Are you practicing patient-centered billing?


These days it would be hard to find a hospital that doesn't advocate patient-centered care or its newer, younger cousin, self-directed care. On the clinical side of the equation, providers are actively seeking ways to get patients to participate in their own care. On the billing side, not so much.

Despite the array of shiny technological toys designed to improve patient billing, hospital billing systems usually churn out confusing bills that patients are told to pay, no questions asked. The problem: All too often the bills contain errors.

One hospital overcharged a leukemia patient's drugs by 286 percent, adding an unnecessary $87,000 to the bill, reports the Denver Post. Another hospital transposed two digits in a patient's medical number, billing her $20,000 for services she didn't receive.

These scenarios are common, and they typically go undetected unless patients hire a medical billing advocate to decipher the bill and hunt down inaccurate charges, creating significant ill will among the patient population. According to the Salem, Va.-based trade group Medical Billing Advocates of America, eight out of every 10 healthcare bills its members audit have at least one error that costs patients money.

Seven of the most common hospital medical billing errors involve: operating room time, the number of hospital days, duplicate charges, unbundled charges, services that weren't provided and upcoding, according to the Giving 'Em the Business blog on the San Diego News Network.

Obviously, mistakes will happen given the complexities involved with coding and billing patient claims. But patients shouldn't have to hire outside professionals to get their bills straightened out. Lee Memorial Health System in Fort Meyers, Fla., is one hospital that is trying to make patient-centered billing a reality, according to an editorial in the News-Press.

Vice President Anne Rose wants to implement three strategies to make bills easier for patients to understand:

  • Bring together a focus group of former patients by this summer to learn what they and their families need from a hospital bill.
  • Establish a permanent advisory group of former patients to provide advice on hospital billing practices.
  • Create a department where patients can access expert help in deciphering medical bills from the hospital, as well as related physicians and laboratories.

Lee Memorial isn't alone in its efforts. The Healthcare Financial Management Association (HFMA) has been promoting the Patient Friendly Billing project for several years. But until more hospitals begin taking concrete steps toward patient-centered billing, medical billing advocacy will remain a growth industry. - Caralyn

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