Software for UK private GP practices
Friday afternoon, four PMI portals. Bupa, AXA, Vitality, WPA. Different fee schedules, different formats. Healthcode is meant to make this one workflow. It doesn’t.
You’re a private GP - solo at a clinic you run from a Harley Street suite, or a principal at a four-GP practice in a market town with a 60% PMI / 40% self-pay mix, or a practice manager at a small group running Heydoc. Each PMI insurer has its own portal (Bupa Provider Online, AXA Health, Vitality Healthcare, WPA, Cigna, Aviva Health), its own fee schedule, its own claim format, its own pre-auth wrinkles. Healthcode is meant to be the EDI layer that unifies it; the integration with your PMS is partial; Friday afternoon the practice manager is on her fourth login of the day. The telehealth consults you’ve moved onto on Whereby save the patient a drive but the recording and the notes don’t flow back into the PMS cleanly. The CD register lives in a green book on the prescribing GP’s desk. The second-opinion paperwork the patient needs for her insurer - drafted twice, lost once, rebuilt from the clinical notes.
This page is for private GP practices specifically - the clinics hub covers the cross-clinic operational loop. What’s on this page is the GP-distinct moments: the PMI billing concierge in depth, the telehealth-to-PMS glue, the CD register, the second-opinion documentation flow, the patient records-request workflow. If you’re a multi-disciplinary clinic (some GP, some physio, some aesthetic), the hub is also worth reading.
What your week actually looks like
- Friday afternoon - Bupa Provider Online, AXA Health, Vitality, WPA, Cigna. Four portals, four fee schedules, four claim formats. Practice manager at the desk till 7.
- Healthcode integration with Heydoc is partial - claims that should auto-submit go to a draft state needing manual review. By Friday the draft queue has 47 entries.
- Tuesday’s telehealth consult on Whereby - patient happy, consult done, recording in Whereby’s storage, notes typed into Heydoc by hand at 6pm.
- Wednesday - patient needs a second-opinion letter for her insurer. First draft in your dictated-notes app, consent for sharing on a separate signed form, the insurer’s submission portal has its own format requirements.
- CD register - green book on the prescribing GP’s desk. Schedule 2 / 3 entries handwritten; Home Office inspection guidance says digital is fine if signed-off; you’ve never had a clean day to migrate it.
- New PMI patient registration - Bupa wants a specific eligibility check, AXA has a different one, Vitality wants the policy + employer combo; each takes 3-5 minutes to verify and you do twelve a week.
- Patient excess - Bupa’s £100 for outpatient consultation, AXA’s £150, Vitality’s £200 with a first £200 paid by patient line on every claim. The patient often hasn’t paid; the claim bounces; the practice manager chases.
- Self-pay alongside PMI - the £350 consult that wasn’t covered (consultation type out of scope for the patient’s policy) needs to flip to self-pay invoicing without losing the clinical record.
- Patient records-request from the insurer or a new GP - currently a 30-minute job assembling notes, consult letters, prescriptions, lab results into one pack, with the consent for release captured against the right purpose.
- Prescription pad - private prescriptions to Lloyds Direct or Pharmacy2U or the local independent; patient asks the GP for status; GP rings the pharmacy on Friday afternoon.
Example problems we could solve
1. PMI billing concierge - at depth
The four-portals moment: Bupa Provider Online, AXA Health, Vitality Healthcare, WPA, Cigna, Aviva. Six insurers, six portals, six fee schedules. Healthcode is partial. Friday is admin day and Friday is now drowning.
Solved looks like: at consultation-close, the visit writes to a structured claim object with the per-insurer fee schedule already loaded - Bupa wants a procedure-pairing rule on outpatient consultation, AXA wants the pre-auth reference on every claim, Vitality has a 30-day submission window, Cigna’s eligibility check runs differently from the rest. The Healthcode submission renders against that schedule with the per-insurer wrinkles handled in code, not in the practice manager’s head. Claim submitted, the tracker watches the status - acknowledged, processing, paid, rejected - and when BACS lands the bank feed auto-reconciles the open receivable. Rejections surface the reason (missing pre-auth, code mismatch, fee-schedule version drift, patient-excess shortfall, policy lapse) with a one-tap re-submit where the fix is on your side and a one-tap “flip to patient self-pay” where it’s not. Patient-excess collection runs alongside - the £100 / £150 / £200 per insurer collected as a deposit at booking, reconciled against the claim outcome. The longer version lives at Invoice & Dunning Ladder.
2. The telehealth consult that doesn’t lose the recording or the notes
The 6pm-typing moment: Tuesday telehealth consult on Whereby. Patient’s happy, consult done, recording sits in Whereby’s storage. The notes you’d dictated end up typed into Heydoc by hand at 6pm. The recording - where is it next month if she has a follow-up?
Solved looks like: the booking creates the video-room link embedded in the patient’s record. At consult-close, the recording (where the patient has consented; EU-region storage, role-scoped access) writes to the patient’s file alongside a transcription that pre-fills your consult-notes template - chief complaint, history, examination findings, impression, plan, prescription - for you to review, edit, and sign-off in two minutes rather than fifteen. Recording and notes both carry the consent state (clinical-only / patient-can-access / insurer-shareable for claim evidence). For follow-up, the prior consult is one tap rather than a hunt through Whereby’s archive. The longer version lives at Multi Channel Comms Thread.
