A Different Approach to Patient Billing

by Mark S. Gothberg

Patient billing has become an even bigger issue for healthcare providers. Patients used to be responsible for about 10 percent of hospital and physician bills. But high-deductible health plans have driven up patient responsibility, which now averages 26 percent and will soon reach 30 percent, according to John Talaga, vice president of the healthcare business at Doxo, a Seattle-based firm that offers an online payment system. Clearly, providers and pay­ers need convenient options to en­gage patients and collect payments while reducing costs.

Online bill pay is the obvious choice for tackling the growing level of pa­tient financial responsibility. The promise of online bill pay is three­fold:

• Financial – Accelerate payment
• Administrative – Reduce cost
• Patient – Improve payment experience

The reality of online bill pay has been different from the promise. “Ninety-nine percent of online bill pay in healthcare is done with a credit card,” says Talaga. “This ac­tually increases costs because of trans­action fees that average about 2 percent.” Virtually all bills are mailed since few patients have gone paperless, and thus administrative costs have not been reduced. And the large number of separate bills and explanation-of-benefit state­ments that a patient receives fol­lowing many medical procedures can make efforts to pay online daunting and anything but an improved pa­tient experience. This may explain why 70 percent of patients surveyed indicate they are interested in paying their medical bills online – but only 12 percent currently do.

An alternative to the typical online bill pay approach was the subject of a presentation at a healthcare Inter­net conference held late last year in Las Vegas. Presenting with Talaga was Jonathan Fine, director of Web services for Advocate Health Care, an integrated system that serves the greater Chicago market. Presenters provided updated information re­cently.

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