Category: HealthRevolution

Payments in healthcare have always been disconnected.  During COVID-19, collecting payments and going to the doctor has become increasingly complex.  Many people struggle with unexpected medical bills.  67% of Americans worry that they would not be able to afford a surprise medical bill.  Even with employer-sponsored insurance, 4 in 10 Americans struggle to afford healthcare. 

When it comes to healthcare, most Americans want price estimates upfront.  84% of Millennials and Gen Z and 65% of Baby Boomers want upfront price estimates.  Even with this high demand, only half of the upfront estimates are accurate.  40% of consumers were surprised by a high medical bill, nearly half of which came from hospitals and another 20% from after a surgery. 

Why are medical costs so unpredictable? 

Over the past decade, high deductible plans with a health savings account have risen 450%, and plans without a health savings account have gone up 231%.  From 2007 through 2017, 19.7 million American adults with employment-based coverage were enrolled in high deductible plans.  Patients who switch to these insurance plans often experience higher out-of-pocket costs, confusion about payment responsibility, and an increase in unexpected medical bills, even though 69% of patients attempt to learn about costs before or during their appointment. 

Along with patient confusion, payment processing often has many problems.  Medical payments are collected from insurance payers, consumers, or a mix of both, which are all processed at a different time in the payment cycle.  25% of wasted spending in healthcare relates to time and money spent on collecting, posting, and reconciling payments. 

Another factor that increases costs is denied claims.  10% of insurance claims are denied, and of these claims, 35% are reworked and resubmitted.  The work required to resubmit can cost up to 18 times more than a claim that is correctly filed the first time.  90% of denied claims are avoidable, becoming potential money savers.  In addition, many people worry about making multiple claims, as they don’t know if insurance can drop you after an accident. Eliminating rework for 100 claims a month would save the average medical practice $37,000 a year and a hospital $149,000. 

Many of the mistakes that cause claim denial can be corrected.  Common errors include incorrect patient identification, services not covered, out-of-network provider, or prior authorization required.  Mistakes can also occur when systems are interoperable, stemming from manual data transfers between systems or difficulty verifying insurance eligibility.

The Rise of Contactless Check In

In response to COVID-19 contactless check in and payments have been implemented across the country to slow the spread of the virus.  Patients complete digital registration documents including COVID-19 screening questions, consent forms, and insurance documentation, and review of outstanding balance and copays.  Contactless check-in and payments in response to COVID-19 have minimized patient-to-patient interaction, contamination of paperwork, pens, and other surfaces. 

The solution for payment issues in healthcare is simple, connected payments.  PracticeSquire efficiently connects healthcare systems providing a variety of benefits to patients, providers, and office staff.  Patients can easily check-in from anywhere without the risk of infection, understand cost and responsibility before receiving services, and save information with a single login.  Providers can reduce administrative workload, leading to greater productivity and cost savings, get accurate data capture and digital insurance verification for faster claims, and encounter fewer mistakes, administrative headaches, and reduce turnover.  Office staff get reduced risk of infection, eliminate mistakes and rework claims from misread insurance cards, and gain more time to focus on other tasks.  PracticeSquire is the reliable and efficient auto assistant that will benefit all.

Source: PracticeSquire