Hospital PPR FAQs

  1. What information is available for hospitals on The PPR?
  2. What if the information on the practitioner is incorrect?
  3. How can Healthcode be trusted with all this data?
  4. What will this cost practitioners? It might be free now but are you planning to charge in future?
  5. Why does Healthcode have the right to publish a practitioner’s GMC registration?
  6. Shouldn’t this information be confidential?
  7. You are encouraging practitioners to register their bank details for e-billing. What steps have Healthcode taken to protect their financial data?
  8. Will this drive up the cost of private healthcare for patients?
  9. Will practitioners be able to control their own profile?
  10. Why should practitioners keep their profile up to date?
  11. What about practitioners who aren’t registered with the GMC?
  12. What guarantees can you give that the information on the register is accurate and up to date?
  13. Will we have visibility of insurer recognition based on the practitioner and treatment location?
  14. If we are on the basic service what happens if bills fail due to insurer recognition?
  15. Insurance companies are not including our hospital in their referrals for a particular practitioner, why is that?
  16. Will we need to wait for the practitioner to enter the treatments and procedures they provide on their profile, so a bill will not fail?
  17. How does this affect the process when we need a practitioner mapped/added to our hospital?
  18. Will practitioners be able to see what the hospital bills?
  19. What checks are performed on initial registration?

 

Answers

A.1) What information is available for hospitals on The PPR?

Hospitals are required to use the basic service and can subscribe to the enhanced standard service. The basic service of The PPR provides limited registration information of:

  • Practitioners that have indicated they practise from that hospital
  • Practitioners previously mapped on the billing site and submitted as a Controlling Specialist on an invoice submitted by a Hospital Provider

Hospitals will be able to view their practitioner population for their hospital and view alerts for:

  • The existence of GMC warnings
  • Appraisal overdue
  • Indemnity overdue

Details of other hospitals their practitioners practise from will not be visible.

The standard service provides the same functionality to hospitals as basic but also enables the hospital to view the practitioner’s full profile. The profile includes the following information:

  • Personal profile
  • NHS and private practice information
  • Fitness to practise information
  • Specialties and qualifications
  • Medical secretary details
  • Publications
  • Bank details
  • Medical indemnity
  • Insurer recognition details
  • GMC status, specialty, qualification, registration and fitness to practise information.

In addition, The PPR will notify the applicable hospitals of updates to the practitioner’s profile. 


A.2) What if the information on the practitioner is incorrect?

Hospitals can update the following information:

  • Practice hours
  • Type of patients the practitioner treats there
  • Type of care the practitioner provides
  • Start and end dates of practise there

All other information is read-only.

If a hospital updates any of the above information, the practitioner is notified by email that changes have been made to their profile.


A.3) How can Healthcode be trusted with all this data?

Healthcode takes data security seriously. Using tech-speak, our systems are secured in accordance with internet banking conventions, using 2048-bit certificates only accessible via encrypted network connections, and are secured within a private dedicated infrastructure physically located in the UK, rather than held in a cloud in an unknown location. Our dedicated Tier 3 infrastructure is of enterprise quality designed to contain no single point of failure and the data are protected and secured by Transport Layer Security (TLS), user credentials and role-based control. A back-up copy of the data is taken daily and is securely stored in a separate UK hosted disaster recovery facility.

Our Information Security Management System complies with the requirements of ISO/IEC 27001:2013 and we have maintained this accreditation since achieving it in 2009. Additionally, we achieved accreditation with the Government-backed Cyber Essentials scheme in March 2019, having passed stringent independent evaluation of our systems by IT Governance.


A.4) What will this cost practitioners? It might be free now but are you planning to charge in future?

There is no cost to the practitioner to register on The PPR. Practitioners have access to their PPR profile via a secure portal to allow them to maintain and update their information. They can also subscribe separately to ePractice, our billing and patient management system.


A.5) Why does Healthcode have the right to publish a practitioner’s GMC registration?

Healthcode does not publish the registration data but does distribute it to those hospitals and insurers with whom the practitioner has a relationship. Any data distributed in this way is also available to the practitioner via The PPR. Healthcode holds a republication licence to the GMC’s List of Registered Medical Practitioners (LRMP) so that users can validate the registration status of medical practitioners in the interests of good governance and patient safety. The LRMP is updated daily, Monday to Friday (apart from Bank Holidays). Information about the licence subscription service is available on the GMC website (https://www.gmc-uk.org/registration-and-licensing/the-medical-register/download-the-register).

 
A.6) Shouldn’t this information be confidential?

The GMC’s LRMP is already publicly available via the GMC website. The information held on the LRMP is not determined by Healthcode and any queries should be directed to the GMC.


