Disrupting Healthcare Billing: How Patient Fairness is Changing the Business of Medical Costs

Updated on October 3, 2024
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In a healthcare landscape where patients are often left feeling powerless against mounting medical bills, Patient Fairness is a beacon of hope. Founded by Matthew Ungs, the platform is dedicated to helping individuals dispute and reduce unfair medical bills, providing a much-needed service in a system where surprise charges and hidden fees are all too common. Patient Fairness offers patients an opportunity to take control of their healthcare costs, advocating for transparency and fairness in a system that has long been criticized for its lack of both. Matthew Ungs, with nearly three decades of experience managing networks of hospitals and physicians for health insurers, created Patient Fairness after years of observing how the healthcare system’s structure exploited patients.

During his time working on the other side of the industry, Ungs witnessed the financial burdens placed on patients while providers and insurance companies profited. “I observed over time that providers’ and health plans’ profits soared while patients faced ever-higher medical prices and insurer premiums. Both providers and health plans used patients as pawns to extract more money from the healthcare system instead of trying to reduce costs for the benefit of their customers (patients). Surprise and other problem medical bills were one of the most troublesome manifestations of how patients suffer under this system.” This fundamental unfairness in the system drove Ungs to create Patient Fairness, a platform designed to help patients advocate for themselves when faced with medical bills that seem excessive or unreasonable. “I started Patient Fairness to help patients stick up for themselves and not be tools for providers and health plans to achieve their own financial rewards. I use my experience and expertise in managing insurance networks so that Patient Fairness can help patients fight and win against unfair medical bills.”

One of the key challenges for patients navigating the healthcare system is understanding their bills. Often, people don’t know what to look for or even that they have the right to dispute charges. Many feel stuck between complicated insurance jargon, ambiguous billing practices, and the sheer overwhelming nature of medical costs. According to Ungs, it’s not about patients making mistakes when it comes to their bills, but rather their lack of awareness of what could be unfair. “I would not say that oversights by patients are a big factor with problem medical bills. Rather, patients usually don’t know in the first place what to look for and evaluate with a problem medical bill to know if they have cause to dispute it.” This is where Patient Fairness steps in. The platform assesses potential legal protections for patients, compares billed charges to fair prices, and reviews any transparency violations on the part of providers. “Patient Fairness assesses or presents the following considerations for customers to dispute a medical bill: (1) Legal protections for patients under the federal No Surprises Act and hundreds of state laws; (2) Review of the bill’s charges and prices billed versus what the patient considers to be a fair price for services; (3) Transparency requirements for providers to publicly disclose prices; and (4) Other factors that the patient considers unfair regarding the medical bill.” These considerations are critical because most patients are unaware of the numerous laws and regulations designed to protect them from unfair charges. “Most patients cannot practically know about all these reasons to dispute a medical bill, so they certainly cannot identify them when they get a bill. They may have a feeling that the medical bill is unfair, but they need help from Patient Fairness to confirm if their concern is legitimate, and then to properly dispute the bill.”

In terms of government policy, Ungs believes that significant progress has been made in recent years to protect patients from surprise medical bills, particularly through federal legislation like the No Surprises Act. However, there is still more to be done to ensure patients aren’t left footing the bill for costs they didn’t agree to upfront. “The biggest opportunity I see for the government’s role in future protection of patients is to codify that patients have the same rights as do consumers of other goods and services. One of these basic rights is that there must be a shared understanding (a ‘meeting of the minds,’ in legal terminology) between the patient and provider about what services are to be provided and what the patient will be expected to pay.” Ungs points out that many healthcare providers impose terms and prices on patients only after services have been rendered, leaving the patient with little recourse. He advocates for a legal framework where patients are recognized as equal parties in a transaction and must agree on the terms of service and costs upfront, just as they would with any other type of service or product. “Many times, providers bill patients in a manner under which the provider tries to impose terms and prices unilaterally on the patient, after the services are rendered. In those cases, the law should always recognize that the patient and provider are equal parties in a transaction, and both must agree on terms and prices.” Looking ahead, Patient Fairness is focused on expanding its reach and letting more people know that help is available.

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With an estimated 70 million problem medical bills issued in the U.S. each year, the potential demand for the platform is vast. “Patient Fairness’s focus is to get the word out to the public that there is an easy and affordable service to help patients challenge problem medical bills. We serve all 50 states and support almost any type of medical bill, so Patient Fairness can help most of the people who receive annually the estimated 70 million problem medical bills.” Understanding that some patients may be hesitant to try a new service, Patient Fairness offers a satisfaction guarantee. This guarantee allows patients to try the service with minimal financial risk, ensuring they only pay the full fee if they are satisfied with the service. “Patient Fairness understands that some patients are reluctant to sign up with us to dispute a medical bill if they haven’t worked with us previously and are uncertain if our program and services are valuable. That’s why we offer a satisfaction guarantee and a low, initial payment.” He explains, “Patient Fairness initially charges only $49 towards the fee to open a medical dispute case. We charge any remaining balance left on the fee 60 days after the case is opened. A customer may notify Patient Fairness within the first 60 days of the case that he or she is not satisfied and wants to close the dispute case. Patient Fairness will not charge the remaining portion of the Case Price beyond the $49 initial payment, and will close the case as requested.”

With its patient-first approach, Patient Fairness is not only empowering individuals to take control of their medical bills but is also slowly changing the healthcare industry’s approach to transparency and fairness. For Matthew Ungs, the journey is personal—using his insider knowledge of the industry to create a platform that helps balance the scales for patients across America.

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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.