Many patients anticipate a learning curve when it comes to understanding their medical bills. A recent survey reported by HealthLeaders found that nearly half of patients, 48% do not fully understand their medical bills. This leads to confusion, frustration and lots of patient questions.
Common Sources of Confusion
There are several reasons for the confusion. One reason is that medical bills often use complex medical billing codes. For patients, these medical billing codes make it difficult to understand what they are being charged for. It’s also common for patients to receive several bills for one medical procedure. For instance, a single surgical procedure could mean separate bills from the surgeon, the lab, the anesthesiologist, and the facility. It’s no wonder the number one source of patient calls to healthcare providers are from billing questions.
If patients are confused and do not trust their medical bill, it’s not just a bad experience for patients. It also means that patients are less likely to pay. However, it’s not that patients don’t want to pay their medical bills. A McKinsey study found that 74% of insured patients want to pay and can pay amounts up to $1,000 annually.
Let’s dive into the most common patient questions related to medical bills, so you can provide the clarity that patients need to manage and pay their healthcare expenses.
Most Common Patient Questions About Medical Bills
Patients have questions and health systems have taken the lead on providing answers, often in the form of a Frequently Asked Questions section on the website.
But, what if there were a better way to address patient questions that didn’t place additional burden on health system team members?
Below are common patient questions about billing listed on health system websites. Instead of relying on patients to find an FAQ section on the health system’s website, we have provided alternative strategies to address patient questions in a more personal, yet scalable way.
1: I had a visit last week – why didn’t I get a call before the visit?
Many health systems struggle with complex, manual processes for engaging patients. These inefficiencies mean your team probably struggles to contact patients, whether it’s to remind them of their appointment, deliver and explain an estimate, or take a pre-payment.
Instead, partner with a patient engagement platform that ingests the appropriate data to deliver estimates and appointment reminders in an easy, patient-friendly way. For example, Patientco’s technology engages with patients how they prefer, in language they understand with intuitive calls-to-action. Once the patient engages with their estimate, they have various affordable payment options. This includes prompt pay discounts and payment plans.
2: Why does my account have a balance?
Most insurance plans require patients to pay a deductible or co-insurance. In addition, patients could be responsible for non-covered services. All of this depends on the patient’s health insurance coverage. Health systems typically advise patients to contact their insurance company directly for specific answers.
3: Why did my insurance company only pay part of my bill?
These questions are similar and stem from a lack of clarity about how insurance impacts the patient’s out-of-pocket cost. However, for patients, it’s a burden to chase down answers via phone with their health insurer. The process usually involves waiting on hold waiting for the next available member services representative to answer the patient’s question.
Instead, make sure your patient billing vendor can explicitly list any previous payments or insurance adjustments on statements. This ensures patients understand what they owe and why they owe that amount. Patientco includes a bill summary on the front of our statements, which breaks down charges, adjustments, previous payments and helps the patient verify what is due. We summarize these details in a vertical format to support quick mental math. This gives the patient an easy way to confirm that everything adds up.
4: How do I know if my insurance company will cover my visit or certain services?
Coverage varies for each patient depending on their insurance. Therefore, health systems often advise patients to refer to their insurance member handbook or call their insurance company with questions regarding benefits and covered services. Even with the price transparency rule in effect, patients may not feel qualified to calculate their costs using a chargemaster and their insurance coverage information.
A better strategy requires personalized price estimates that explain what patients owe and why. Patientco embeds patient-friendly definitions for terms like co-pay, deductible and more so that patients truly understand their estimate, how their insurance fits in, and why they owe what they owe.
5: Will I receive more than one bill for my hospital services?
Several providers may be involved in the patient’s treatment and bill independently. As a result, patients may receive more than one bill when they receive care at a health system’s facilities. This is a common occurrence for many patients.
Patientco’s 2020 State of the Patient Financial Experience survey revealed that 1 in 3 patients received 2-3 bills the last time they visited their healthcare provider. When patients receive multiple bills for a single visit, they often have questions and concerns about their charges. However, the various bills will have a phone number for the specific billing office for each service rendered. This means patients must direct relevant questions to the appropriate provider.
Instead, strive to offer patients a single, personalized view of their financial responsibility, across all services, including hospital and physician charges. Providing a single, unified view of a patient’s financial responsibility ensures patients understand what they owe and makes it clear how to pay, which enables health systems to foster patient trust, satisfaction and loyalty.
Rise Above the Status Quo
These questions provide great insight into patient confusion. It’s as if a translator is needed to bridge the communication gap between providers and patients.
Patient questions about medical bills are the top contributor to patient call volume, according to Patientco’s past survey reports. And in our 2020 State of the Patient Financial Experience report, nearly 1 in 5 providers said high patient call volume is the biggest pain point for their revenue cycle teams. Simplifying billing communication can go a long way toward reducing patient call volume.
Still, there will always be patients who have questions. Consider tools, such as Patientco’s Live Chat feature, which gives patients a convenient way to get their questions answered in real time, so they can move forward without having to call the business office. This makes it easier for your team to efficiently address patients’ inquiries, too.
Rising above the status quo to go beyond an FAQ resource on the website benefits everyone, from patients to health system team members.
Check out this guide for more ways your health system can measure the effectiveness of its current billing communication. If you’re curious to learn how Patientco has helped other health systems, like Piedmont Healthcare improve their approach to patient billing, schedule a meeting with us!