Company overview
Yorkshire Shoulder Clinic is a specialist private clinic founded by three leading shoulder and elbow surgeons. Working across hospitals throughout Yorkshire, the team provides personalised care for shoulder and elbow conditions, ranging from specialist advice, physiotherapy and injections to evidence-based keyhole and open surgery.
What was going wrong
Visibility and speed when it came to working with insurers was becoming a limiting factor whilst scaling the clinic.
- Sector
- Orthopaedics, MSK & Sports Medicine
- Team
- 3 Consultant Surgeons
- Sites
- 6 Hospital Locations across Yorkshire
- Go-live to First Claim Submission
- <4 hours
- Practice-Management System
- Cliniko
- Insurers
- Aviva, AXA, BUPA, Healix, Vitality, WPA and Bluline Health
"Effra has been an excellent addition to my private practice. It integrates exceptionally well with Cliniko: I create invoices for appointments and surgical procedures in Cliniko and they are seamlessly picked up and actioned by Effra."
In a growth phase with a decision to make
The clinic was widening its variety of specialist orthopaedic and MSK treatments, and treating more patients as a result. However, they were using a billing company which meant speed and visibility started to become a bottleneck, with it becoming increasingly difficult to keep track of remittance statements, disputes and excesses.
As a result, the management team had a decision to make: hire more employees to support the billing processes, find a larger billing company or explore an automated alternative.
Automation without replacing the systems the clinic already trusted
- No replacement of the practice-management system
- No new portal for clinicians to maintain
- End-to-end visibility of every invoice
- Automated remittance allocation
- Automated patient shortfall and excess collection
- Reconciliation through to cleared funds
- Human support during implementation and for exceptions
- Works across major UK health insurers
Live in two weeks, without interrupting the clinic
- Phase 1ConnectEffra was connected to the clinic’s existing practice-management and billing workflow.
- Phase 2ValidateThe teams reviewed insurer details, invoice rules, historic balances and exception scenarios.
- Phase 3AutomateClaims, remittances, patient excesses and reconciliation moved into one monitored workflow.
How Effra changed the workflow
Effra submits the invoice while the appointment is still fresh, follows its progress, processes the remittance and checks that payment reaches the clinic’s bank account. Staff only need to intervene when Effra identifies an exception.
- 01Appointment completedPMS
- 02Invoice submitted automaticallySubmitted · same day
- 03Insurer response monitoredAccepted
- 04Remittance allocatedMatched to invoice
- 05Patient excess collectedCard on file
- 06Payment reconciled to bankCleared funds
The impact
What the numbers show
4211days
Average appointment-to-payment time was cut by 31 days after Effra. Invoices were submitted immediately instead of waiting for the next manual billing run, and payment issues became visible much sooner.
Zero Aged Debt
Debt aged over 90 days fell from £5,000 to £0 after 6 months. This is down to Effra automatically resubmitting dropped claims, saving patient's card details on file and reconciling what's been paid to their bank account vs what hasn't.
Operating with full visibility and speed
"Significantly improved my visibility of billing and made the whole process clearer and more manageable."
Neil PenningtonConsultant Orthopaedic Shoulder SurgeonWhat the clinic plans next
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