Medical billing is a very complex process, and it needs cooperation from all parties, like patients, doctors, medical billers, and insurance companies, to make this process smooth and efficient. It is very important that all parties should have knowledge of the medical billing process, and they should know their role in the process of completion of medical billing.
Medical billing patients are the primary subjects who encounter medical billing from registration to health insurance companies. It is also studied that lack of education and information on the medical billing process among patients is the leading cause behind the denial of claims. Educating the patients with complete instructions and information on the whole process is recommended. Patients often feel confused when they get long medical bills, and it causes frustration and disturbance, which can even make them weaker than the disease. Educating patients can lead to the cessation of this turmoil.
In this article, we will learn the major challenges and problems medical billing patients face. We will also learn how the administration should educate the patients about the medical billing process.
Challenges Patients Face in Medical Billing
The medical billing process determines how patients will be compensated for healthcare services and is directly related to finance. Any mistake or error in this process can greatly impact the person’s financial well-being. Following are the few challenges that patients face:
● Complex Terminology and Information
Medical bills are mainly written with many complex terminologies like medical codes, and patients often need help understanding these terminologies, which can lead to serious problems. Sometimes, it is also seen that hospitals or insurance companies send bills with less information or in a vague manner. It needs to be clarified for the patients to understand the bills, and patients incorrectly pay the bills, which can lead to financial burden at once.
● Lack of Standardizations
There needs to be more standard medical bill formats and practices in healthcare institutes and insurance companies, which can lead to confusion. It is difficult to understand and compare the medical bills by the medical billing patients.
● Surprise Bills
Surprise billing remains a major concern for medical billing patients as it burdens them a huge financial burden. Healthcare service from out-of-network physicians without the knowledge of patients is a basic lacking behind the surprise bills. Sometimes, hospitals provide unnecessary services to the patients and add them to the bills. This creates chaos for the patients.
● Insurance Confusion
The patients must read the instructions of the insurance companies before getting the insurance. Patients often need clear knowledge about their coverage of healthcare services, and it can lead to confusion and huge bills. Patients consider the given service under the insurance coverage. Still, they get the bill for that service because of negligence in understanding and reading all the instructions of the insurance companies.
Ways to Educate the Patients about Medical Billing
1. Clear Communication
There should be ways to define all the healthcare services and their bills clearly. Easy terminologies should be used while explaining healthcare services and related bills. Hospitals can use infographics and charts to make complex things easy. There should be a better explanation of the disease, its treatment, and the services used for the particular case.
2. Pre-service Estimates
It is a bad way to start the treatment and follow-ups before explaining the expenses and other outcomes to the patients. In the case of out-of-network physician service, it is mandatory to seek patients’ consent. Before starting any treatment, the administration should inform them of the treatment procedure’s total cost. It will make things easy for both the patients and hospitals regarding their payments.
3. Billing Transparency
All the services in the bills should be divided into blocks, and the expense of each service should be mentioned separately. Then, the sum of all services should be mentioned at the end. This will give a better understanding of total expenses. Writing just a total sum without explaining it causes problems for the patient to understand the bill.
4. Online Portal and Financial Counselors
There should be financial counselors with complete knowledge of the policies and rules of the insurance companies. These counselors can explain the important things before getting health insurance and clear the patients’ confusion in case of any problem like insurance coverage, medical bills, and payment options.
Creating an online portal where medical billing patients can learn about their medical bills is also important. Patients can ask queries in case of any confusion.
5. Insurance Literacy
Lack of knowledge is the main reason for all the medical billing errors and problems. It is the need of the hour to educate the people and healthcare staff about the billing method. Federal healthcare departments should arrange workshops, educational seminars, and media campaigns to give knowledge about the important things of medical billing to the patients and the hospital and insurance administration. This step will make the patients aware of their major mistakes while getting healthcare services and medical bills.
6. Written Instruction
Insurance companies must provide patients with written instructions to learn about the medical billing process. Instructions should be written in an easy and readable format. Patients can read and understand the instructions thoroughly when they have the time. Written papers always remain in sight and mind rather than verbal instructions.
Benefits of Patient Education in Medical Billing
● Financial Literacy and Empowerment
With a complete understanding of the medical bills, patients can avoid paying the bills, which can lead to huge fines due to late submission. Educating the people about medical billing will give them an understanding of the expenses mentioned in the bill.
Financial literacy helps the patient detect errors in medical services. They can challenge the incorrect bills and refuse to pay the dues. Sometimes, the hospital charges extra for services that are not provided. Patients can also challenge this fraud type of case.
Trust is the bridge between the patients and healthcare institutes. With the knowledge of bills and the mentioned expenses, it is easy for the patients to trust the healthcare institutes and their services. This smoothens the whole process of medical billing. Medical billing patients cooperate with the healthcare and insurance company staff for reimbursement.
● Preventing Medical Debt
Medical debt is the main concern in many states of the USA. It is reported that patients suddenly get huge medical bills for their previous services. It happens when the patients need to learn about the medical billing process and don’t pay their medical bills on time. Then, the payment is doubled with time, and patients get stuck in the trap of medical debt. They must clear that medical debt; otherwise, they must face legal action against them.
Medical billing is essential in healthcare departments for all parties, including patients, insurers, and hospitals. Patients want a fair medical bill for the services, and hospitals want payment. However, many problems can create hurdles in this process due to the financial illiteracy of the patients. It is very important to educate the patients to escape the confusion and delay in the medical billing process. Medical billing patients may face challenges like difficult terminology and incorrect information in the medical bills. They can also have insurance coverage criteria needing clarification, which leads to surprise bills or medical debt. To avoid these issues, they need to be educated by using simple and easy language in the medical bills and in the written instruction form provided by the insurance companies. Financial counselors and online portals can also serve as a source of information about the medical billing process. By taking these actions, the completion of the medical billing process on time can be ensured.