Each day, patients seek care from medical providers, ranging from routine care to emergency services. And those services can be quite costly, even when patients have health insurance plans with good coverage. The world of medical billing is incredibly nuanced and for patients especially, it can be overwhelming and confusing. When patients don’t understand their medical bills, that can significantly impact your collections rate. In today’s blog, we’re talking about the top questions patients have about medical bills, how you can educate them, and ways you can address their financial concerns.

Why It’s Important That Patients Understand Their Medical Bills

Understanding medical bills is crucial for both patients and healthcare providers. For patients, it clarifies their financial responsibilities and helps them make informed decisions about their healthcare. For providers, it ensures fair compensation for the services rendered.

When patients comprehend their medical bills, they can evaluate whether they were accurately billed for services received. This knowledge empowers patients to advocate for themselves and seek clarification from their healthcare provider or insurance company if necessary.

For healthcare providers, ensuring patients understand their medical bills has proven to greatly reduce the likelihood of underpayment. Patients who are knowledgeable about their bills are more likely to pay their obligations in a timely manner, minimizing the need for collections or write-offs. This, in turn, improves the financial health of medical practices and allows providers to continue delivering quality care.

Empowered patients can navigate the complex landscape of medical billing more effectively, while providers can ensure fair compensation for their services. By working together to promote transparency and education surrounding medical bills, the healthcare system can become more financially stable for all parties involved.

Frequently Asked Questions About Medical Billing

So, what are the top questions patients have about their medical bills? Let’s explore below.

1. What Do I Pay vs. What Insurance Pays?

One of the biggest questions patients have about their medical bills is understanding what they are expected to pay versus what is covered by insurance. This confusion often stems from the complex world of health insurance and the various terms and concepts involved, such as deductibles, copayments, and coinsurance.

Patients want to know what portion of the bill they are responsible for and what their insurance will cover. It can be especially challenging when dealing with multiple providers, network facilities, or out-of-network services. Clear communication and transparency from both the healthcare provider and the insurance company are essential in helping patients grasp their financial responsibilities and make informed decisions about their medical care.

2. How Can I Pay My Bills?

In many cases, patients want to pay their bills — but they just don’t know how. By ensuring patients understand the different options available for making payments, you increase the likelihood of receiving full compensation for the services you offer.

3. Why Was My Bill So High?

Medical appointments can get hectic, especially if unexpected procedures or tests need to be performed. Sometimes, patients may not understand what services they received at an appointment, and that may contribute to confusion surrounding a bill that’s higher than anticipated.

How to Address Your Patients’ Questions About Medical Bills

As a healthcare provider, it is crucial to address your patients’ questions about medical bills promptly and accurately. By providing clear and transparent information about healthcare costs, you can help ease their concerns and ensure that you get paid for the services you provide.

1. Provide Good Faith Estimates

Healthcare providers are required to disclose all fees and charges associated with a service. Good faith estimates, or “GFEs”, are documents that healthcare providers must provide to patients prior to treatment for certain services. GFEs are designed to give patients an accurate estimate of their expected out-of-pocket costs and provide them with a better understanding of their financial responsibility before proceeding with the service. By clearly identifying the expected costs of care, providers can help patients make informed decisions about their healthcare needs all while ensuring fair compensation for their services.

2. Use Your Website to Explain Billing Policies

If your existing patients or prospective patients have questions about how you handle billing, one of the first places they may turn to is your website. By having clear, easy-to-understand information accessible on your practice’s site, you can increase the likelihood that patients will pay their bills in accordance with your policies. Plus, you may be able to reduce calls regarding financial questions, saving your front-desk staff precious time.

3. Have a One-Sheet Readily Available to Send to Patients

Having a one-sheet readily available to send to patients regarding medical bills is incredibly important. Medical bills can be overwhelming and confusing, especially for patients who may not be familiar with billing terms and processes.

A one-sheet can break down information into bite-sized pieces, making it easier for patients to understand common terms and processes. By providing clear and concise explanations of common billing terms, patients can have a better understanding of their medical bills and feel more empowered to navigate the financial aspect of their healthcare.

At Benchmark Solutions, we want to empower you to improve your revenue cycle management. We’ve put together a one-pager that you can send to your patients. All you need to do is download the template and tweak it to your liking, adding branding or contact information suited to your practice.

Download the Template

Have Dedicated Billing Staff — Either In-House or Outsourced

Having dedicated billing staff, either in-house or outsourced, can help you better navigate the healthcare industry’s complicated revenue cycle. Revenue cycle management (RCM) specialists can help you submit claims, address billing inquiries, and follow up on outstanding bills. There are two options you can consider — staffing an internal billing department or outsourcing with a group of RCM specialists.

Within a billing department, various roles work together to streamline the billing process. These may include patient account representatives handling patient inquiries and insurance verifications, revenue cycle specialists overseeing billing operations, and medical collection specialists focusing on resolving outstanding balances. It’s a lot to manage in-house, but it’s certainly feasible — or you can consider outsourcing.

Outsourcing billing services to specialized companies like Benchmark Solutions can be a viable option that helps you save more time and can better bolster your practice’s finances.