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Pulse Magazine

Billing Tree Survey Reveals Increase in Shift to Online Payments

  • January 31, 2019
  • Published in Billing

Online payments are catching up in the health care industry, where common payment methods continue to be on-site, mail and through live phone agents.  BillingTree, in results from its third annual Healthcare Operations and Technology Survey, reports 63 percent of providers offer web portal payments and more than 25 percent also offer options for text-based payment—a substantial increase over previous years’ findings.

Of note, providers’ responses show that plans to implement text-based payments surpass “Interactive Voice Response (IVR) automation.”  “The survey found the biggest payment pain-points facing health care providers for two consecutive years have been a patient’s inability to pay, collecting once the patient has left the facility, a lack of payment channels, compliance and issues related to insurance billing,” according to a news release from BillingTree, an ACA International affiliate member company in Phoenix.

However, the survey results also show payment options are changing to address these pain-points as well as patients who prefer having customer service and payment availability 24/7, according to the news release. “The BillingTree Healthcare Survey series continues to show a sector gravitating toward new payment technologies to improve revenue cycle management. 

This is evident in the continued strong adoption of web portals, IVR and now, for the first time, text-related payments—mirroring the overall mobile payment trend in the industry,” Pat McIntyre, BillingTree’s vice president of health care, said in the news release.  More information: https://bit.ly/2LvgltR

 

Senators Cosponsor Legislation to End Surprise Medical Bills; Lower Healthcare Costs

Two U.S. senators recently introduced companion legislation that would help consumers manage health care costs and stop unexpected medical bills. U.S. Sen. Jeanne Shaheen, D-N.H., introduced the Reducing Costs for Out-of-Network Services Act of 2018 in October to “combat escalating out-of-pocket healthcare costs for uninsured patients and for patients in the individual health insurance market who receive out-of-network care,” according to a news release.

Cosponsor U.S. Sen. Maggie Hassan, D-N.H., introduced companion legislation to help end surprise medical bills for consumers as a result of receiving care they didn’t realize was considered out-of-network. “Shaheen’s legislation protects patients who are uninsured or in the individual health insurance market, while Hassan’s legislation protects patients with employer-sponsored health plans,” according to the news release.

“The bills that Senator Hassan and I are introducing would help fix chronic problems in our health care system by lowering costs for patients and increasing access to health services,” Shaheen said.  Shaheen’s bill, would cap the amount that hospitals and physicians could charge uninsured patients and out-of-network patients who have individual market coverage, according to the news release.

The Reducing Costs for Out-of- Network Services Act, it states, would:

Significantly reduce out-of-pocket costs for patients who have individual market health insurance and receive care from out-of-network hospitals and physicians;

Substantially reduce out-of-pocket costs for uninsured patients who could otherwise be charged very high “full charge” prices for hospital and physician services; and 

Reduce premiums for individual market health plans by improving individual market insurers’ ability to hold down negotiated provider payments and costs for in-network care.

Shaheen is also cosponsoring Hassan’s legislation, the No More Surprise Medical Bills Act of 2018 that will help “protect patients with medical emergencies from surprise billing by prohibiting hospitals and providers from charging more than the in-network amount.”

Hospitals would also be required to notify patients in non-emergency situations if their services are is out-of-network and obtain their consent before providing care.  In November, Hassan highlighted the importance of her legislation during a hearing with the Senate Health, Education, Labor Pensions Committee focused on health care costs.

“Studies have shown that nearly 1 in 5 visits involves care from providers who are out-of-network, and non-emergency situations often result in surprise medical bills as well,” Hassan said.  More information: https://bit.ly/2PfE0yY

 

Medical Debt Declines with Patients’ Age

Credit report data for more than four million Americans examined by researchers for Health Affairs shows medical bills in collections are declining among older consumers, but their medical spending is increasing.

According to the research, “the share of people with at least one medical bill in collections decreased nearly 40 percent from patients age 27 to 64.”  Overall, as of 2016, about 16 percent of consumers’ credit reports showed unpaid medical bills referred to collection agencies, Health Affairs reports.  While aging consumers’ medical bills in collections decline, spending increases.  For example, the mean medical spending for 2011-2015 ranges from $4,000 to $6,000 for consumers ages 70 to 80.

The authors of the Health Affairs study, Michael Batty, an economist at the Federal Reserve Board, Christa Gibbs, economist at the Bureau of Consumer Financial Protection, and Benedic Ippolito, an economist at the American Enterprise Institute, also found that “un-insurance rates tracked closely with total medical debt, with younger adults having both higher dollar amounts of medical debt and a higher likelihood of being uninsured.

However, the number of people who accumulate medical debt by age was less closely tied to insurance coverage rates.”  Read more on the study on the Health Affairs website: https://bit.ly/2o9cFmQ.

Emergency Brake

The health care world has many moving parts. As a debt collector, it’s your job to be the health care expert—which means it’s often up to you to explain medical bills and insurance coverage to consumers. 

You’ll hear things like, “My insurance should have paid that!” and “I was told I was covered.” In an emergency situation, medical bills get even more confusing.  The patient might not even have been conscious at the time of care to consent to the treatment.

The Emergency Medical Treatment and Active Labor Act requires hospitals to evaluate and stabilize patients regardless of their financial situation. These requirements are mandatory and not affected by payment considerations. The hospital still bills the patient, and the patient is responsible for paying that bill.

This is particularly stressful if patients aren’t satisfied with the treatment and find out their health insurance won’t cover it.  Sometimes patients go to the emergency room, change their mind and refuse treatment, but are still charged a facility fee. Facility fees are charges for a hospital’s services and equipment, and they often come as a surprise to patients.

Even if patients disagree with these charges, unless they can negotiate a lower amount with the health care provider, they are responsible for paying the bill.  Sometimes patients aren’t familiar with their copays. Depending on the insurance plan, copays can vary depending on the type of service used; for instance, payments often differ when you have a preventative medical exam in your doctor’s office versus going to the emergency room after you tumble off a ladder.

Many emergency room doctors–and even ambulance services–are private contractors who might not be covered by a patient’s insurance plan. When a patient receives care from an out-of-network physician, even if it’s at an in-network facility, the patient may be charged for the out-of-network fees.

When patients apply for financial assistance through the hospital, they may believe their bills will be taken care of completely. However, the hospital’s financial assistance policy only covers the hospital’s bill—not those of the emergency room physician, the radiologist, the anesthesiologist or other providers that gave medically necessary care in the hospital. 

Hospitals must list which providers delivering emergency or medically necessary care are covered by financial assistance and which are not.  Here are some helpful questions you can ask the patient:

“What does your explanation of benefits tell you is owed?”

“Why do you feel you are not responsible? Tell me what happened.”

Many consumers feel by carrying insurance, they’ve fulfilled their financial obligation to the medical provider.  But insurance doesn’t relieve patient responsibility. The terms of a patient’s insurance policy will differ between insurance companies. The bottom line: the patient is responsible to pay for services not covered by insurance.

 

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