How to Cure America’s Healthcare Payment System

Finance


The kindest way one can describe the payments system in American healthcare is… complicated. Each year, nearly $200 billion in wasteful spending goes toward administration of healthcare payments. While the overwhelming majority of Americans want price estimates upfront, half of the estimates they receive are inaccurate. This causes millions of Americans to struggle with unexpected medical bills.  Even for those on employer-sponsored insurance plans, many fear they could not afford a surprise medical bill. 

Why are medical costs so unpredictable?  One reason is that high deductible health plans (HDHPs) are increasingly popular.  Almost 20 million Americans are enrolled in high deductible plans. The dark side of HDHPs is that patients who switch to them often have higher out-of-pocket costs, confusion about payment responsibility, and an increase in unexpected medical bills.

On the side of healthcare providers, payment dysfunction is also a major pain. A quarter of the wasted spending in healthcare relates to time and money spent on issues related to payment management. Payments come from insurance and consumers, and each is processed at a different time in the payment cycle. Complicating the process further are denied claims. 10% of insurance claims are denied, and 35% of denied claims are reworked. The work required to resubmit claims costs up to 18 times the amount of a claim correctly filed the first time. Eliminating the need to rework as low as 100 claims a month would save an average practice $37,000 per year. A hospital, on the other hand, could save $149,000 a year.  

The cure to this money-sucking illness? PracticeSquire. PracticeSquire provides contactless check-in and payment platforms. They collect necessary data in pre-registration and confirm insurance coverage and payment information on the day of appointments for accurate, upfront pricing estimates sent to everyone involved. Everyone can benefit from PracticeSquire.

Further reading: The Digital Future of Healthcare



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