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Patients Frustrated with Process to Address Billing Errors

Analysis  |  By Jay Asser  
   January 19, 2023

A survey of privately and publicly insured individuals highlights the need to improve the healthcare financial journey.

Many patients are at their wits' end when trying to correct a billing error—an issue that crops up far too often, according to a study from Zelis and Hanover Research.

The findings were gathered through an online survey to 800 privately and publicly insured adults who had found at least one medical billing error in the last five years.

More than two in five respondents (41%) said they are significantly frustrated trying to address billing errors, with only 30% expressing extreme confidence in their ability to identify an error in their bill.

Knowing who to contact and how to find the right contact information were identified as the two biggest hurdles during the bill correction process, suggesting that the patient financial experience is too complicated.

When patients did notice an error, it was either by comparing charges with estimated costs (32%), comparing charges to explanation of benefits (29%), or noticing items on the bill that differed from their care experience (29%).

Most of the respondents (62%) said saving money is the primary motivator for correcting a billing error, with half the respondents reporting incorrect charges of at least $200 and a quarter experiencing a difference of more than $500 in the past five years.

The bill resolution process can not only be confusing, but time-consuming as well. Forty three percent of respondents spent up to one month getting bills corrected, while 70% spending more than two hours on the process.

As such, 80% of patients believe their health insurance plan could have a more well-defined process to deal with billing errors, as well as better service, clearer options, and more efficient resolutions.

"Our research reinforces that healthcare billing systems are complicated, and bills can be complex and with the potential for errors," Michael Axt, chief member empowerment officer at Zelis, said in a statement.

"This negatively impacts healthcare consumers, particularly those with lower incomes or less health literacy. Healthcare organizations have an opportunity to reduce friction in the billing process to support consumers and create a more seamless healthcare financial journey."

A separate YouGov survey commissioned by revenue cycle firm AKASA further establishes how befuddling medical bills can be for patients.

More respondents either found bills extremely confusing (19%) or somewhat confusing (19%), compared to those that said bills are not confusing (11%) or lean towards bills not being confusing (14%).

Being able to understand what they're being billed for (29%) was chosen as the biggest source of frustration, while uncertainty on if they can pay the bill (27%) was a close second.

Jay Asser is the contributing editor for strategy at HealthLeaders. 


KEY TAKEAWAYS

Zelis and Hanover Research conducted a survey to better understand the patient financial experience when it comes to billing errors.

Half of the respondents reported incorrect charges of at least $200 and a quarter saw a difference of more than $500 on their bills in the past five years.

Forty one percent of those surveyed said they are significantly frustrated trying to address billing errors, with knowing who to contact and how to find the right contact information being the two biggest challenges in the process.

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