Many Americans feel the burden of medical debt: in 2023, more than 100 million people living in the U.S. reported carrying some kind of medical debt.¹ A couple years earlier, 63% of respondents in another survey said they were anxious about paying for medical debt.² To put it simply, the anxiety patients feel about medical debt is very real, even among patients with health insurance.

It’s also worth noting that 40% of patients find medical bills confusing. This can be especially true for large or more complicated bills, like behavioral health practices, orthopedic practices, and urgent care centers. The good news? These practices can take a few key steps to reduce billing confusion among patients.

And with less confusion comes less anxiety.³

5 Tips for Clarifying Medical Bills

• Communicate Patient Responsibility Early: No one likes to be blindsided by large medical bills, but unfortunately, 41% of patients have found themselves in this situation.⁴ To minimize financial frustrations and surprises, explain as early as possible what a patient will owe out of pocket and what insurance covers.
• Break it Down: Using orthopedics as an example, most health insurance plans cover medically necessary orthopedic surgeries. However, the exact coverage depends on the patient’s specific plan. Details like the copay, deductible, and pre-authorization requirements will also vary by plan. To ease confusion, foster transparency, and empower patients to make informed decisions about their care, orthopedic practices should pursue eligibility verification on an ongoing basis and provide patients with breakdowns of coverage in advance of appointments. In addition, committing to ongoing eligibility verification can be especially critical for behavioral health practices, given the many regulatory, prior authorization, documentation, and CPT code requirements that can delay reimbursement.
• Empower with Options: As part of the insurance coverage discussion, explain the various payment options your practice provides, such as payment by debit, credit, check, or potential financial plans (especially for larger bills). Knowing these options, as well as the expected costs, helps patients plan for what’s ahead and builds the type of confidence that reduces anxiety. Even for last-minute appointments, billing teams should communicate about co-pays as soon as the patient schedules the appointment. That may seem like a tight turnaround, but modern-day technology makes it doable. For example, many urgent care centers now use text messaging for timely appointment confirmations, even for same-day appointments. Teams can send reminders about upcoming copays using the same automated messaging tool, and perhaps even include it in the same text as the appointment confirmation.
• Prioritize Patient Convenience: Use patient portals to provide patients with access to billing information. Offer virtual and self-service payment options that meet patient preferences for online bill pay. Automating messaging that you’d typically use for appointment reminders can also be useful for billing and copay reminders. Just make sure that your patients have consented, or “opted-in” to receive billing-related communication by test.
• Use Plain Language: One survey found that 96% of Americans don’t understand basic health insurance terms, such as “deductible,” “co-insurance,” “copay,” and “out-of-pocket maximum.”⁵ That being said, it’s best to err on the side of caution and explain medical bills using simple, clear terms. It can sometimes be difficult to make this shift in language, therefore, encourage teams to practice patient finance discussions before they take place.

The medical billing experience plays a large role in overall patient satisfaction – 64% of patients note that transparency in billing significantly increases their satisfaction with healthcare providers.⁶ Financial health is integral to the success of a practice, but cash flow cannot flourish without patients feeling more comfortable with the bills they will inevitably have to pay. Luckily, by taking these actions you can give patients more ownership over the billing experience, build their confidence, and ease any anxiety they may feel over medical bills. Medical debt is a nationwide problem, however, the anxiety it creates does not need to stand in the way of your ability to run an efficient practice and maintain patient satisfaction rooted in quality care and timely, transparent billing.

Need Help Demystifying?

If you’re unsure how to best navigate finance discussions with patients and think your process could use a tune-up, the Med USA team can help. Connect with a member of our team to learn how to demystify bill pay for patients at your practice.

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Sources:

1. NPR. (2023, December 10). The Sunday Story: The Unbearable Weight of Medical Debt. NPR; NPR. https://www.npr.org/transcripts/1198909604
2. Plescia, M. (2021, December 10). Medical debt in the US: 11 numbers to know. Beckershospitalreview.com. https://www.beckershospitalreview.com/finance/medical-debt-in-the-us-11-numbers-to-know.html
3. Gu, Y., Gu, S., Lei, Y., & Li, H. (2020). From Uncertainty to Anxiety: How Uncertainty Fuels Anxiety in a Process Mediated by Intolerance of Uncertainty. Neural Plasticity, 2020, 1–8. https://doi.org/10.1155/2020/8866386
4. Lieneck, C., Gallegos, M., Ebner, M., Drake, H., Mole, E., & Lucio, K. (2023). Rapid Review of “No Surprise” Medical Billing in the United States: Stakeholder Perceptions and Challenges. Healthcare, 11(5), 761. https://doi.org/10.3390/healthcare11050761
5. 4 Health Insurance Terms 96% of Americans Don’t Know. (2018, January 24). Policygenius. https://www.policygenius.com/health-insurance/health-insurance-literacy-survey/
6. Accenture. (2019). Accenture 2019 Digital Health Consumer Survey. Accenture Consulting. https://www.ehidc.org/sites/default/files/resources/files/Accenture-2019-Digital-Health-Consumer-Survey.pdf