3 Significant Pain Points Patients Have About Medical Bills

One of the significant impacts of the pandemic is the increase in healthcare consumerism. Job loss due to the pandemic caused many to lose their job-based insurance coverage.

This year, as patients continue to have an increasing amount of financial responsibility for their care, they become more discerning shoppers and expect more convenience and better experiences.

According to TransUnion’s second annual patient survey, 49% of survey respondents reported the current economy has influenced how they seek medical care to some extent.

It is clear that the global pandemic has changed the way we live. It has also made a significant impact on what consumers are choosing in terms of their purchasing behavior and payment options.

Patients now demand greater transparency around prices and billing. They also research healthcare decisions online — from health questions to online reviews, before moving on to selecting a provider.

On Jan. 1, a new regulation kicked in requiring hospitals to publish payer-specific negotiated rates for 70 stipulated services and 230 others online.

With hospitals posting negotiated rates online, patients will now be able to compare charges and open a dialogue between their physicians about cost discrepancies.

However, patients still won’t know what they’re paying out of pocket. What they really need to understand is what the impact is to their financial responsibility—their copay and deductible —which is often complicated by in-network and out-of-network billing.

The negotiated rates won’t give the patient any idea where other expenses may come from, such as anesthesia or surgeon fees.

According to a TransUnion survey, while the number of patients receiving clear cost estimates did increase from 2019, TransUnion found only 52% of respondents completely understood their financial responsibility for their recent medical bill.

As discerning shoppers, consumers expect more from the patient experience that their providers are delivering. However, they are often more concerned about medical billing than the quality of care they receive, according to a 2020 Waystar survey.

Complex billing processes keep patients from understanding exactly how much they owe. Medical bills are so confusing that patients are ultimately more concerned about the bill than about the care they receive.

According to the Waystar survey, 52% of respondents stated that they were either slightly (25%) or significantly (27%) more stressed about their medical bills than about care.

Poor financial experience seriously affects a provider’s bottom line as patients delay payments or even don’t want to return, hurting the whole revenue cycle.

Late payments from are in large part due to confusion over the bill and who owes what.

The Waystar survey revealed that 48% of respondents have been late on a medical bill payment due to the following reasons:

• Couldn’t pay due to financial reasons – 51%
• Assumed insurance would cover – 37%
• Unclear how much is owed – 19%
• The bill was incorrect – 18%
• Forgot to pay – 16%
• Wasn’t sure when payment was due – 13%

When asked what would help them better understand their medical bills, 46% of patients answered they need an upfront explanation detailing what their insurance will pay.

In addition, 42% of respondents also shared that a clearer explanation of what is owed compared to what their insurance will cover, would make it easier for them to pay their bills on time.

As healthcare consumerism is on the rise, patients will expect more convenience in ways to pay and also better financial experience.

Providers can get ahead of the game when they have patient financial advocates or counselors who give patients out-of-pocket estimates for the facility fee, the surgeon, assistant, and implant fees, as well as provide estimates on other potential bills such as anesthesia, pathology, etc.

Patient financial advocates can also provide upfront financial communication to patients so they know what to expect and understand their financial responsibility.

We believe every patient deserves a helpful, transparent, easy to navigate financial experience in healthcare.

Mnet is the premier revenue cycle management & technology provider to the surgical industry. We provide custom patient-pay solutions to surgical hospitals and ambulatory surgery centers. As of 2020, Mnet Health partners with over 700 surgical facilities nationwide and is the preferred vendor of both United Surgical Partners International (USPI) and Surgical Care Affiliates (SCA) – both directly with and in support of centralized billing offices.

Mnet’s custom brand, PaySUITE, is a white-labeled payment technology platform that helps surgical facilities and their providers grow their business by helping patients pay. Mnet’s patient-pay solutions significantly increase self-pay collections while creating a better financial experience for patients. For more information, visit https://onemnethealth.com.