Do you understand your medical bills? If you answered no, you are not alone. Nearly half of all Americans questioned in a recent survey found their medical bills to be confusing.
They said they have difficulty understanding what they were being billed for, they were unsure whether the bill would be in line with the estimate given for the treatment, and they were uncertain whether they could afford to pay the bill.
They also complained about receiving their bills weeks after they had received the treatment or service from the hospital or physician.
Only one in 10 found their medical bills not to be confusing at all.
Black box
The results of the survey show that managing and understanding medical bills has become challenging for a large number of families for whom medical bills remain a black box, says Amy Raymond, vice president of revenue cycle operations at AKASA, a developer of artificial intelligence for healthcare and the company that commissioned the survey from YouGov.
She urges patients to check their medical bills and to find out what they mean and for what they are paying. They should not simply accept a bill they do not understand, but should ask their providers or their insurance company to explain what the bill is for before paying it. They might be paying for services or treatments they did not have.
Errors make it worse
The situation is complicated by errors that continue to be made in medical bills, Raymond says.
She advises people to review their bills diligently so that they are sure their bills are accurate.
An additional problem that arises from confusion about charges is that many who are unsure of what the costs of a treatment or service might be are afraid of going into debt if they have the treatment. The result is that they avoid obtaining care.
Raymond says, too, that it is up to the healthcare organizations—both insurers as well as providers—to ensure that medical billing is less painful for patients.
Factors behind the confusion
A number of factors lead medical bills to be challenging for so many patients, explains Raymond.
Among them:
• An increase in high-deductible health plans;
• Patients do not know what they are being billed for;
• The complications of which charges are in-network and which are out of the network; and
• Uncertainty about how much they will be charged.
In the survey respondents were asked what they thought would be the most beneficial to help them to understand how much they were expected to pay for services or care.
The responses:
• A call from the hospital staff or physician’s office before the procedure is performed on what the patient can expect in relation to the payment and whether payment plans are available—27%;
• A calculator provided online that would help to determine the ranges of cost for procedures or care—12%;
• An email from the insurance company to explain the bill after the treatment or service has been provided—9%;
• Access to a live online customer service agent that is provided through the insurer’s website—9%;
• A call from the hospital staff or physician’s office to discuss the bill after the treatment or service has been provided—8%.
A quarter of the respondents were apparently so dillusioned by the medical billing process that they said that none of these responses would help.
Automation would help
Raymond suggests that automation might be a tool that leaders in healthcare can use to correct medical billing as well as to ensure that the process becomes more seamless for patients.
Automation will make it possible to relieve those who handle medical revenue of a lot of their more tedious work, enabling them to become better advocates for their patients.
An example, she adds, is the automation of authorization for procedures. That automation would free up staff who are now involved in the process. Staff also could take on more activities that directly involve patients, such as financial counseling, in order to deliver an improved service for them.
