Surprise Medical Bills May Stimulate New Laws

As healthcare insurance and payment networks continue to evolve, patients continue to receive surprise medical bills. Narrow healthcare network coverage can cause patients to increase use of out of network providers. Hospitals, groups, and dentists needs change their process to be more up front with patients about the cost of their care. This article futher re-enforces the need for up front estimates of care and better communication with patients:

http://www.wsj.com/articles/surprise-medical-bills-fuel-fight-between-providers-insurers-1468008989

Discuss with us how we can help solve this growing problem.

Obamacare Growing Pains Trigger Rise In Unpaid Hospital Bills

As patients continue to pay more out of pocket, bad debt will continue to grow. It is better to establish a payment plan with a patient prior to the services. This reduces the likelihood of unexpected bad debt.

To read more about this growing problem, click here:

http://www.forbes.com/sites/brucejapsen/2016/01/10/obamacare-growing-pains-trigger-rise-in-unpaid-hospital-bills/?utm_campaign=yahootix&partner=yahootix

Health insurance deductibles up 40 percent since 2010

People with work-based health insurance are paying much bigger deductibles than they used to.

Those with single coverage are paying an average deductible this year of $1,318, up some 40 percent since 2010, when the total was $917, according to national data released Tuesday.

Patients will continue to pay more out of pocket for healthcare over the next several years. Even Medicare will cover fewer services and pass more expense to the patient.

It is time for healthcare to embrace being UpFront with patients about costs, so patients can make informed decisions and healthcare organizations to work through payment options prior to the surprise medical bill.

To read more about this article, click here:

http://www.startribune.com/kaiser-study-average-deductibles-up-40-percent-in-past-five-years/328664941/

Collecting from patients is not a new issue! Says MGMA

The April 2010 issue of MGMA Connextion describes some of the major problems facing healthcare organizations today, but which are even getting worse. Here are some of the highlights:

• Providers collect 25% of their revenues from patients directly.
• 60% of the providers reported that it was extremely difficult collecting from patients after the services were provided.
• Providers send out 3.3 billing statements before they are paid.
• They recover only $15.77 for every $100 owed.

Providers are often reluctant to address past due payments because of long term relationships and belief it is unprofessional.

The article provides 17 recommendations from “peer healthcare providers”. These include:

• Provide payment options including credit cards.
• Set up on line billing payments.
• Encourage patients to pay current balances and charges at the time when services are provided.
• Send out invoices as soon as possible after the services or procedures are provided
• Train staff to firmly but gently communicate about payments due.
• Be willing to refuse service to patients who will not abide by the financial policies.
• Replace collection letters with personal collection phone calls.

Of course you need Enablemyhealth to automate all these recommendations in one easy to use solutions. Enablemyhealth will enhance your cash flow and improve patient satisfaction. 

Read more of the article:

http://www.mgma.com/Libraries/Assets/Practice%20Resources/Publications/MGMA%20Connexion/2010/Perspective-on-patient-payments-MGMA-Connexion-April-2010.pdf

More in Minnesota have health coverage but still can't afford to be sick

In the past year, Minnesota’s main hospital and clinic groups filed nearly 9,000 lawsuits against people with large or long-standing medical debts — a sharp increase since 2005, according to a Star Tribune analysis of court records.

Once a leading cause of personal bankruptcy in the United States, medical debt was widely expected to decline as more Americans got health insurance following federal health reform. Instead, shifts in the insurance market are pushing more people toward high-deductible policies that can require them to pay as much as $7,500 before any insurance benefits kick in.

To ensure strong patient satisfaction and prevent these lawsuits, hospitals and groups need to provide estimates to patients prior to their medical visit, procedures and tests. Patients will contine to take on more of the financial risk of healthcare.

http://www.startribune.com/more-minnesotans-have-health-coverage-but-still-can-t-afford-to-get-sick/318545021/

Out-of-network medical bills a costly shock in N.J.

They were moments of crisis for each family. A newborn who wasn’t breathing was rushed to intensive care. A 15-year-old skier who wiped out on a slope in the Catskills needed surgery to reconstruct his shoulder. A 65-year-old insurance agent who survived a heart attack needed urgent bypass surgery to clear his arteries.

The stress didn’t stop once these medical crises passed, however. Within a few weeks, each family received an unexpected medical bill.

They had been savvy enough to follow their insurers’ rules and choose in-network hospitals to maximize their coverage and minimize their out-of-pocket costs. But one or more of the physicians who took care of them — and over whom they had no choice — did not participate in their insurance network.

Enablemyhealth allows surgeries, tests and all treatment to be managed Upfront. Know what providers are in network for insurance plans. Know what the cost is before you receive that surprise medical. Hospitals and groups need to solve this problem equally as much as successfully treating patients! 

Here is the complete article:

http://www.northjersey.com/news/out-of-network-medical-bills-a-costly-shock-in-n-j-1.1345737

NY's New "Surprise" Medical Bill Law

Health care consumers in New York had a great deal to celebrate when, on the last day of the Affordable Care Act’s first open enrollment period, the state legislature passed new consumer protections from “surprise bills"—medical bills to consumers that result from the unexpected use of out-of-network medical providers, or bills which impose far higher costs on consumers than they have reason to expect. The “Emergency Medical Services and Surprise Bills” law, together with associated changes in a number of other statutes, is a response to years of advocacy and reflects the considerable efforts of the State Department of Financial Services to bridge the different perspectives of consumers, the health insurance industry, and New York’s medical societies. Prior to the new law—which is effective April 1, 2015—insured individuals often complained about receiving inadequate reimbursement (or none at all) from their insurers for medical services that they received outside of a provider network. In many cases the patients were unaware that the medical services they were receiving were, in fact, out of network and thus more expensive. Many patients were not financially prepared to handle these additional costs. The problem was so common that these types of consumer complaints outnumbered all other complaints handled by the state’s health consumer assistance agencies, insurance regulators, and the state Attorney General’s Health Care Bureau. - See more at: http://familiesusa.org/blog/2014/04/new-york%E2%80%99s-new-surprise-bill-law-rolls-out-new-health-insurance-protections-consumers#sthash.SRn51QAY.dpuf

Read the complete article:

http://familiesusa.org/blog/2014/04/new-york%E2%80%99s-new-surprise-bill-law-rolls-out-new-health-insurance-protections-consumers