The Relative Value Review (RVR) and Electronic Billing

RELATIVE VALUE REVIEW

After a great deal of preamble and work the Relative Value Review has been made public. The reason behind this venture was the admission by the major insurers that there were many imperfections and imbalances in the current remuneration to patients of consultant's fees.

There does not seem to be any guarantee that the RVR is going to be acceptable to the insurers, let alone the profession. At the Open Meeting at the RSM on the 5th March 2001 we have invited Mr. Kingsley Manning to speak on this topic. He is the Chief Executive of Newchurch Limited, the company responsible for developing the RVR schedule and this promises to be an interesting part of the evening. (CLICK HERE FOR PROGRAMME)

The full report may be obtained from Newchurch (www.newchurch.co.uk).

Many have expressed reservations about the RVR exercise, particularly the anaesthetists. The LCA will make its position clear in due course and in the interim we invite any consultant to let us have their views. What is clear is that BUPA Insurance regard the RVR exercise as the first step and a commitment to Electronic billing.

ELECTRONIC BILLING

A further manifestation of increasing controls over the medical profession comes from the introduction of electronic billing. On the face of it Electronic billing may seem to be attractive. Who after all would not wish to be paid promptly? However, along with other major professional organisations, the LCA is very much against electronic billing by this company, which we understand will be called Healthcode.

The LCA objections to electronic billing by Healthcode are clear;

• Electronic billing prevents the doctor from presenting his/her bill directly to the patient and therefore further undermines the contractual basis between the patient and the consultant.
• Electronic billing will encourage the perception that the insurance companies are setting the consultant's fees.
• Healthcode is a company owned and operated on a national scale by a consortium of most of the major insurers (controlling in combination about 90% of the insurance market) and possibly one or two of the hospital provider groups. This could become a vehicle for controlling access to medical care and it will, with all the information it receives through the electronic billing (from hospitals and doctors) be in a very strong position to control the market. The pooled information on practice patterns and on individual behaviour will be very valuable to certain outside parties.
• We have less concerns about any of the smaller individual insurance companies outside Healthcode who set up their own separate electronic billing system, as this retains current aspects of confidentiality. Furthermore, as the information is already available to these insurers, and with the guarantees of ongoing confidentiality over the information, we believe that consultants may enter these arrangements with less anxiety. However, consultants should still retain their right to submit their fees to the patient.
  

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