Award-winning hospitals are rightly celebrated for the excellent clinical care they provide but the work that goes on behind the scenes is often just as critical to their success.
Schoen Clinic’s Orthopaedic & Spinal Hospital in central London has achieved deserved recognition as a centre of excellence for treating musculoskeletal conditions and sports injuries. In addition to winning Hospital of the Year in 2019 at the LaingBuisson Awards, it was a finalist in 2021 and is part of an award-winning international group which treats more than 300,000 patients each year.
With world class facilities including a high dependency unit, three operating theatres and a state-of-the-art imaging department, Schoen Clinic London provides the entire treatment pathway, including diagnosis, non-surgical and surgical treatments and rehabilitation. As well as self-funded patients and GP referrals, the hospital is one of a select number in the Healthcare Purchasing Alliance (HPA) which buys complete packages of care on behalf of Aviva and Vitality Health.
To maintain Schoen Clinic’s high standards, it’s important that the back-office admin is managed as effectively as the delivery of specialist care. Finance and Revenue Assurance Manager, Henry Muscatt, oversees this aspect of the business but says it would be virtually impossible without Healthcode services including pre-authorisation, membership enquiry and online invoicing.
“We’ve been using Healthcode since we opened in August 2018,” he says. “Overall, they’re fantastic and there simply isn’t anyone else that can do what they do. Submitting all our invoices manually, for example, would be a full-time job whereas we can raise them in-house, and submit them as XML files online. The whole process flows really well and it works for everyone: the insurers get the bill sooner; we get paid sooner; and our patients have peace of mind that the invoice has gone through and been sorted.”
The simplicity of electronic invoicing means Henry can focus on ensuring invoices are accurate and validated first time. Again, we’ve been the ideal support.
Henry explains: “When patients are referred by HPA (Aviva & Vitality), we use the online pre-authorisation service to obtain the data for that episode of care such as consultant, authorisation number, policy number and the patient’s name and date of birth. It’s really useful as it minimises how much information we have to get directly from patients and provides another layer of security as we have the correct details from the beginning.”
If Henry and his team don’t have an insured patient’s membership number, they use our Membership Enquiry service which checks their demographic details against the relevant insurer database. “Sometimes the number has been taken down wrong or it’s slightly out of date,” he says. “When this happens, I ask the admin team to use Healthcode’s Membership Enquiry service. Although it doesn’t always find a match, the service is straightforward to use: you just type in the patient’s details, hit refresh and the results are virtually instant. When we don’t have a valid membership number for the patient, we reach out to them directly but this can be a time-consuming process.”
“When an invoice doesn’t go through, it’s mostly because of a problem with the patient’s membership details although sometimes it can be a coding issue such as where a prosthesis isn’t mapped to an insurer. When this happens, I contact Healthcode’s Coding team who are really good,” says Henry.
Thanks to the performance dashboard on its account, Henry can see that around 80% of Schoen’s electronic invoices are validated first time, slightly higher than the industry average. However, Henry has a more ambitious target of 95% in mind and is keen to work with us to make this a reality. “I’d recommend hospitals use Healthcode services,” he concludes. “In fact, if a new hospital started up and they decided not to use them, I think they’d be in trouble!”
