Healthcare-related costs continue to soar. The number of patients who are surprised when they receive an astronomical bill for a covered service is also growing at an alarming rate.
JUL 2020 | Get the latest from the best RBP advocates and auditors
Industry Perspective
Amy Pellegrin, J.D.
Senior Vice President and Chief Legal Officer
New Transparency Rule
Healthcare-related costs continue to soar. The number of patients who are surprised when they receive an astronomical bill for a covered service is also growing at an alarming rate. The patient cannot foot the bill; the provider writes the bill off as an uncollectible, bad debt and then decides to raise their arbitrarily created “fair and reasonable” rates to subsidize this rather novel, first-world problem. Where is the disconnect?
While it would take at least a dozen peer-reviewed journal articles to scratch the surface of this question, there is at least one major and widely accepted (save for the deep-pocketed and fiercely traditional provider lobby) solution: Price Transparency. This certainly is not the end-all-be-all boon to save the traditional model of healthcare. However, it is a step in the right direction. It is well documented a primary struggle with healthcare costs is the inability for a patient to “shop” and get accurate prices prior to purchase. When estimates are provided, they are so inaccurate and contain enough caveats that it is truly an “enter at your own risk” scenario. Read more..
Client Savings
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes five recent client savings audit results bi-monthly. See the savings below and know that together we can make healthcare affordable.
1. Bridgeport, CT
Twenty-day hospital stay for treatment of multiple fractures resulting from a car collision
Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.
Did You Know?
UnitedHealthcare recently made headlines by crushing their second-quarter earnings expectations. Earnings increased 98% driven by medical costs falling to 70.2% of premium versus 83.1% a year ago. Although providers often appear to be the target of RBP, large insurance companies are the real problem with out-of-control healthcare costs. UnitedHealthcare and the other large insurers are crushing their earnings while employers and employees are getting crushed by costs. It’s clear who the winners are in this game.
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