Insurance claims for staff pets

Re: Insurance claims for staff pets

Martin Atkinson — Wed, 13 May 2015 13:31:25 GMT

[quote user="Evelyn Barbour-Hill"]I'm baffled anyway as to how anyone can justify an "injection fee" more than a pound in small animal practice.[/quote]Sadly. probably because the numbie f*** wit client who is conned by loss leader prices doesn't appreciate that what he/she is paying for is your time and expertise so doesn't think it has any value but giving an injection is magic, even though a blind monkey could be trained to do it.

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Wed, 13 May 2015 12:16:46 GMT

[quote user="Bob Russell"]I have mentioned before invoices my brother inherited with a rescue dog. Consultation £15 but injection charge over £20 plus cost of drug. Every time the dog went in he had at least one but more often two injections![/quote]

I remember you mentioning it before. In my opinion that's a case for the Disciplinary Committee. See, there are ethics involved in "freedom to price" (cross reference to other thread )

I'm baffled anyway as to how anyone can justify an "injection fee" more than a pound in small animal practice.

Re: Insurance claims for staff pets

Bob Russell — Wed, 13 May 2015 11:12:33 GMT

I would consider the Animal Trust type of issues as sharp practice rather than greed. Misleading with 'bargain' prices that suggest owners are going to get cheap veterinary treatment.

I have mentioned before invoices my brother inherited with a rescue dog. Consultation £15 but injection charge over £20 plus cost of drug. Every time the dog went in he had at least one but more often two injections!

Re: Insurance claims for staff pets

Martin Atkinson — Wed, 13 May 2015 10:43:24 GMT

[quote user="Anthony Dennison"]

[quote user="Martin Atkinson"]Of course if you're The Animal Health Trust you don't make any profit anyway![/quote]

Animal Trust.

Animal Health Trust is the referral/research centre just outside of Newmarket.

[/quote]You see that's why they chose the name, to give themselves credibility and confuse simple folk like me.

Of course I did know this considering the number of times I've moaned about it!!

Re: Insurance claims for staff pets

Anthony Dennison — Wed, 13 May 2015 09:51:59 GMT

[quote user="Martin Atkinson"]Of course if you're The Animal Health Trust you don't make any profit anyway![/quote]

Animal Trust.

Animal Health Trust is the referral/research centre just outside of Newmarket.

Re: Insurance claims for staff pets

Martin Atkinson — Wed, 13 May 2015 09:41:43 GMT

[quote user="Bob Russell"]Those able to take three or four expensive holidays, new car every year and a £1m mansion, all on the back of clients may be considered greedy! I would probably consider them just better businessmen than I am![/quote]This is of course assuming they reward their staff commensurately and don't keep them on subsistence wages, and are not deriving their profit from extortionate fees and performing excessive or unnecessary procedures. Of course if you're The Animal Health Trust you don't make any profit anyway!

Re: Insurance claims for staff pets

Bob Russell — Wed, 13 May 2015 09:24:08 GMT

I have to say detailing what people consider is employers greed strikes me as being a bit silly. The overall profitability of the practice is where greed should be determined.

If the practice owner makes a reasonable return on his or her investment then there is no greed factor. Those able to take three or four expensive holidays, new car every year and a £1m mansion, all on the back of clients may be considered greedy! I would probably consider them just better businessmen than I am!

it seems I am now a Seasoned Poster. Does that mean a knowall or busybody?

Re: Insurance claims for staff pets

Rob Davis — Wed, 13 May 2015 08:41:06 GMT

[quote user="Evelyn Barbour-Hill"] Insurance is to recompense the insured for what the treatment has cost them.[/quote]

And the premiums should be calculated to reflect this. If insurance claims should be for the cost AFTER any staff discount then the premiums should be reduced accordingly. I do not believe that this is likely to be the case. If the staff member is paying the same premium as any other client, then why should the insurance company be getting a discount?

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 22:38:26 GMT

[quote user="Laurence Webb"]

does 'normal' mean what you would charge a normal client or does it mean what you normally charge staff?

[/quote]

Well of course it means what you normally charge staff. And it means what you normally charge staff after any regular discount , so nobody can get out of it that way.

But you are all missing the point. Insurance is to recompense the insured for what the treatment has cost them. If you bump up the claim by anything (in this case, a sum equivalent to 50% of whatever the lab fees were) then that's fraud. It doesn't matter that the payment is coming "direct" from insurance company to practice.

If I were the OP I'd tell the (non-veterinary surgeon, note) practice owner that I would not be party to fraud. This is sheer greed, the practice owner trying to claw back what he feels he has "lost" by giving staff discount.

