50% of patients leave because of a billing issue: How to respond

In your busy medical practice, providing high-quality patient care is top priority, and rightly so. You want to give patients the best clinical experience possible to help them achieve optimal health. However, in doing so, you may overlook the patient financial experience. When questions about medical bills arise (and they always do), do you provide enough support? What about the right kind of support? 

Addressing unexpected medical bills

How often do patients have questions about medical bills? A lot. Forty-five percent of insured, working-age adults say they received a medical bill or they were charged a copayment in the past year for a service they thought should have been free or covered by their insurance, according to a recent survey conducted by the Commonwealth Fund. 

Given the complexity of today’s health plans and the heterogeneity of benefits across those plans, this percentage may continue to increase if you don’t have a strategy in place to address patient confusion. When you don’t respond to patients appropriately, you run the risk of losing them. More than 50% of medical practices say a patient left their medical practice because of a perceived billing issue, according to a recent survey conducted by Inbox Health. 

Improving the patient financial experience 

Here’s what you can do to help patients when they receive an unexpected medical bill:

1. Validate feelings. When patients receive a confusing or unexpected medical bill from your medical practice, they may feel confused, frustrated, or even betrayed. Put yourself in the patient’s shoes. As their provider, you are someone they trust. To receive a surprise medical bill can be overwhelming because they didn’t plan for it, and they may feel that you deceived them. Many of these patients also face other types of debt. In fact, 81% of Americans with medical debt are putting other financial goals on hold, with many struggling to pay their bills, according to a recent U.S. News survey. The best thing you can do is validate their feelings and then explain what they owe and why.
   
   
2. Provide multiple ways for patients to ask questions. While some patients may prefer to speak with someone over the phone, not everyone does. Providing multiple avenues of support for surprise medical bills—including HIPAA-compliant email, live chat, and SMS correspondence—are critical. These options also demonstrate to patients that you care about their preferences and value their time and attention—all of which can help improve the patient financial experience when patients receive unexpected medical bills. 
   
   
3. Train staff on how patients can appeal and challenge their medical bills. With proper education and training, you can help patients understand their state- and federal-level rights to appeal their insurer’s billing and care denial decisions. Many patients don’t realize that the Affordable Care Act granted them the right to appeal decisions made by their health insurers, regardless of their insurance type or state of residence. Patients can also request a reconsideration of decisions to deny payment, and if their insurer upholds its decision to deny payment, they also have the right to file an external appeal. Half of those who challenged their care denials said their insurer ultimately approved their care, the Commonwealth Fund survey found.
   
   
4. Encourage timely action. Almost three of five adults who experienced a coverage denial said their care was delayed as a result, the Commonwealth Fund survey found. What’s worse? Nearly half of adults who experienced care delays because of a denial of coverage said their health problem worsened as a result. Providing multiple ways for patients to contact you with billing questions about surprise medical bills means patients get the answers they need so they can continue to get the clinical care they need.

Looking ahead

While federal efforts to improve price transparency and promote protections against surprise medical bills are well underway, patient confusion will likely remain. The confusion isn’t something you can eliminate. What you can do is change the way in which you respond to it. Providing wraparound patient support improves the patient financial experience while simultaneously helping patients access the clinical care they need. Learn how Inbox Health can help.

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