Kaitlin Howard is a researcher and writer producing insightful content across the healthcare revenue cycle. She has written and produced content for Zelis, Waystar, and Recondo Technology, as well as agencies. With a B.A. in English and Writing from University of Denver, Kaitlin stays current on market updates on claims management and healthcare payments, publishing a regular educational blog series on industry trends and Zelis offerings.
As patients continue to struggle with medical debt, how can providers provide support along the patient journey for a better healthcare billing experience?
A negative healthcare billing experience can cause patients to lose trust in their provider. Zelis Chief Member Empowerment Officer Michael Axt sat down with Healthcare Finance News to discuss how you can enable the patient’s financial experience all the way from initial shopping around to post-service responsibility.
We’ll discuss the highlights below, but you can find the full podcast here.
A Bit of Background
As Chief Member Empowerment Officer, Michael helps to connect capabilities across the entire Zelis organization to tap into solutions that empower members to take control of their healthcare financial journey and payments process.
With COVID-19, expectations have changed dramatically (even beyond financial aspects). Across the board, consumers are now more open than ever to digital solutions and engagement. In fact, one of the most transformative trends in digitization lies within the healthcare industry. Members have recently come to expect a digitized aspect for the administrative process.
But the acceleration of digital solutions and virtual engagement merely serves as an “and”. It must be considered “in addition to” in-person services, as it’s not a 100% solution for those types of services. Members want to be able to find a doctor, schedule care, receive bills, and pay online but still crave access to an actual person.
Simply put, healthcare consumers want versatility and individual preference. They want the option to talk to providers and payers virtually, but they also want to be able to go into an office and receive in-person care and assistance as they see fit.
No One Wants to Wear Two Hats
Within the payer/provider dynamic, members want better alignment throughout between their payer (insurance company) and their provider (doctor or hospital). No consumer wants to be stuck in the middle.
Consumers only want one source of truth, and yet today’s current healthcare environment forces consumers to act as both a patient (e.g. engaging with the provider) and as a member (e.g. attempting to understand one’s coverage and benefits).
But can this be avoided?
Let’s take a look at the data.
- 86% of patients still receive paper medical bills.
- 88% of providers still receive paper checks and explanation of payments from at least one of their payers.
By driving the digital relationships between payer and provider, organizations can address waste while connecting solutions and capabilities. The best part? These tools are already available for payers and providers to access.
Said tools enable communication, accelerate the payments process to near real-time, and, as a result, improve member engagement within the financial journey.
Consumers Don’t Need (or Want) More Solutions
We don’t need to fundamentally change the infrastructure of healthcare. The solutions are already there. Rather, it’s now about driving adoption within the system and connecting the dots between existing capabilities.
Right now there is a surplus of single-point solutions. The industry is not fully optimized for the consumer. These disjointed solutions can’t capture data flows between the payer and provider or the full view of the member experience.
The bottom line: healthcare organizations need to bring forward platform capabilities that can connect these disparate systems together to create an integrated and streamlined healthcare billing experience.
The Wrap Up
Healthcare can be a confusing journey. That’s why it’s so important to offer an end-to-end member experience (e.g. estimating the cost of care, explaining costs owed, verifying correct payment amount, and, of course, payment).
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