One topic that inevitably comes up whenever medicolegal experts congregate is payment. In fact, surveys show that most experts are concerned about payment to some extent. Concerns range from not receiving timely payment, to payment of fees being made conditional on a specific outcome of the final report, something that is specifically not allowed under the Civil Procedure Rules. This article will provide some ideas for safeguards you can implement for your practice to ensure that you get paid for the services rendered and that payments are delivered in a timely manner.

The results of the 2019 Bond Solon Annual Expert Witness Survey indicate that issues regarding payment continue to be top of mind for medicolegal experts. For example, 73% of the experts surveyed indicated that they would not continue working in legal aid cases if expert witness fees were further reduced. Moreover, at least one respondent referenced a legal agency withholding payment in exchange for altering a report.  

The 2019 surveys for experts and lawyers, conducted by Inspire MediLaw, provide and even clearer illustration of the concerns and worries experts experience in relation to collecting payment. Of those surveyed, 63% reported having to chase payment at some point. In some cases, lawyers ceased communications to avoid paying, in others, experts were met with attempts to re-negotiate the fees after the work had been completed or lawyers attempted to add on services at no additional cost. 

While there is no foolproof way to guarantee timely payment for every case, there are strategies that a medicolegal expert can follow to make the process less stressful. Below are some approaches I have found helpful in my own practice:

• Have clear terms and conditions (T&C) in place that are agreed upon before a case is accepted. T&C’s can always be negotiated, but this should be done at the beginning of the process with payment amounts and conditions clearly outlined and agreed to before work starts. 
• Carefully consider payment timelines. In some cases, it may make sense to accept terms with long deferral periods, or to defer payment until the end of the case, although I would never recommend this as this means waiting for a number of years in Clinical Negligence cases, or schedule that some of the work must be paid for before further work is done at specific stages of the litigation. Remember that your payment of tax owed on your invoices may be required before you have received payment of the invoice if your payment deferral is too long.
• Once you have set up clear T&C’s, make sure to regularly follow up with clients. Invoicing for completed work in a timely manner, using case references from the instructing solicitor, will help both you and the client stay on track with the payments. 
• Control your credit to prevent concentration of debt in a small number of debtors (especially agencies). Assess your risk carefully. Do not repeatedly take on cases from slow payers without significant debt reduction.
• If fees become past due, follow up promptly. In some cases, the delay may be an oversight or the client having not received the invoice or the work done. Following up will resolve at least some of these issues and help you stay within the memory of the client. It is important to regularly follow up until payment is received.
• Chasing payment can be one of the most difficult and time-consuming parts of administrating a medico-legal practice. For some practices, it may make sense to use a professional billing agency although this will add to your costs and will lose the personal interacton between you and your client.
• If all else fails, some strategies for collecting payments owed include debt collection agencies, invoice factoring and legal redress. 

If you have a question that you need assistance with, please consider contacting me for a free conversation about all aspects of running a medico-legal business.