Patients Shoulder Nearly 25% of Medical Bills

John Commins, June 18, 2013

Data from the American Medical Association details the costs of medical billing complexity on patients and physicians, who are put "in the awkward situation of having to ask patients for money," says an AMA board member.



Barbara L. McAneny, MD

Higher co-pays, deductibles and other fees have held patients responsible for nearly 25% of their medical bills and forced physicians to become reluctant bill collectors, a new study from the American Medical Association shows.

For the first time in its six year history the AMA's National Health Insurer Report Card [PDF] examined the portion of medical bills that patients are responsible for through co-pays, deductibles and coinsurance. In February and March this year patients paid an average 23.6% of the amount that health insurers set for paying physicians, the report found.  

"The patient isn't always aware of what they signed up for and physicians don't like being the bearers of bad news to these patients," says AMA board member Barbara L. McAneny, MD, a board certified medical oncologist/hematologist from Albuquerque, NM.

"As we have more and more third-party administrator types of insurance claims, and there are more and more payers out there, each of whom has their own rules on how they are going to pay you, it gets more complicated," McAneny said in an interview.  

"Physicians now are concerned with having to collect a significant amount of the money they're contracted to be paid from the patients who are often unaware that they are going to have to pay part of the fee. It puts physicians in the awkward situation of having to ask patients for money and doctors don't like doing that. We're not very good at that."  

John Commins

John Commins is a senior editor at HealthLeaders Media.


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