Medicine as a Business: Billing 4: What's Wrong

Making fun of medical billing, as I have done with gusto in the previous series of posts, is way too easy. Everyone involved knows it's a problem. But it's not getting better. Money that should be spent helping people be healthy or get healthy is instead being spent in completely unproductive ways, annoying and harassing everyone along the way.

It's amazing how many issues are illustrated by just two bills from one healthcare system. Sadly, this is not an isolated example: it illustrates business-as-usual in healthcare billing.

I make no claims to be comprehensive, but fixing the medical billing issues I've illustrated would be plenty!

Here are the prior posts:

http://www.blackliszt.com/2018/07/medicine-as-a-business-billing-overview.html

ttp://www.blackliszt.com/2018/07/medicine-as-a-business-billing-1.html

http://www.blackliszt.com/2018/07/medicine-as-a-business-billing-2.html

http://www.blackliszt.com/2018/07/medicine-as-a-business-billing-3-insurance.html

Here are some of the highlights:

• The first obvious issue that makes medical billing different from the rest of the world is that there are no price lists. You have no idea what you will have to pay. When you sit down at a restaurant, you get a menu with prices. Not in the medical office.
  
• The next glaringly obvious issue: unlike most other services you can think of, the bill was not presented at check-out time! Fixing this would fix a whole host of problems!
• A single health network has multiple billing systems, each amazingly different from the others, each with its own staff, software, costs, etc. It doesn't have to be this way.
• The bills can arrive months after the service was rendered. What service organization you interact with lets billing slide for months? It sure sends a message that they're not serious about collecting.
• When the bill arrives, the address that it comes from and the place to which you send the payment can have totally different names and places from the organization that served you.
• When you get a bill, you sort of expect to know exactly what the bill is for: what service was rendered, when it was rendered, where and by whom it was rendered. Without those key facts, how can you be sure about the bill? Both bills were a strike-out on this subject. Why is it hard to provide this simple, common-sense information?
• For many people, receiving bills and paying electronically is convenient. For many organizations, sending bills and receiving payment electronically is more efficient, and encouraged. As I've illustrated in these bills, the health system's electronic payment is like a programming 1.01 course project -- one that failed.
  • They didn't even try to have e-bills.
    
  • E-payment was offered on the paper bills, but the process was amazingly bad and error-prone.
  • In the end, e-payment simply did not work. Period. And of course, there was no electronic way to get help or even register a problem!
• The second the insurance company is involved, things get real baroque in the bills, with confusing additional information that, in the end, makes no difference to the patient. And without even the name of the insurance company correct.
  

Wow-za! Not that any self-respecting healthcare system manager will spend money on fixing billing instead of promoting innovation, AI and ML anytime soon! Why, if they stooped to merely making things better for patients while reducing costs, they would rapidly lose prestige among their peers in the industry!