Re: Insurance claims for staff pets

Laurence Webb — Tue, 12 May 2015 22:07:43 GMT

From my reading of the OP I got the impression that a 50% mark-up of lab fees was probably normal for practice clients (and did not differentiate between those insured or not) but staff were charged cost price only. Assuming this to be the case, the question of what constitutes normal charging is really one of sematics - does 'normal' mean what you would charge a normal client or does it mean what you normally charge staff?

As the number of normal clients far exceeds the number of staff members I would feel it is right and proper for the invoice to reflect the fee that a normal client would be charged. You could speak to RCVS for clarification (or muddying of the waters). A change of practice protocol such that staff are given a discount after normal fees have been charged rather than charged cost may make this easier to demonstrate but I think the principle is the same.

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 20:20:55 GMT

[quote user="John Flynn"]

I personally follow the same rule for lab tests that I do for drugs: I sell them at the price I want to sell them at.

For instance:

lepto testing costs nothing as I recommend near-universal vaccinations for lepto and am interested in the prevalence of it and serovars responsible in clinical cases in my area
culture and sensitivity is charged out at the highest price where I can get approx 80%-90% uptake where recommended (i.e. quite cheap)
food allergy testing on blood is charged at a high price to make sure that doing an actual diet trial is not more expensive (I prefer the latter, Dr Google has often recommended the former before I see the patient)
some lab tests are charged on a "pay-if-positive" basis or a "pay-more-if-positive" basis.

[/quote]

I find this quite strange and far too complicated. But then I don't consider that I'm "selling lab tests". I recommend – insist upon – external lab tests when I consider them necessary. Certainly I don't jack the price up for a test that I know many people will want. The whole idea sounds distinctly odd. Maybe you're in farm practice and you're talking about herd tests, metabolic profiles, that sort of thing? I can see that might be different.

I just can't see a parallel with drug sales at all.

Do I state the lab's charge and state the flat rate markup separately to the client? No. Will I tell them if they ask me? Yes.

Charging a big fat percentage smacks of fee-splitting to me.

Re: Insurance claims for staff pets

John Flynn — Tue, 12 May 2015 19:27:45 GMT

[quote user="Hannah Wynne Richards"]the fee for reporting should reflect the work involved,not be a % of lab fee.[/quote]

I'm not sure I totally follow here.

Is there some moral reason that the fee charged for a lab test should by necessity be reflective of the costs incurred? And if so that sale cost should be governed by a fixed value mark-up on cost-price (or sale-price) as opposed to a percentage or any other universal or non-universal rule?

I'm all for transparency, but I'm not sure I'd expect my vet to make known their analysis of unit cost be it a tablet, test, surgical-procedure or what-not when selling it to me - just the price they were charging for it. I'd prefer that price to be known in advance for comparison to their competitors (where competitors are available).

I personally follow the same rule for lab tests that I do for drugs: I sell them at the price I want to sell them at.

For instance:

lepto testing costs nothing as I recommend near-universal vaccinations for lepto and am interested in the prevalence of it and serovars responsible in clinical cases in my area
culture and sensitivity is charged out at the highest price where I can get approx 80%-90% uptake where recommended (i.e. quite cheap)
food allergy testing on blood is charged at a high price to make sure that doing an actual diet trial is not more expensive (I prefer the latter, Dr Google has often recommended the former before I see the patient)
some lab tests are charged on a "pay-if-positive" basis or a "pay-more-if-positive" basis.

(In keeping with the thread theme, in the event that a client had third-party insurance, the charge would be the same as if they didn't)

Ultimately, I'm interested in what I can charge for a lab test and get the uptake I want for it when recommended. Yes I have to balance the books, but for that I'm looking at the big picture of the practice finance (for instance lepto vaccines are profitable for me, lepto testing is obviously not), not whether the amount I spend on lab testing exceeds the amount clients pay me for it by a fixed sum, a percentage sum or any other sum. I procure said lab tests based on an attempt at a rational balance between best lab practise, cost to me and any other details I might consider relevant such as loyalty and support of local facilities.

I may of course be entirely on my own here and the majority may add £x to a lab test irrespective of the test. If so, is this common practice these days with drug sales also where you list the cost of the drug and then your fixed-handling-fee or %handling-fee (or whatever the term might be) separately? I can see that this would be transparent, but I'm not sure that I think this sort of transparency is necessarily desirable.

Re: Insurance claims for staff pets

Martin Atkinson — Tue, 12 May 2015 18:32:54 GMT

[quote user="mariette asselbergs"] I can imagine that you don't ask a staff member to pay for bloods he/she has taken from his/her own animal and interpreting the result.[/quote]Imagination is a wonderful thing!

