1.1. Taking advantage of working with insurance providers
As an orthopaedic consultant in the UK, registering with and accredited by private medical insurers (PMIs) can be a critical step in growing your private practice. PMIs represent a significant share of revenue for private consultants, with some estimates suggesting they account for up to 71% of total revenue. Understanding how to optimise your PMI profiles can ensure you attract and retain more patients while maintaining control of your practice.
Read on to explore how to maximise your profile, evaluate the need for preferred network status, and increase PMI patient enquiries and bookings.
Understanding the Value of Your PMI Profile
Your profile on insurance provider platforms like Bupa Finder and the Private Practice Register (PPR) is often the first point of contact between you and prospective patients. Most PMIs provide patients with a list of three consultants within a specific radius who match their needs.
Many large insurers, including AXA, use the PPR to provide consultant options and contact details for patients. Keeping your PPR profile up to date is crucial, as some insurers prioritise consultants who have updated their profile in the last six months, making it a key tool for capturing patient attention.
How to Optimise Your Profile:
Accurate Contact Information
Ensure your profile directs patients to contact your practice directly instead of the hospital(s) you work with. Include phone numbers, email addresses, and links that connect directly to your booking system.
Enhance Your Description
Highlight your specialisation, years of experience, and patient outcomes. Include specific keywords that align with common patient searches.
Add Online Booking Links
Embed a direct appointment booking link on your profile. This has proven effective in increasing bookings, as demonstrated in practices like Jasvir Grewal’s, where a direct Bupa booking link significantly grew PMI patient volume.
Professional Photos and Credentials
A high-quality photo and clearly stated qualifications help build trust and credibility.
By refining these elements, you increase the likelihood of being chosen by patients over other consultants listed in their PMI correspondence.
Platinum/Preferred Network Status: Do You Need It?
Many PMIs rank consultants within networks, such as Bupa’s Platinum or Open Referral Networks. These rankings can influence how often you are recommended to patients. Understanding how these networks work and what benefits they offer can help you decide if it’s worth pursuing.
Benefits of Platinum/Preferred Status:
Increased Visibility
Being part of a preferred network may position you as a top recommendation within a patient’s search radius.
Higher Patient Volumes
Consultants in higher-ranking networks often receive more referrals due to perceived quality and cost-effectiveness.
Improved Patient Experience
PMIs are more likely to promote consultants who provide seamless experiences, such as easy booking and efficient care pathways.
PMI Network Development Guide
Private Medical Insurers (PMIs) have analytical review processes to decide how to increase volume to their “preferred” providers. These reviews are typically based on limited historical data, often spanning the last 4 years, and are conducted every 1-2 years. This means that changes in your behaviour or practice take time to reflect in preferred network status outcomes.
Key Metrics Considered by PMIs:
Complaints Received
PMIs track the number of direct complaints against you. They also assess whether these complaints are attributable to you or external factors.
Billing Amounts
Your performance is compared against expected total costs for typical pathways, such as W4210 (Total Prosthetic Replacement of Knee Joint). Costs include the entire patient journey from 6 months pre-op to 6 months post-op, covering consultations, tests, implants, imaging, and more. Excessive resource use may negatively impact your status.
Clinical Practice Standardisation
PMIs evaluate whether your clinical activity aligns with evidence-based best practices. Outlier behaviour, such as performing procedures outside standard guidelines, may raise concerns. For instance, conducting arthroscopic meniscectomies disproportionately in patients over 40 compared to peers could be flagged.
Billing Behaviour
Adhering to the insurer’s fee structure is crucial. Consultants who bill beyond agreed rates or charge top-up fees risk losing their “Fee Assured” status. This also applies to anaesthetists you regularly work with.
How to Improve Your Status:
Align Your Practice
Optimise your practice for PMI metrics where possible. This includes standardising clinical activity, optimising resource use, and maintaining competitive billing practices.
Challenge Decisions
If you’re labelled as an outlier, consider challenging the decision. Historically, providing clinical explanations and evidence has been a valid way to address concerns. Although this process may have evolved, it is worth exploring with your insurers.
Tips for Attracting More PMI Patients
While your PMI profile is vital, there are additional steps you can take to increase the number of PMI patients choosing you:
Direct Booking Integration
Embed direct booking links not only on PMI profiles but also on your website. This simplifies the patient journey and ensures more enquiries are captured by your practice rather than the hospital.
Optimise Your Online Presence
Patients often search for consultants online after receiving PMI recommendations. Ensure your website ranks highly for searches of your name and includes clear “Book a Consultation” calls-to-action.
Leverage Paid Search Advertising
If validated, highly targeted Google ads using your name and speciality can capture patients searching for a consultant online. By linking these ads to a simple booking process, you increase conversion rates.
Regular Profile Reviews
Review and update your insurer profiles regularly. Ensure they reflect your current practice, specialisations, and achievements.
Working effectively with PMIs is essential for growing your private practice. By optimising your profiles, understanding the value of preferred network status, and improving the patient experience, you can attract more PMI patients and retain greater control over your referrals.
Medbelle PatientConnect offers tailored support to help you reach more PMI patients, from profile optimisation to booking system integration and even advertising strategies.
