How Health System Billing Can Improve Patient Experience, Streamline Payments

When it comes to billing, the healthcare landscape can be quite confusing. Patients receive bills that they do not understand. Providers can deal with claim denials and delayed payments. Beyond the numbers on the charges, component codes, insurance policies, and regulations can frustrate even the most seasoned staff.

The good news is that billing does not have to be this difficult. Health systems can solve and simplify the billing process with effective communication and technology, while reducing confusion and complexity, and increasing transparency. It actually fosters trust and enhances the patient experience, while also improving the financial viability of hospitals and clinics.

What is Health System Billing?

Health system billing is the complete process, from a visit to a healthcare provider until the final satisfied payment is received. The process includes documenting services, associating a medical code, submitting claims to a payer, and collecting balances.

This may sound simple, but it doesn't always feel simple. Each step creates major rules related to reimbursement, along with the chances of errors accumulating through these processes. A small error can result in a claimed service being delayed by weeks or even trigger an audit or payment denial.

Hospitals and clinics complete thousands of transactions each day. Efficiency is about being accurate, building trust, and patient satisfaction.

Why is billing complex?

Healthcare billing is distinct from that of any other industry. Several unique factors add to the complexity.

There are literally thousands of codes to choose from; there are different sets of policies for every insurer; government sponsored programs change their rules regularly.

Even patients have a challenging time understanding what is going on with their insurance and why they owe a balance. All of these layers lead to confusion for everyone involved.

Consequences of Billing Errors

A patient who receives an unexpected bill may delay care in the future. A provider may be stuck working hours to correct a claim, rather than working with patients who need help.

Studies indicate that a majority of patients have received a medical bill that was confusing to them. Confusion often leads to distrust, and when that occurs, relationships suffer. Clarity gives trust and confidence. Clarity shows you care about your patients and leads to firm trust and loyalty.

Improved Relationship

Transparency is quickly becoming commonplace in healthcare. Patients want to know what they plan to pay for their care, prior to agreeing to it.

Hospitals that are able to provide an upfront estimate of the cost of care typically have higher satisfaction ratings. Clear billing summaries of fees due or liabilities owed to the facility can be very helpful as well.

Communication matters as well. A quick explanation of coverage or a modification in a patient's billing, which could become confusing if not communicated, goes a long way in preventing any potential misunderstanding.

Training Drives Outcomes

The best technology cannot always correct poor communication or processes that do not hold up, so staff training always comes to the forefront of effective billing.

A billing staff member must understand medical jargon and customer service. They must feel confident in their ability to deliver an accurate response to an inquiry and use language that is simple for a patient or family to understand. Patients value their clear and kind explanations.

Positive billing leads to account accuracy, collaboration, and empathy. When billing teams reduce denials or even improve patient ratings, everyone feels the positive results in morale and overall performance.

Collaboration Across Departments

The billing process is involved in every aspect of a healthcare organization. Everyone, from clinicians, coders, and administrators working with any finance team, must synergize.

Clinicians need to record an accurate account of services. Coders must translate this account correctly. Administrators need to stay on top of insurance and regulatory changes.

Many hospitals are now utilizing revenue cycle committees to improve coordination. These committees align the clinical teams with the financial teams and help everyone understand how their work factors into services delivered and financially. Therefore, it creates fewer denials, quicker payments, and ease in the patient's experience.

Outsourcing Billing the Right Way

Certain healthcare systems may select to partner with an external, often proprietary, company for the billing function. Outsourced billing can help gain access to subject matter experts, an existing system or tools, and scale the services without the upfront implementation costs of hiring employees. This can also help meaningfully reduce the administrative burden of billing services and cash flows.

It is vital to choose a vendor which is compliant with the federal regulation of HIPAA and other data protection statues.

Future of Billing

The billing future will transition from passive to being patient-centered. A patient-centered billing paradigm will transform paying bills into active, informed participants in their service delivery experience.

Patients can pay online, create their own reminders, or reach out through text or email. The support teams will communicate with patients in a way that simplifies charges or coverage.

When patients feel seen and understood, they pay sooner and rate a higher experience while remaining compliant. It enables patients to feel embraced, which is drastically better for both parties.

Key Takeaways to Improve Billing Process

Billing doesn't have to be cumbersome in a health system. A few clear strategies can make it a lot easier.

It is necessary to have a clear line item pricing structure along with transparent communication. During a patient's care journey, it is important to treat billing as an extension to care instead of additional work.

Efficiency and compassion can transform billing into an extension of care, with a healthy bottom line for healthcare organizations and trust built with patients.

Billing might not be the most visible part of healthcare, but it has enormous power with the connection of care and compliance, along with communication.

A purposefully designed billing structure supports everyone. It allows healthcare providers to care for patients, improves patient understanding of pricing, and enables healthcare organizations to be financially solvent.

The goal is not just faster payments. It is clarity, fairness, and connection. When billing is done right, the entire health system works better.

Providers can decrease costs up to 80%, and have hourly rates that start at $7 per hour. Vendors will offer health system billing services, as well as full end-to-end revenue cycle management.