Simplification & Consolidation Will Lead To Efficient Medical Billing

May 10, 2016 by Antonio Arias, MBA, CHBME

Topics: Practice Management, Medical Billing Company

A wide-ranging national discussion of ‘reforming’ (or otherwise improving) the American healthcare system has been loud for years – and thanks to our current election cycle, it’s reached a higher decibel level than ever.

Conversations about expanding U.S. patients’ coverage, changing (or overturning) the Affordable Care Act, and implementing universal Medicare (or a lesser “public option”) are dominating American newswaves. Like ‘em or not, the candidates have lots of people talking about what kinds of changes to the system are best for American healthcare consumers.

But amid our nation’s collective focus on improving healthcare for the benefit of patients, we forget that patient-centered improvements will also benefit providers. The inefficiencies of the current system don’t just cost patients money; they weigh down hospitals and medical practices with expensive responsibilities, outdated expectations, and high administrative costs.

The medical billing ecosystem – and its continued embrace of billing statements and ‘explanations of benefits’ (EOBs) delivered by mail – is a case example of just how problematic the situation is for providers. According to a new ‘Ideas and Opinions’ piece published in the Annals of Internal Medicine, burdensome paperwork is continuing to drive up costs for many U.S. healthcare organizations.

Even though virtually every other large industry has shifted to (primarily) electronic payments, the U.S. healthcare system remains heavily reliant on paper. The authors of the Annals of Internal Medicine article estimate that the mailing and printing costs for “just one single-page statement per claim” exceed $1.7 billion for the 2.5 billion medical claims generated each year. In addition, the cost of creating and collecting bills contributes to the $361 billion in annual health care administrative costs shouldered by providers (and passed on to patients).

“Simplification, consolidation, and real-time point-of-care cost information could help address these inefficiencies,” the piece advises. The article details the strategies needed to make efficient medical billing a more ‘patient-centered’ system, but the benefits extend to care administration and delivery as well.

Here are three suggestions the authors recommend shifting across the industry. Keep in mind that individual practices can work to make these goals a reality now… that is, we don’t have to wait for a new presidential administration to mandate them.

Bills and EOBs should be simplified for easier comprehension. Hopefully, a time will come (soon) when billing statements and EOBs are integrated and patients receive one piece of mail per episode of care. Until then, the onus is on providers to review the formatting and readability of their patient-focused communications and make sure they’re simple and easy to understand.

Paperwork should be issued in a more timely manner. Audit your billing processes with an eye for promptness. How long is it taking for your billing statements to get to your patients? The longer it takes to ship them out, the longer you wait for payment – and the lower the likelihood of receiving payment, at all.

A checkout model should be the norm. Our current system relies primarily on ‘post hoc’ payments, but your practice should aim to make real-time payments a reality. Insurance verification, pre-authorizations, and more transparent pricing can make it more feasible for you to collect payment at the time of service.

Contact NCG Medical Billing today to start making your patient billing efforts more streamlined!

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