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Medical Billing Meeting Patient ExpectationsMost healthcare providers outsource medical billing and coding to ensure effective revenue cycle management. But what about the patient? It’s important that healthcare organizations provide patients with proper information on billing so that they can make the right medical decisions. Today, patients are assuming greater financial responsibility for their healthcare needs and it’s only fair that well informed about pricing. Comparison shopping and health care budgeting would be easier with price transparency.

According to the American Hospital Association (AHA), patient expectations on billing include: filing medical claims with health insurers, answering questions about bills, and providing doctors with documentation needed for billing. If patient eligibility verification reveals that a patient does not have coverage for a procedure, hospitals are expected to help the patient make financial arrangements or to provide other support. A Gallup poll revealed that hospitals that do not meet these expectations are ranked low in terms of patient satisfaction on billing. The poll found several issues that could lead to dissatisfaction with billing:

  • Hospital care is expensive, but patients who receive large bills are confused and angry. This occurs in the absence of adequate communication with patients in advance of billing.
  • Patients tend to have the most negative and emotional reactions when they discover medical billing errors or believe that such errors exist.
  • Healthcare staff does not pay attention to or deal with patients’ billing complaints properly.

Physicians Practice reports that a recent national survey, “Patient Payment Check-Up”, conducted by HIMSS Analytics and sponsored by Navicure, found that there can be a disconnect between providers’ perceptions of what their patients want and what patients actually want. In fact, the survey reveals some major attitude and behavior differences between providers and patients regarding key patient billing and payment processes. The issues identified include:

  • 90 percent of surveyed providers still mail paper patient statements, but more than half of the patients surveyed (52%) would prefer to be billed electronically, with the proportion being higher among younger patients. The sooner providers update payment processes, the better.
  • More than 50% of surveyed providers indicate it takes the average patient more than three months to pay their bill in full, while only 18 percent of patients said that it takes that long. This could be due to patient confusion caused by multiple billing statements. A Consolidated Patient Friendly Statement (CPFS) could resolve this problem.
  • Patients want a more transparent and easy-to-navigate financial experience.

A recent article in Journal-Advocate discusses the need to bring price transparency to medical services. The article gives several instances where patients ended up angry and distraught when neither their insurer nor their hospital would give them information about pricing. An organization called ClearHealthCosts is providing a novel solution to this patient angst – it is using crowd sourcing to build a community-created guide to health costs.

With the Centers for Medicare and Medicaid Services (CMS) evaluating hospitals on the quality of care and the patient experience, patient satisfaction is the key to the future of health care. Further, in a marketplace scenario where consumers are assuming increasing responsibility for costs of their medical care, price transparency for medical services is essential. While outsourcing medical billing and coding can ensure faster payments and stronger revenue cycle performance, Organizations need to implement payment solutions to meet patient expectations and increase patient satisfaction.