Re: Insurance claims for staff pets

Martin Atkinson — Tue, 12 May 2015 18:29:56 GMT

[quote user="Hannah Wynne Richards"]With cheap tests it's < 50% With expensive tests it can be much less.[/quote] I will reduce the mark up on very expensive tests but it tends to be arbitrary,

And who charges a sampling fee for a skin scrape or blood sampling? I never used to but as I can't put my consult fees up in order to compete with the cheapskates down the road there have to be some stealth charges - not fictitious but for extra work done which once upon a time may have been absorbed into a sustainable consultation fee.

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 17:35:19 GMT

[quote user="Bob Russell"]

If I am only allowed to make a profit on consultation fees then my prices would become totally uncompetitive especially against the £15 consultation fees being advertised.

It is called making a living!

[/quote]

However, since I've started this other sub-thread:

Yes of course I charge a bit on lab fees – a flat rate sum per submission – and nothing remotely like 50%. The lab's charge is determined by all sorts of things, including operator's time, cost of reagents, ratio of capital cost to usage of the apparatus, all sorts, which are not directly related to the end value to me or the client. If it's something that's a real hassle to interpret and deal with, I'd make it a little bit extra. I can't charge a whopping markup for interpretation if, as usual, it consists of reading the lab's interpretation and running my eye over the figures to be sure it makes sense.

I charge a reasonable small amount for the actual sampling, which covers my trouble, the blood tubes and microscope slides, running the centrifuge, going to the pillar box.

Interpretation, advice, all comes into my consultation fees; they are all part of the consultation, aren't they?

[quote user="Bob Russell"]Do practices charge cremation at cost? Apply a markup to cover costs associated with handling and storing of bodies.[/quote]

Of course. That's built into the euthanasia charge. But what's that got to do with the question?

If people want to lure the public in with ridiculously cheap consultations and then hit them with all sorts of hidden extras and huge charges for this, that and 't bleedin' other, and they can live with their consciences, well.............. can't stop 'em.

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 16:57:51 GMT

[quote user="Bob Russell"]

[quote user="Evelyn Barbour-Hill"]

[quote user="An On MRCVS"]If a staff pet has investigation carried out by an external lab, when we invoice it, we charge the fee the practice is charged by the lab. However, if the pet is insured, we are told to add a 50% mark up... [/quote]

Insurance is supposed to recompense the insured for the amount it has cost them, not for what it would have cost them if they had been somebody else.

Adding a chunk (for instance, a sum equal to 50% of the lab fees) to make a windfall profit for the practice owner is fraudulent.

[/quote]

Disagree!

[/quote]

You are replying to the wrong sub-thread, Bob.

I should have said "Adding a chunk....... to the insurance claim, to make a windfall profit for the practice owner". It's fraudulent.

Re: Insurance claims for staff pets

mariette asselbergs — Tue, 12 May 2015 16:57:44 GMT

[quote user="Martin Atkinson"]

[quote user="Evelyn Barbour-Hill"]does anyone else charge a 50% mark-up on external lab fees?[/quote]Yes. Why, don't you mark them up? Covers a host of time and administrative related things and your professional interpretation of the results. It is also a commodity you have bought and are reselling at a profit as much as anything else you have paid for.

[/quote]

Mariette

[quote user="Martin Atkinson"]

[/quote]

In my practice this is called "sampling and interpretation fee". I can imagine that you don't ask a staff member to pay for bloods he/she has taken from his/her own animal and interpreting the result.

Re: Insurance claims for staff pets

Hannah Wynne Richards — Tue, 12 May 2015 16:21:00 GMT

It seems you're more or less agreeing with me, the fee for reporting should reflect the work involved,not be a % of lab fee.

Wynne

Re: Insurance claims for staff pets

Michael Woodhouse — Tue, 12 May 2015 16:05:00 GMT

[quote user="Hannah Wynne Richards"]The work involved in interpreting and reporting is the same - regardless of the cost of the teast.[/quote]

It's not though. Maybe more of a large animal issue but I've just had a neospora result back on an aborted cows - the lab fee is £5.50. It was negative so I sent the farmer a text message. Easy. If that was positive then it might have taken 20 minutes on the phone to sort out.

Bleed a cat to check kidneys and T4 - all normal - 2 minutes. If abnormal then I guess the advice is to bring it in and then charge for advice etc with your consult.

