July 30, 2020

How COVID-19 Billing is Shining New Light on an Old Problem

Recently, the New York Times reported on a patient who survived the coronavirus but then received a $400,000 bill for her COVID-19 treatment. In another report, two friends who were tested for the virus – even at the same location – saw massive variation in their out-of-pocket costs: One bill was $199. The other? $6,408.

The truth is, these aren’t new problems. This has been a story in healthcare for a while and the coronavirus angle is just giving new opportunities to run these types of stories with a refreshed headline. In fact, one study found that 57% of Americans have been surprised by a medical bill.

In the news examples shared above, there seem to be a few main areas for improvement to relieve the shock of medical bills and create a patient-friendly approach to healthcare financial outcomes.

Cultivating a More Competitive Market
In a recent blog post, we discussed the unique marketplace that healthcare represents. With years of hidden charges and undisclosed agreements between insurers and providers, healthcare costs have soared.

Seeking a way to create a more natural competitive market, the Department of Health and Human Services (HHS) has announced a new rule outlining measures for price transparency. By providing consumers with a realistic view of potential medical costs prior to their encounter, HHS hopes to create a more competitive economy, where market forces can help bring healthcare costs down. Comply with this ruling with a consumer price shopping tool that meets the regulations outlined by the HHS.

Proactively Preparing Patients
Regardless of the end cost to the patient, having a realistic expectation about upcoming medical costs in advance increases the likelihood that you will receive payment. In a patient survey conducted by RevSpring, 70% of patients said they would be more likely to pay their healthcare bill, after they receive the first bill, if they had an estimate of the costs.

Start the financial conversation at the earliest stages of an encounter and use tools that can give patients options from the start: whether it’s a pre-service payment plan, or a payment deposit. Take the guess work out by using analytics that tailor the payment to the patient.

Post-Service Statement Clarity
When a patient does receive their post-visit bill, it should be clear the amount they owe and their options to pay. There is no need to list the initial chargemaster price (as we saw in the example of the New York Times COVID-19 patient story), when they don’t add any value in communicating what the patient should actually pay. While payers list the gross charges on the patient EOB so that members can see the cost benefits of their insurance coverage, there is no need for hospitals to list these prices when it’s not what patients are paying on; it only causes confusion.

In fact, most statements are built from the perspective of hospital billing and patient accounting systems. Unless you’re familiar with the inner workings of the healthcare revenue cycle, they can be difficult to navigate – even for healthcare providers who have an intimate understanding of what’s being billed. Use plain-language descriptions and leave off parts that have no bearing in calculating the patient’s cost. Incorporate practical design elements like color and white space that give the reader’s eyes room to process the information they’re trying to absorb.

Of course, the purpose of the statement is to provide instructions for the patient on how to pay the balance. Use data analytics to drive the patient to the best payment outcome – for some that will be to pay in full, but for others a payment plan is more appropriate. From a no-log-in portal to 24/7 automated payment by phone, give patients the flexibility to pay in the way most convenient to them with clear directions on how to access payment options.

Putting It All Together
Patients crave clarity and simplicity while navigating a healthcare billing process that can be stressful and intimidating. Their familiarity in other industries sets the expectation for a healthcare financial experience where they can compare competitors and shop around prior to service, have a clear understanding of what they will owe so they can budget and prepare accordingly, and pay when and how is best for them.