Power Shift. What Happens When Legislators And TV Reporters Address Medical Billing And Pricing

By Infinx
April 21, 2017

The issue of legislation to stop surprise medical billing was a hot topic just 3 weeks ago, and now another state is taking action on medical billing, but in a different form. The Colorado state legislature is now considering a bill that would protect citizens from erroneous and aggressive medical bill collectors. The legislation was prompted by a new report by the Colorado Public Interest Research Foundation (CoPIRG) and the Frontier Group that says that Colorado “ranks seventh nationally for the most complaints per-capita for mistakes in medical billing, with 7.2 complaints per 100,000 residents.” Six states rank even worse than Colorado; Nevada, Florida, Delaware, Georgia, New Jersey and Maryland.

The fact that medical billing is so rife with mistakes that it garners the attention of state legislators makes us think that attention is lacking to two essential parts of the billing process:

  1. Knowing patient pay estimates and engaging the patient in payment and/or payment plans before the patient leaves the physician’s office.
  2. Ensuring that your billing and coding are accurate from the get-go.

These two steps can be automated and standardized to improve not only your revenue, but patient satisfaction as well.

Spotlight on pricing transparency

If news out of New Orleans is any indication, physicians and hospitals will soon be forced to provide increases pricing transparency, whether they want to or not. Consumer consciousness of medical costs just got a boost of adrenaline.

An item in the news this week indicates that medical pricing has been picked up as a consumer issue by the media. The Times-Picayune in New Orleans has teamed with the local Fox 8 TV news investigative reporting team for a series called “Cracking the Code of Healthcare Costs”. This isn’t just one investigative report. The newspaper and TV station websites have posted a video asking consumers to send in information from their latest medical bills indicating payments by their insurance company and patient pay amounts. The video teaches viewers how to read their Explanations of Benefits (EOB) form in order to submit the information.

Then the TV reporter suggests that viewers can submit comments telling them “about their doctor or hospital visit”. Let the games begin, as they say. This puts medical pricing front and center in consumer/patient awareness and cracks open the shell of healthcare pricing that many healthcare organizations do not want opened.  Make no mistake. An idea like this series doesn’t stay with just one media group for long. It has the potential to spread across the country like wildfire as other media groups sense the power of the story.

Pricing transparency with patients is essential

The issue of transparent pricing has been floating around the healthcare industry for decades. It has never caught on as a standard practice because pricing is fluid according to patient, provider, location and other factors. This brings us back to your billing practices and the need to make sure that pricing, coding and billing are standardized and documented. You need to be able to show patients, at the time of care, their preauthorization, estimated total cost and patient pay estimate. That is the absolute best way to retain patient loyalty, engage patient payment, avoid surprise bills, and debt collection costs.

About the Author



Infinx provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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