We are looking at banding the advice fee as we currently charge £6ish and sometimes it's reasonable, sometimes woefully inadequate. I'm not convinced the work reporting the result is in anyway proportionate to the value of the tests, so a percentage markup doesn't fit for me. I did £250 of mineral tests on some cows and sheep on the same farm - that was reported with a text "all normal - keep on with the boluses". I'd not sleep at night charging £125 for that, but I'd not eat at night charging £2.75 to report the neospora result..............

Re: Insurance claims for staff pets

Hannah Wynne Richards — Tue, 12 May 2015 15:33:31 GMT

Advice from Royal College (which I comply with) is to add a flat rate lab referral fee, which is clearly invoiced as "lab referral fee". With cheap tests it's < 50% With expensive tests it can be much less. The work involved in interpreting and reporting is the same - regardless of the cost of the teast.

Wynne

Re: Insurance claims for staff pets

Bob Russell — Tue, 12 May 2015 14:45:37 GMT

[quote user="Evelyn Barbour-Hill"]

Insurance is supposed to recompense the insured for the amount it has cost them, not for what it would have cost them if they had been somebody else.

Adding a chunk (for instance, a sum equal to 50% of the lab fees) to make a windfall profit for the practice owner is fraudulent.

[/quote]

Disagree!

If I just handed the results to the owner then I might not have a mark up on lab work. I interpret, phone the lab as necessary then phone owners to discuss the results. Some are straightforward and I make a profit on the mark up. Others I may spend considerable amounts of time on the phone to the lab, specialists or doing further research. All has a cost attached.

Do practices charge cremation at cost? Apply a markup to cover costs associated with handling and storing of bodies.

Not a windfall in my opinion. I charge drugs with a markup to cover costs and make a profit.

If I am only allowed to make a profit on consultation fees then my prices would become totally uncompetitive especially against the £15 consultation fees being advertised.

It is called making a living!

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 14:34:58 GMT

Insurance is supposed to recompense the insured for the amount it has cost them, not for what it would have cost them if they had been somebody else.

Adding a chunk (for instance, a sum equal to 50% of the lab fees) to make a windfall profit for the practice owner is fraudulent.

Re: Insurance claims for staff pets

Martin Atkinson — Tue, 12 May 2015 14:01:55 GMT

Re: Insurance claims for staff pets

John Flynn — Tue, 12 May 2015 12:31:06 GMT

[quote user="Michael Woodhouse"]So if I use my discretion to give a little old lady a discount on a pyo, does that mean I can't charge anyone the full amount on an insurance form?[/quote]

Possibly.

There is a fine line between fraud and compassion.

If you do 1000 pyo's a year at a fixed price of £600 each, 10% of your caseload is insured and you "discount" a single case to a little old lady to £300, then you have not been fradulent.

If you do 10 pyo's a year at a fixed price of £300 each, 90% of your caseload is insured and you "discount" the single non-insured case to a little old lady to £150, you might have a harder job explaining that you are charging the insured cases the "normal" fees - some may consider this fraud.

If the next year, you do 10 pyo's (with the same "fixed price" of £300) but now only 10% of your caseload is insured, and ALL the uninsured ones happen to be little old ladies and you compassionately discount each to £150, I'm pretty sure an objective observer would call your charge of £300 to the insured one fraud.

[quote user="Michael Woodhouse"]Deliberate increase in fraud, but I would charge the normal rates.[/quote]

This is really semantics, not how I would reckon fraud is considered. Simply having a price written down somewhere as your "normal" wouldn't count for much if that is not what the client would actually have been charged had they not been insured.

If you genuinely believe this maxim, then just put up all your "normal" prices by 10% and then "discount" the bulk of your uninsured clients. Your "normal" price is not what you have written down somewhere surely, but what you would have charged if you were billing the client directly rather than the insurance.

I have no doubt, however, that there are plenty of means of legitimately charging most insured clients more than those that are not - perhaps the simplest is to offer a universal 10% discount for settlement of the balance in full on the same day.

I think the golden rule is to decide what would that work be charged at if the client was not insured and then simply charge that. If a discount would have been applied before it was known that the staff member had insurance, then it should still be applied in my opinion. If there is a "rule" either in a contract, or through examination of application of charging to other staff members of a certain fee structure, then I certainly consider that it should apply irrespective of this staff member having insurance - to do otherwise would be fraud in my books (though I have no doubt that clever work-arounds are an option).

Re: Insurance claims for staff pets

Evelyn Barbour-Hill — Tue, 12 May 2015 12:07:02 GMT

[quote user="An On MRCVS"] The practice owner (not a vet)[/quote]

That speaks volumes.

[quote user="An On MRCVS"]says it is perfectly fine for me to sign...[/quote]

A Mandy Rice-Davies moment..........

Cripes, does anyone else charge a 50% mark-up on external lab fees?