70% of consumers say healthcare makes a payment more difficult than any other industry. Collecting payments on the payer side and going to the doctor during COVID-19 has become increasingly complex and disconnected. When it comes to healthcare, most Americans want price estimates upfront; 84% of Millennials and Gen Z and 65% of Baby Boomers want these estimates. Even with this high demand, only half of the upfront estimates are accurate, adding to payment confusion.
Many Americans struggle with unexpected medical bills. 67% of Americans worry they could not afford a surprise medical bill. In 2019, 40% of consumers were surprised by a high medical bill; nearly half came from hospitals, and 1 in 5 came after a surgery. Even with employer-sponsored insurance, 4 in 10 struggle to afford healthcare.
The rise in popularity of high deductible health plans has contributed to unpredictable medical costs. High deductible plans with a health savings account have risen 450%, and without a health savings account they have risen 231%. From 2007 to 2017, almost 20 million Americans were enrolled in high deductible plans. Increases in unexpected medical bills, higher out-of-pocket costs, and confusion about payment responsibility have all been reported as people make the switch to high deductible plans. Many patients aren’t sure about their cost responsibility; 69% attempt to learn about costs before or during their appointment and 42% simply wait for the bill to arrive before they address it.
Wasted spending is a large issue in healthcare; every year, $190 billion in unnecessary spending goes toward the administration of healthcare payments. Accepting a $20 copayment in cash can cost up to $50 to process. Nearly one-quarter of all wasted spending relates to the time and money spent collecting, processing, posting, and reconciling patients. Payments are collected from insurance payers, consumers, and a mix of both, which are each processed at a different time in the payment cycle.
Denied claims also raise healthcare costs. Up to 10% of insurance claims are denied, and 35% of denied claims are reworked and resubmitted. The work required to resubmit claims costs up to 18 times more than a claim correctly filed the first time. 90% of denied claims are avoidable. Common mistakes that cause denial include prior authorization required, out-of-network provider, incorrect patient identifier, and services not covered. Mistakes that occur when systems aren’t interoperable include manual data transfer between systems and difficulty verifying insurance eligibility. Eliminating rework for 100 claims a month would save an average practice $37,000 a year and possibly save $149,000 for a hospital.
The solution for connected healthcare management is contactless transactions and check-in. From February to March 2020, contactless transactions grew at 2 times the rate of non-contactless transactions. Amid the pandemic, healthcare organizations switched to contactless check-ins and payments to slow the spread of the virus. Patients complete digital registration documents including COVID-19 screening questions, consent forms, insurance documentation, and review of outstanding balance and copays. At the time of service, the patient calls or texts to let the office know they have arrived. They then wait in the parking lot until the clinician is ready. This process minimizes patient-to-patient interaction and the contamination of paperwork, pens, and other surfaces.
The key to upfront cost estimates is through insurance eligibility. Pre-registration collects necessary data including your photo ID and insurance card and demographic data. It also confirms insurance coverage is valid on the date of service and displays patient responsibility for copays and coinsurance. This data can then be used to calculate accurate, upfront pricing estimates for individual patients.
PracticeSquire makes connecting healthcare systems simple. Benefits to patients include easy check-in without the risk of infection, cost transparency before receiving services, and saved information with a single login. Benefits to providers include reduced administrative workload for greater productivity and cost savings, accurate data capture and digital insurance verification for faster claims, fewer mistakes, administrative headaches, and reduced turnover. Benefits to office staff include reduced risk of infection through the exchange of documents and payments and more time to focus on other tasks. Getting paid is fast and simple with PracticeSquire.