Two Johns Hopkins University professors proposed five metrics for billing quality benchmarking.
With patients paying more out of pocket for their medical services, the billing process has become a source of frustration for providers and patients alike.
Price transparency and cost of service estimates alleviate some issues, but when it comes to making payments, the billing quality of many organizations leaves much to be desired.
“Healthcare billing continues to be a complex process especially since you have the provider, patient, and payer all involved,” Chris Johnson, vice president of revenue cycle at Atrium Health, previously told HealthLeaders.
“Quite frankly, when some patients see an insurer’s use of CPT and ICD-10-CM codes, it can be like a foreign language, and it can cause real confusion.”
In a recent article for JAMA, Simon C. Mathews, MD and Martin A. Makary MD proposed five billing quality metrics providers can use to rate their own practices:
Itemized bills – Are patients given an itemized bill with easy-to-understand language?
Price transparency – Are the prices for elective services available to patients if they ask?
Service quality – Can patients speak with a billing representative promptly about any concerns and if potential accommodations can be made?
Suing patients – Does the institution sue patients for unpaid medical bills?
Surprise bills – Are patients who pay out of pocket expected to pay more than others for the same care?
“In the same way medical complication rates are collected for improvement purposes, and some are available to the public,” the article explained. “Metrics of billing quality could be used to create public accountability for US hospitals.”
HealthLeaders previously reported how patient collections has surpassed denials management and staffing as the biggest concern for revenue cycle leaders. To make the patient financial experience easier, some organizations have begun exploring cash sharing apps like Zelle and Venmo as payment options.
Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
Billing statements can often be difficult for patients to understand due to the use of medical codes.
The proposed metrics consider price transparency, service quality, and surprise billing.