A.7) You are encouraging practitioners to register their bank details for e-billing. What steps have Healthcode taken to protect their financial data?

Bank details will only be used to receive payments from insurers and practitioner accounts will not be debited. Healthcode takes data security seriously – see Question 3. Additionally, access to The PPR is protected and secured by user credentials and passwords.

As the UK’s official clearing body for private medical bills Healthcode has over 20 years’ experience in handling sensitive financial data. In 2019, for example, we cleared over 7m bills worth in excess of £3.3bn. Over 80% of private hospitals and all major insurers trust Healthcode’s e-billing system and Healthcode has circa 25k practitioner accounts.


A.8) Will this drive up the cost of private healthcare for patients?

The PPR provides one central secure online system to all key stakeholders (practitioners, insurers and hospitals) and removes some of the repetitive cumbersome processes currently in place. We believe streamlining these will add value, reduce administrative costs overall and facilitate the transparency and accuracy of information within the healthcare system, something that is very much at the forefront of current thinking.


A.9) Will specialists be able to control their own profile?

The PPR enables practitioners to build their profile, decide which private medical insurers (PMIs) to apply to for recognition and indicate which private hospitals they practise at.  Subscribing PMIs only have read-only access to a practitioner’s full profile.  Hospitals can modify the following information:

  • Practice hours
  • Type of patients the practitioner treats there
  • Type of care the practitioner provides
  • Start and end dates of practise there

For hospitals all other information on the practitioner’s profile is read-only, with the amount of information available being determined by their subscription level.

 

A.10) Why should practitioners keep their profile up to date?

It is important for practitioners to ensure that the organisations they have a relationship with have the most up-to-date information to maintain their insurer recognition statuses and hospital practising privileges. Making sure the profile is up to date is their responsibility and it is in their best interest that the information is accurate to support compliance and transparency across the sector.


A.11) What about practitioners who aren’t registered with the GMC?

The PPR is available for all regulated healthcare professionals who practise in the private health sector. It covers eight of the UK’s statutory regulators: the GMC, GDC, GPhC, GCC, GOC, GOsC, HCPC and NMC.


A.12) What guarantees can you give that the information on the register is accurate and up-to-date?

It is the practitioner’s responsibility to ensure their information is accurate and up to date as per Healthcode’s terms and conditions, but it is also in their best interest to ensure private medical insurers and hospitals have accurate information about their practice.


A.13) Will we have visibility of insurer recognition based on the specialist and treatment location?

This information is available in the standard service of The PPR on subscription. Insurer recognition is based on the practitioner.


A.14) If we are on the basic service what happens if bills fail due to insurer recognition?

The practitioner must be recognised by the insurer if they appear on a bill. If bills for specific practitioners are failing due to PMI recognition issues the hospital will need to contact the practitioner concerned. However, hospitals can see insurer recognition if they subscribe to the standard service.

 

 A.15) Insurance companies are not including our hospital in their referrals for a particular practitioner, why is that?

This may be because the practitioner is not registered on The PPR. For those insurers that have adopted The PPR as their recognition system, the practitioner must be on The PPR and indicate they practise at your hospital. Practitioners can register on The PPR at www.theppr.org.uk.

 

A.16) Will we need to wait for the practitioner to enter the treatments and procedures they provide on their profile so a bill will not fail?

This is procedure credentialing and is currently not part of this release. Procedure credentialing will be introduced in a later phase.


A.17) How does this affect the process when we need a specialist mapped/added to our hospital?

You will no longer be able to contact Healthcode Customer Services to perform this service. Using The PPR you should search the database and link the practitioner to your hospital. If you are unable to find the practitioner, it will either be because they do not have a PPR profile or they are not known to Healthcode and have never been listed on an electronic bill. You therefore need to request that the practitioner registers with The PPR at www.theppr.org.uk. Once this has been done and the set-up of his/her profile is completed, any hospitals on their profile will be notified.


A.18) Will specialists be able to see what the hospital bills?

No, practitioners do not have visibility of hospital bills via Healthcode.


A.19) What checks are performed on initial registration?

Healthcode will perform standard verification and validation of professional numbers against the following regulatory bodies on new registrations:

  • General Medical Council (GMC)
  • General Chiropractic Council (GCC)
  • General Dental Council (GDC)
  • General Optical Council (GOC)
  • General Osteopathic Council (GOsC)
  • General Pharmaceutical Council (GPC)
  • Health and Care Professions Council (HCPC)
  • Nursing and Midwifery Council (NMC)

Healthcode also undertakes the manual checking that information on new registrations are sensible, the files are relevant, suitable and readable and renewal dates are in the future.