation reduce admin, speed up collections and give patients an easy and secure way to pay, contact the This email address is being protected from spambots. You need JavaScript enabled to view it..