Saturday, November 5, 2011

Crowd-sourcing medical bills will uncover errors and overcharges


This post is by Katie Vahle, co-founder of CoPatient, LLC

What if everyday purchases were priced and consumed like healthcare services?

These days you’d have to try hard not to know the price of a product or service before you buy it. So imagine booking an airline ticket with zero knowledge of the cost, only to return home to a bunch of outstanding bills for the trip. One statement may cover the seat rental and fuel used. Another bill may itemize each time the flight attendant handed out drinks. A few weeks later a bill for the pilot’s flying time may roll in. Can you imagine the resulting confusion, stress and angst?

I know it sounds absurd but this is the nightmare patients face every time they use the healthcare system. And it isn’t uncommon for these confusing medical bills to spiral out of control. Last year, the Commonwealth Fund (a non-profit healthcare research group) reported that 20% of US adults had medical debt or faced problems paying medical bills and only 58% of Americans felt confident they would be able to afford the care they needed.

So what options do consumers have when faced with the reality of paying for their healthcare?

Option #1: Prepare ahead of time. Ideally everyone would find the right insurance policy and shop for services before care is needed. The good news is price-shopping tools are coming to healthcare. Companies such as Healthcare Blue Book, Out-of-Pocket, and Fair Health allow patients to research prices ahead of time. Taking price transparency a step further, straight into the hands of doctors, Cost of Care will make it possible for physicians to consider the cost of medical care as they treat patients.

Inevitably, there are going to be situations where cost cannot be considered beforehand. What options remain for patients facing the resulting bills, explanation of benefits (EOBs) and insurance policy questions? And it’s not just those without medical insurance that face these problems. In 2009, researchers at Harvard University reported medical debt was involved in roughly 2/3 of bankruptcies, even though the majority of those individuals had health insurance!

Option #2: Deal with the aftermath. Most consumers are left to sort through the resulting pile of medical bills to understand how much is owed and if the statements are correct. Healthcare experts are regularly quoted estimating 30% to 80% all medical bills contain mistakes. But just because mistakes happen, it doesn’t mean they are easy to identify and fix.

This is the reason we launched CoPatient. We set out to create a community-based resource where patients can find answers to questions about their medical bills … where caregivers can understand if these bills contain errors … where everyone learns about options to reduce the burden of their medical debt. Rather than consumers facing their medical debt in isolation, imagine a web-based community that demystifies medical bills while pointing out potential errors or ways to negotiate down the debt.

The next time you receive a medical bill in the mail, consider taking action to make healthcare more affordable for yourself and the broader community.

Step 1: Remain Calm. Take a deep breath and don’t let the deluge of paperwork overwhelm you.

Step 2: Get Organized. Sign up for your insurance company’s website to access documentation about your benefits and keep track of EOBs. Reach out to the hospital and doctors’ offices to request copies of each itemized bill.

Step 3: Join the Community. Work with an advocate to recognize errors on your medical bills and identify ways to negotiate a lower price.

Aggregating the experience of those who are dealing with medical bills and sharing that information widely will make everyone facing medical debt better off. It will be services like CoPatient that will help patients understand and manage their medical debt, putting them on a path to physical and financial recovery!

References:
• Schoen, et al. How Health Insurance Design Affects Access to Care and Costs, by Income, in Eleven Countries. Health Affairs Web First, Nov. 18, 2010.
• Himmelstein, et al. Medical Bankruptcy in the United States, 2007: Results of a National Study. The American Journal of Medicine. Vol 122, No 8. 2009.
• Silver-Greenburg, Jessica. How to Fight a Bogus Bill. Wall Street Journal. February 19, 2011.

7 comments:

  1. What a great article!!Comparing healthcare costs to a plane trip.Funny and understandable. I am 61 and believe me I have had my share of health care expenses!!Yes after an operation you get like 4 extra bills after the fact-1.anestheiologist 2.pathologist 3.Radioligist 4.The HOSPITAL DOCTOR who takes care of you while you are in the hospital cause your own doctor(not surgeon)is too busy to come to the hospital now-because he is soo over scheduled in his office your 3P.M. appointment is no gurantee that you will see THE DOCTOR at that time.No first you do not get to the "BACK" until 3:45 then the nurse or someone has to weigh you and announce to everyone loudly the results.Then you get in the room in the"BACK" where they proceed to ask you all these questions-which you have to repeat to the DOCTOR cause he never looks at the chart she has written down on.Then you get a paper gown(and if you are there cause you don't feel good)and wait freezing for the DR. to come in. You can hear him out in the hall and hope just hope he will come in your room but No he goes into the room next to you and lo and behold It is his golf buddy in the next room .After you have heard the blow by blow account of each hole of their last game together,you hear how the family is!!!Finally at about 2 hours after your apt. time in comes your doctor. Well you asked for a comment. Sue Atkinson

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  2. You can actually find the perfect help in the online world. Doctors are now recognizing the need to reach out to those who need their expert services.

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  3. Very good points you wrote about this .. Great stuff ... I think you've done some really interesting points.Keep a good job.
    professional medical billing services

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  4. Sue - you are definitely not alone in your less-than-ideal experiences with our healthcare system! It is so alarming as all those medical bills start rolling from doctors and facilities you didn't even realize treated you during your stay.

    If you like the airline analogy, check out this YouTube video that BobbyG over at thehealthcareblog.com posted. http://www.youtube.com/watch?v=5J67xJKpB6c.

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  5. Sue - you are definitely not alone in your less-than-ideal experiences with our healthcare system! It is so alarming as all those medical bills start rolling from doctors and facilities you didn't even realize treated you during your stay.

    If you like the airline analogy, check out this YouTube video that BobbyG over at thehealthcareblog.com posted. http://www.youtube.com/watch?v=5J67xJKpB6c.

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  6. Katie Vahle OMG that video is hysterical I shared it on Facebook Thanks for sharing.

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  7. Nowadays, we should really be planning ahead. Especially when it concerns our medical bill.

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