Healthcare providers focus on providing high-quality, equitable, and safe care as patient care and patient satisfaction are the ultimate motives for running practice. Patient billing is an important part of the care experience, where most practices face challenges day-to-day basis.
Most of the surveys focusing on patient satisfaction report that patient bills can be difficult to read, sent separately from different providers, contain unintentional errors, might contain an unexpected amount, and fail to provide ready access to easy payment options.
For example, for breast cancer surgery, a patient may receive separate bills from the hospital, the surgeon, the anesthesiologist, the pathologist, and the laboratory, depending on each provider’s relationship with the hospital or health system and whether they do their own billing.
Patient billing issues are further worsened by increasingly confusing and convoluted policies implemented by commercial health insurers, including changing coverage rules midyear and complex cost-sharing structures that leave patients uncertain about what they owe and what their plan will cover.
These sorts of issues can contribute to patients missing their payments and negatively impact their relationship with their providers. Recent acts like the Federal Hospital Price Transparency Rule and the No Surprises Act highlight efforts by policymakers to intervene and address patients’ concerns.
In this article, we identified key challenges in inpatient billing and discussed ways to improve the patient billing experience.
Challenges in Patient Billing
Patients are looking for simple, consolidated bills, multiple payments and payment plan options, pre-service out-of-pocket cost estimates, and improved customer service. Consumer research identified the following key issues with the patient billing experience.
- Confusing bills: The majority of patients are confused by their medical bills. Confusion can arise out of lack of clarity about the amount owed and how it relates to any payments already made by the patient, less than clear-cut descriptions of services, and how different types of coverage, such as Medicare, private health insurance, workers’ compensation and/or auto insurance, interact to pay for care, among other issues.
- Multiple bills: Patients report confusion as a result of receiving multiple bills from different providers for what appears to them to be a single episode of care. They would prefer to receive consolidated bills and pay bills from different healthcare providers all in one place.
- Unexpected bills: More than 90 percent of patients surveyed report being surprised by a medical bill in the past year, which includes receiving a bill that they did not expect or that was far more than they expected. A vast majority of patients would prefer to know how much they will owe for a medical bill before receiving medical care, and many prefer to find that information using an online cost estimator.
- Outdated communication channels: An increasing number of patients, regardless of age, prefer to receive and engage in communications around medical bills through electronic communications, yet only 23 percent of patients are receiving their medical bills in this format. Not surprisingly, younger patients between the ages of 18-34 are more likely to prefer e-billing than older patients.
- Lack of multiple payment options: In a recent survey, more than a third of patient participants believed available payment options were inconvenient. Patients increasingly prefer to pay using an electronic payment method, including payment by credit or debit card, or directly from a bank account or health benefits account. There also is a growing demand to offer mobile payment systems, such as PayPal, Apple Pay, Samsung Pay, or Google Pay.
Improving the Patients Billing
Once practice owners acknowledge patient billing challenges, they can come up with solutions that can be done relatively easily, whereas others are more complex and require assistance from billing companies.
- Provide accurate bills: Commit to billing accuracy and adopt quality control processes to ensure that bills are accurate before they are sent to patients. Errors should be investigated for resolution prior to sending the bill to the patient.
- Provide cost estimates: If not already providing easily accessible out-of-pocket estimates, work to do so for shoppable services, such as those services that are scheduled in advance, tend to follow a common course and are not dependent on patient characteristics, such as comorbidities. Technological advances enable hospitals and health systems to help patients get this information in new ways, such as through online calculator tools.
- Simplify bills: Try to simply patient bills. You can work with consumer advocacy and focus groups to improve clarity. You can format bills that clearly state the amount due and do not include charges, allowed amounts, or any other dollar figure that could distract from the amount owed. The summary also should clearly state the deadline for payment and the options for making payment, as well as provide contact information for customer support.
- Consolidate bills: Work toward consolidating billing for all care delivered within the system. Bills could be consolidated for an episode of care, or, alternatively, 30-day billing cycles. In the latter option, bills that occur during a 30-day period would be bundled together and sent to the patient at the end of the cycle. Providers would need to communicate clearly with patients about what would be included in these consolidated bills and ensure that patients understand that care sought outside of the system would not be included in these bills.
- Provide flexible payment options: Develop and introduce to patients a variety of standard payment options, recognizing that some payment options may need to be customized based on the individual patient’s experience. Expand the ways in which patients can transmit payment beyond checks and credit cards, such as through a variety of electronic means. Begin to engage in electronic communications around medical bills, such as email, text messaging, in-app messaging, or a live chat feature.
The biggest hurdle in managing patient billing challenges is the lack of providers’ time. Practice owners get stuck in the technicality of medical billing resulting in a waste of time and revenue. You can free some time for patient care by outsourcing your medical billing operations.
Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle solutions. We share insurance coverage reporting helping you to provide accurate cost estimation along with patient responsibility.
To know more about medical specialty-wise billing services, email us at info@medicalbillersandcoders.com or call us at 888-357-3226
FAQs
1. Why is patient billing so confusing for many patients?
Patients often face confusion due to unclear charges, unexpected bills, and separate bills from multiple providers for a single treatment. These issues arise from complex insurance policies and billing practices.
2. How can healthcare providers improve the patient billing experience?
Providers can simplify bills, consolidate charges, offer clear cost estimates, and provide flexible payment options, including electronic payments, to enhance patient satisfaction.
3. What are some common patient billing challenges?
Key challenges include confusing bills, multiple bills from different providers, unexpected charges, outdated communication methods, and limited payment options.
4. How can practices reduce billing errors?
Practices can reduce billing errors by implementing quality control processes to ensure accuracy before sending bills and resolving discrepancies before patients are billed.
5. What are the benefits of outsourcing medical billing?
Outsourcing medical billing can save time for providers, reduce billing errors, and streamline revenue cycle management, allowing healthcare professionals to focus more on patient care.
