Digital tools can solve healthcare payment problems

As consumer complaints about medical billing and collections flood government agencies, healthcare providers and systems on the other side of the equation seek reimbursement for the essential and often life-saving services that They provide.

In April, the Consumer Financial Protection Bureau (CFPB) said it sent more than 750,000 complaints to businesses for review and response in 2021 over billing issues for an $88 billion medical debt issue, though some say that the actual figure is much higher.

As inflation escalates and consumers miss more payments, healthcare providers must preempt a new wave of medical debt by providing the transparency patients now demand.

“As we see pressure on consumers, health care bills are one of those bills that are pushed to the bottom of the pile,” Jason Considine, senior vice president of Experian Health, told PYMNTS.

Noting that federal aid has helped people pay off their debts and stay on top of their bills in 2020 and 2021, he said: “These federal aid programs are being unwound, the country is opening up to new, so people spend money on things they weren’t spending money on. before, and to compound this problem, we have inflation coming to levels we haven’t seen in decades.

Now is a good time to make technology investments that provide cost transparency and payment options that allow consumers to budget and help suppliers get paid.

Features to focus on are those that help providers offer flexible payment options, provide estimates before or during the period of care, and identify correct medical insurance claim information so they can bill payers right the first time, Considine said.

“All of these things will speed up payments for suppliers and help take the pressure off consumers, but I wouldn’t wait,” he said. “These solutions can typically take a little time to implement and then be adopted by patients, so now is the time for providers to prepare, prepare and implement these technologies.”

See also: CFPB reports flood of medical debt collection complaints last year

Digital Healthcare Table Issues

With the No Surprises Act and the Medical Debt Relief Act monitoring providers and credit bureaus, respectively, the healthcare industry needs to update its billing and collection capabilities.

This will subject organizations to new and different collection pressures, prioritizing “solutions that help give patients flexibility, offer them payment plans, put them on the right financial path and provide estimates before the cost of care”.

Additionally, consumers now expect the same digital convenience from their doctor as they do from their bank. This is especially true among millennials and bridge millennials who are digital patients first.

“Accessing Healthcare: Easing Digital Frictions in the Patient Journey,” a collaboration between PYMNTS and Experian Health, said “digital-first patients on average have more difficulty accessing the capabilities they need than non-digital patients” .

Get the study: Reduce digital friction in the patient journey

In this study, 21% of digital users said they encountered problems receiving cost estimates before appointments, while only 2% of non-digital patients reported such problems.

“Historically, [healthcare] is an area where vendors have failed to meet consumer needs,” Considine said. “Healthcare is one of those areas where you don’t know what you’re going to pay until you go to the doctor. There really isn’t any other part of our life where this is true.

It is no longer enough to provide an estimate, he added. Patients want it texted to them and they want to engage with it online.

“We want flexible payment options that reflect an Amazon experience or other payment methods in other aspects of our lives,” he said.

With new laws, we are seeing fines imposed on healthcare systems and billers who step out of bounds, even accidentally, and with more patients willing to switch doctors than ever before, the days of antiquated healthcare billing and disconnected is slowly coming to an end.

Smarter decisions, sooner

Patients leaving doctors and familiar healthcare practices promise to become more pronounced unless these organizations are ready for a possible deluge of new debt this year.

Physicians and their teams have long controlled these interactions with few patient inquiries on things like pre-care cost estimates and payment options.

It’s the old model of healthcare, and it’s unlikely to survive beyond 2022. Considine said we can expect more and more patients to leave providers who don’t. have the right billing and payment tools in place and gravitate toward those that provide the most convenient patient and customer experience.

“What it’s going to look like is an experience that I can figure out what I’m going to have before I go in,” he said. “I’m going to have the ability to easily sign up for a payment plan if that’s what I want, put a credit card on file and make it easy for me to pay, and then engage with my provider through means online.”

Readily available data is key to all of these offerings and is critical to solving reimbursement and collection issues that hospitals need, perhaps more than patients.

From financial assistance that may be available to other aspects of choice, “data is available before the patient arrives as to what is the right financial path for that patient. It may not always be a payment,” Considine said.

When patients want or need a payment plan, “we can know that in advance and offer the right payment plan based on their financial disposition,” he said. “It helps the consumer, it helps the provider, so leveraging data to make smarter decisions and more personalized decisions based on that patient’s unique financial disposition are all tools available to providers today.”

See also: Most patients are happy with their healthcare experience, but want more information before appointments

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Elaine R. Knight