3. The CD register that’s signed-off, searchable, and inspection-ready
The green-book moment: Schedule 2 / 3 controlled-drugs register - green book on your desk. Home Office says digital’s fine if signed. You’ve put off migrating it for three years because the day you do, you’re not seeing patients.
Solved looks like: the CD register as a structured object with the audit fields the regulations require - date, patient identifier, drug name, form + strength, quantity prescribed, prescriber signature (cryptographic plus name), running balance per drug. Each prescription event writes a new entry; the running balance updates automatically; the discrepancy alert fires before the inspection finds it. The signed-off entry exports to PDF for any inspector or CD Accountable Officer review; the running balance reconciles against the pharmacy’s dispensing record where the pharmacy returns a structured feed. For controlled-drugs destruction (DOOP records, witnesses), the workflow captures the witness signature on the tablet at the moment of destruction. The named CD Accountable Officer responsibility stays with the practice - what the system does is make the evidence trail one URL rather than a green book. The longer version lives at Compliance Evidence Record.
4. The second-opinion letter - and the records-request - that draft themselves from the clinical record
The forty-minutes-I-don’t-have moment: patient needs a second-opinion letter for her PMI insurer. You draft it; the consent for sharing isn’t where you expected; the insurer’s portal wants a specific format. Same shape for the records-request that came in from her new GP yesterday. Forty minutes per pack.
Solved looks like: the consultation that triggers a second-opinion or referral letter pre-fills the letter from the clinical record - chief complaint, examination, working differential, the rationale for second-opinion or onward referral, the named consultant or service. The patient’s consent for sharing (specifically with the named recipient, specifically for this purpose, with a tick-list of what’s included) is captured at the moment the consent’s needed, not retrieved later. The letter exports in the format the receiving insurer or consultant expects (Bupa wants a specific consult-pairing reference; AXA wants the policy number; Vitality wants the original consult date). For onward-referral-to-NHS letters, the format follows the NHS referral standard. The records-request workflow runs on the same engine - the new GP’s request creates a structured pack-assembly job, the patient gets a one-tap confirm-or-redact link for the consent state, the pack assembles within a day rather than a week. The longer version lives at Multi Channel Comms Thread.
Closest builds we’ve shipped
- mendbuddythe agent platform behind the patient-side enquiry triage (the “is this covered by my Bupa policy?” and “can I book a follow-up telehealth consult” questions that eat reception time), trained on your scope-of-service and your practice voice. See Mendbuddy.
- pharmaceutical-analytics.coma custom analytics dashboard we built for an analytics consultancy. The practice-manager PMI dashboard (claim age by insurer, rejection-reason distribution, patient-excess collection rate, claim-to-cash conversion by GP) is the same shape: operational data captured at every claim touchpoint, decision dashboard for the principal. See Pharmaceutical Analytics.
- mmi-serviceslegacy insurance-claims surface we’ve been modernising. Different domain (motor insurance), same operational shape: claim object, status pipeline, reconciliation against insurer-side payouts, rejection-reason taxonomy. Useful when the practice’s PMI work sits on top of an older internal system that needs lifting rather than replacing. See Mmi Services.
FAQ
Will the PMI concierge work with Heydoc / Semble / Pabau?
Heydoc and Semble both expose APIs we read consultation events from and write claim-state back to; Pabau likewise. The Healthcode-side EDI submission is rendered by the concierge against the per-insurer fee schedule. If your install carries a non-standard fee schedule override (some larger practices negotiate per-procedure rates), we configure that in discovery.
Will the system actually reduce the Friday admin?
The dimension that reduces is rejection-workflow time - currently it’s 5-15 minutes per rejected claim of figuring out what went wrong, where the practice manager is doing detective work. With the rejection-reason surfaced and the one-tap re-submit, that drops to a minute or two. New-claim submission stays at roughly the same effort; what changes is the claim doesn’t disappear into a black box between submission and BACS landing.
Will telehealth recordings be stored in compliance with health-data rules?
EU region; encryption at rest; role-scoped access (patient-record-level not practice-wide); audit log on every read. Patient consent for recording is captured at the moment of the consult (not buried in a terms page); withdrawal of consent pulls the recording from external surfaces and writes the withdrawal-event to the audit log.
Will the CD register meet the Misuse of Drugs (Safe Custody) Regulations and the Home Office inspection standards?
The structural fields and the signed-off-by-prescriber requirements are met; the regulations evolve and we revisit as updates land. The named CD Accountable Officer responsibility stays with the practice.
Do you handle CQC / GMC registration and revalidation on my behalf?
No. CQC registration, GMC revalidation, scope-of-practice, indemnity, complaint-handling - all clinician-side or practice-owner-side accountabilities. The system makes the evidence trail assemble as you work; the registration itself stays yours.
What does it cost?
Every build is scoped per practice - depends on GP count, PMI insurer mix, whether the telehealth glue + CD register + second-opinion engine are all in scope, what PMS you run. We talk it through, agree price in writing. See pricing.
Up to the hub
← UK private clinics (hub) · Dental (sibling) → · Aesthetic / cosmetic (sibling) → · Vet (sibling) →
Tell us about your practice
What practice you run, how many GPs, what PMI insurer mix, where the Friday admin pain sits - the four portals, the telehealth glue, the CD register, the records-request pack. Send an enquiry - we’ll come back with a sketch of what we’d build.