Benchmarking Patient Billing Processes is Key to Overcoming Challenges

Updated on May 12, 2021
Patient Billing

By Blake Walker, co-founder and CEO of Inbox Health 

These days, technology allows us to measure virtually everything we do — from logging our daily step counts to tracking the amount of sleep we get each night. These technologies help us identify potential problems and seek opportunities for betterment. Unfortunately, medical billers don’t have readily-available access to technologies to identify pain points and possible areas for improvement. Consequently, many medical billers aren’t able to pinpoint  specific problems in their process, even though their margins are slowly being eaten away by high costs and limited ways to increase revenue. Left undetected, that problem could seriously impact their profitability long-term — or eventually put them out of business.

According to a 2019 McKinsey and Company report, 33% of Americans believe providers don’t do enough to enhance the patient billing process, and 50% of patients want more clarity from their bills. To improve the patient experience and increase profitability, medical billers must first assess current billing practices. 

After many years working with medical billers, we’ve found that there are three critical focus areas that billing teams need to evaluate to understand how to improve their patient billing process — staff efficiency, collections and the patient experience. Pinpointing these shortcomings and determining strategies to overcome them is key to reducing staff workload, growing collections and creating happier practices and patients.

Outdated Technology, Meet Modern Demands

The healthcare industry has experienced a rapid shift toward patient responsibility, leaving medical billers with two core problems: expensive patient billing and the growing impact it has on their businesses. A 2018 report from the Kaiser Family Foundation reveals that from 2006-2016, the average out-of-pocket costs for patients rose 54%, and patient billing responsibility has risen 255% since 2006.

In the past, billing teams could rely on insurance companies to pay for the majority patients’ healthcare, paying little attention to the minor patient responsibility component. No longer. Now, a significant portion of health care bills are allocated to the patient to be paid out of pocket. Co-payments paid at the time of service have turned into deductibles and coinsurance that needs to be collected after the patient leaves the office, because they can’t be easily understood during the duration of the visit. Once claims adjudication is complete, medical billers are left to figure out how to best engage with patients about much higher costs than expected, which they are less likely to be able to understand and maybe afford. In 2017 alone, TransUnion Healthcare found that patient out-of-pocket medical expenses rose 11%. Even more, patients are much more likely to have questions and concerns about those costs.

As a result, patients spend time calling billers, doctors and insurance companies for answers, and billers are also caught in a vicious phone circle to provide clarity. Medical billers are equipped with the same communication toolkit as before even though they are navigating a process that has drastically shifted and exponentially multiplied their problems.

Evaluating Performance with Patient Billing Score

The medical billing industry needs modern resources to solve modern patient billing challenges. Communication capabilities, such as real-time chat, text, email and yes, even paper statements, help medical billers quickly meet patients where they are — and boost efficiency, patient experience, collections, data accuracy and accessibility in the process.

Until now, there was no way to evaluate performance as a billing company or billing team with regard to patient billing and communication. Patient Billing Score, a free algorithmic assessment of medical billing processes that identifies specific areas of opportunity for businesses, aims to fill that gap and help medical billers improve their bottom lines. 

Patient Billing Score helps quantify often murky metrics like wasted time, lost collections and patient experience, and allows billing teams to measure their process, benchmark how they compare to peers, and access immediate and long-term strategies to improve operations — in just five minutes.

Blake Walker is obsessed with how people experience the world. He started Inbox Health, the platform modernizing patient payments and a founding sponsor of Patient Billing Score, out of his own frustration paying medical bills and saw it immediately as an experience problem that needed fixing. He’s passionate about design, and technology, and is constantly seeking out new ways to solve problems combining the two. When he is not working on Inbox Health’s next project, he’s spending time with his two kids, wife, and bulldog Gus.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.