My fees for the forensic report are not based on any tariff, as this is considered uncompetitive in South Africa and therefore illegal. For 2016, my fees depend, among other things, on the complexity of the report prepared, the time required, my expenses incurred and the perceived risk of delay and/or non-payment. My fees range from R2,500.00 VAT incl. for medico-legal advice to R16,000.00 for full reports. In the current economic climate, many consultants are looking for other ways to expand their private practice. As the private health insurance sector has shrunk in recent years, it is difficult for many to increase their market share, so consultants outside this sector have sought out lawyers working in this sector independently or through a group, as well as through forensic agencies. Because of this plethora of potential customers, it is absolutely crucial that you properly prepare your practice from the first contact with these business organizations. In our experience, many consultants start forensic work without due regard to the fees they should charge, or in particular their terms and conditions. What tends to happen is that they then discover some time after work that the case they worked on is on a “no pay, no cost” basis.
And that means they often wait years for their money. The obvious problem is the impact this can have on the cash flow of the practice. The biggest problem, which is often overlooked, is that once the invoice is created, it means you end up paying taxes on it. This means that until you receive the money, you actually pay for the forensic work. If you have a large law firm and you charge VAT, the situation is much worse because you would have had to pay the current 20% VAT to HM Revenue and Customs (HMRC) every quarter – which increases your total debt and exacerbates your cash flow situation. The worst case we`ve seen over the years is a practice that started forensic work many years ago and charged more each month than it collected. It had taken so long that the result was an amount of outstanding debt that had reached over £400,000 almost ten years before the work began. There are many factors to consider before starting to work on medico-legal cases, and I`ve focused on the billing and collection aspects, highlighting the main issues in the box below.
It is rare to find a practice that has the time to continually track these invoices; Even rarer that they have the skills in-house. Another optionThe alternative is to use a professional billing agency. Hire them before you start a forensic job or, if you`ve been doing it for a while, you need to take control of this crucial aspect or take the risk of paying HMRC for the privilege of working. It appears that while these amendments are intended to simplify the forensic assessment and reporting process by ensuring that only relevant documents are sent to the assessor for review and comment, they undoubtedly increase the cost of medico-legal processes. Most of the increase in costs comes from the $3.00 per page exam fee. Nevertheless, physicians may want to consider their own private rate when offering fees to lawyers. However, the possibility of using these costs in criminal matters is limited; Almost all cases are legally supported and very few are initiated as a result of a private trial.