HIMSS News

Transforming healthcare billing

As of today, there is no standard for consumer medical billing — and it shows. If you’ve ever had medical bills, you’ve probably faced one or more of the many problems with the current medical billing system. This May, AARP and the U.S. Department of Health & Human Services sponsored a challenge to find ways to end the headache of healthcare billing called, “A Bill You Can Understand.”

Eighty-five participants entered the competition and two main winners were announced in September at the Health 2.0 Conference in Santa Clara, California. The two categories to compete in were for, “Easiest Bill to Understand” and “Transformational Approach” because these two elements are crucial for clearing up the problems with healthcare billing.

Patients are having trouble understanding the design of their bills — they don’t know who to pay, how much to pay and have trouble understanding the jargon, among other problematic issues with inconsistent medical billing documents.

According to Mad*Pow research, 61 percent of respondents rated their medical bills as confusing or very confusing. And 56 percent of them said they hesitate to get care because of billing confusion.  

The two categories from the “A Bill You Can Understand” competition are necessary for healthcare consumers. But, when it comes to executing a new billing system, health organizations also need to make sure design and innovation are coming together in one bill.

The design of the healthcare bill should be free of industry jargon, easy to locate and include the most important information, like when the payment is due and payment options. The design is most certainly a roadblock that needs to be cleared.

But the future of healthcare billing demands much more.

The HIMSS Revenue Cycle Task Force has a vision for the patient financial experience of the future to address these issues head on:  more individuals assume increasingly larger amounts of direct financial responsibility for their healthcare, and in turn, they begin to view their healthcare as more of a retail experience. Patients aren’t only researching where to get their care, they want their billing issues to be addressed so they aren’t inundated with multiple bills for the same continuum of care and sent in a dozen directions when they need to pay or consult with someone. This is where the transformational part of the bill comes into play.

Health systems need to interrupt this system with a transformational approach. We need a billing solution that brings both of the “A Bill You Can Understand” categories together so it’s designed to focus on the user, provides one bill, one place to pay, and one place to call — just like when you go to the mall and buy from multiple stores with one credit card. This multifaceted, transformative solution happens when someone takes the reins to step between the provider, the payer and the ultimate user of services.

Now it’s time for healthcare leaders to embrace the solution that combines a consumer-focused designed bill and transformational approach to the billing system.

About the author: Beth Griffin has 30+ years of experience in financial services and healthcare payments in a variety of leadership roles. Health Payment Systems is the only company that eliminates billing confusion by consolidating a consumer’s healthcare bills and Explanations of Benefits into one statement.