The insurer money nobody bills for
When an insurer pays less than the invoice, the gap is a shortfall, and often the patient owes it. How much of yours is ever actually billed?
Clinics that treat privately insured patients (Bupa, AXA Health, Aviva, Vitality, WPA and others) live with two slow leaks. Insurers pay less than invoiced, and the difference is easy to lose track of. And insurers take time to pay, so cash you've already earned sits with them for weeks.
Shortfall and cash calculator
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An estimate from your inputs. Some shortfalls are written off on purpose. The real figure needs your insurer remittances joined to your invoices.
Why shortfalls slip through
- The information arrives in a different system. Remittances come through Healthcode or the insurer's portal; invoices live in Xero or your clinic software. Nobody sits with both.
- The reasons are buried. Each shortfall has a reason code or note. Some are fixable paperwork, some are the patient's excess or limit.
- It's small per invoice. £20 here and £30 there never feels worth chasing, until it's added up over a year.
And the cash that's late
Days to pay matters as much as the shortfall. If insurers take 34 days instead of 30, more of your money is sitting with them at any moment, and a slow drift is easy to miss without a monthly figure for each insurer.
How to get the real numbers
Match each insurer remittance line to its invoice by invoice number. Shortfalls with no matching patient invoice are your unbilled money; the gap between invoice date and paid date, by insurer, is your days to pay. It's a slow job in a spreadsheet, and it's one of the joins our free data check makes when you give it your remittance and invoice exports.
See what insurers are holding back
Drop last month's remittance export and invoice list into the free check. It runs in your browser, nothing is uploaded, and it shows your top three gaps in pounds.