While many practices often think about revenue cycle management from a dollars-collected standpoint, looking at the patient's satisfaction with their financial experience is critical, too. In fact, improving patients billing experience should be a priority for revenue cycle managers, administrators, and leaders. Often, at the crux of that goal is redesigning patient bills, so they're easy to understand and take action on when patients receive them.
In a recent article published by two physicians in JAMA, they make a case for billing quality as an essential type of medical quality. Along with looking at patient pain points and proving why billing quality is a kind if medical quality, they also proposed some potential metrics for assessing medical billing that are worth considering.
Patient Pain Points
Today, healthcare is a $3.5 trillion economy within the U.S., and prices for medical care have reached record highs. Unfortunately, this leads to financial strains for patients as they are increasingly being asked to pay for more medical service costs out-of-pocket. How is this affecting patients? Here are a few sobering statistics:
- Medical bills currently account for 58% of U.S. consumers' debt
- Among a survey of patients who had stage IV breast cancer, half had been contacted by debt collectors about a medical bill
- Surveys show that 64% of patients neglect or delay seeking medical care because they're worried about high medical bills
Beyond the significant money that patients are paying out-of-pocket these days, prices vary significantly as well, too. A recent study found that out of 1010 hospitals, only 53 were able to offer patients a price for a coronary artery bypass graft surgery. Among the ones who did, that price ranged between $44,000 and $448,000, and the price quoted had no associated with quality of care. As the media continues to report egregious medical prices, patients are beginning to demand more honesty and transparency in billing and pricing for available medical services, and a lack of pricing information before elective or self-pay care results in financial hardship for the patient and can reduce competition among medical practices and institutions.
Four Potential Metrics for Assessing Your Practices Billing Quality
With patients paying more out of their own pocket than ever and a huge variation in pricing and collection practices, practices need to begin looking at their billing as a type of medical quality. Some potential metrics proposed for measuring billing quality include the following:
1 - Itemized Bills
First, are patients regularly provided with an itemized bill of their medical services that is easy to understand? In the past, many medical bills have listed medical terms and codes. However, it's critical to describe medical services provided in a way that patients can easily understand if you want to achieve patient-centered and patient-friendly billing.
2 - Price Transparency
Are the prices for elective medical services provided to patients who ask about them? In some medical centers, prices for commonly provided medical services are available on third-party online consumer marketplaces. One study conducted on several ambulatory surgery centers that do list their prices for surgical services publicly online found that offering this type of price transparency to patients resulting in higher ratings in patient satisfaction.
3 - Service Quality
Billing quality should also include good customer service quality for patients. This means patients have the right to talk with someone promptly about their medical bill. This way, any billing errors can be dealt with and possible accommodations can be offered in discounted or delayed payment options to patients who may qualify for such assistance. Patients often feel abandoned when they need some help negotiating or even understanding their medical bill. Practices and institutions need to do a better job offering prompt service that helps patients with their billing questions, which should ultimately increase the rate of payment.
4 – Billing Surprises
Patients should not have to deal with billing surprises. There's sometimes been a double standard for patients who pay their bills out of pocket, and they get billed for more than others for the same services, something patients should not face. It's also essential to note that patients shouldn't be charged for serious complications that are avoidable when a medical procedure is conducted.
The Bottom Line
Billing quality should no longer be separate from medical quality. Both the financial harm due to medical care and the clinical consequences of those care should be considered. After all, both have a significant influence on the health and overall well-being of the patient. Financial harms have the potential to affect a patient's access to care, and incorporating billing quality measures into reports on practice and institution quality can provide patients with a better comprehensive assessment of a given practice or medical center. Billing quality is valuable information for the patient. As the healthcare industry becomes more of a consumer-driven marketplace and more patients pay significantly higher costs out-of-pocket, practices and medical centers will need to keep up by improving their billing quality to boost patient satisfaction, and ultimately, their bottom line.
Are you looking for ways you can streamline your billing process? Do you want to improve billing quality while ensuring you maintain and improve your practice's bottom line? M-Scribe Medical billing can help. M-Scribe is a national provider of quality medical billing services to physicians, clinics, and group practices across the country. Learn more about the solutions we offer medical practices to help them improving billing efficiency and increase practice revenue by contacting M-Scribe.com today.
Patrick Dougherty is the General Manager at M-Scribe. Patrick has worked in the RCM field for 20 years. He was the founder and CEO of his own billing company before joining M-Scribe three years ago as the GM and VP of Business Development. Patrick enjoys golf, traveling and spending time with his family in North Georgia.