Medical Billing: A Paper Blizzard Not Addressed by EHR

Everything we read suggests the day is nearing when all hospitals and doctors will use computers instead of paper to create, store, and share our medi

Everything we read suggests the day is nearing when all hospitals and doctors will use computers instead of paper to create, store, and share our medical records. It is something that is long overdue. But despite the progress being made to eliminate paper in hospitals and clinics, there remains an insidious blizzard of paper in the health industry that seems to be only getting worse–medical billing.

Frankly, I’d rather sit down and do my tax return than try to manage the paper trail involved with explanation of benefits and medical bills.  Lately, my wife and I have been trying to help our elderly parents deal with Medicare and secondary insurance carriers following their hospitalizations or illnesses. What a nightmare! Both my wife and I have worked in healthcare, so we know our way around medical terminology and billing codes. But pity the poor civilian who even tries to understand how much they owe and to whom after a hospitalization or major illness. Pity them even more if they are elderly, disabled or slightly demented.

The past few weeks there has been a lot of press about the federal government releasing a “rate card” that details the full price hospitals charge before insurance companies apply discounts for the most common medical services and procedures. No surprise, those prices vary widely. Prices are literally are all over the place. Much is being made of the release of the rate card and the impact it could have on price transparency in healthcare. Pundits say consumers might use this information to shop around.

Let me tell you, price transparency is only the tip of the iceberg and probably a minor issue compared to the most predominant source of consumer stress. In this day of electronic billing, why in the world does it take months, and yes sometimes years, for a person to know how much they owe and to whom after spending time in a hospital or after having a medical procedure? Not only are the explanation of benefits forms and medical bills inconsistent in how much detail they do, or don’t reveal; the information is mailed to the patient’s home over such a protracted period of time and in such volume that it truly is a paper blizzard. There is no way the average consumer can make heads or tails out of  this. Our elderly parents often just give up and pay for things that are already covered by Medicare or their insurance. Worse yes, they become so confused about what they owe that they neglect to pay bills entirely, and then have to deal with nasty letters and phone calls from collection agencies.

I firmly believe this problem is only going to get worse, and not just for elderly people on Medicare. As more and more employers shift healthcare costs to employees through complicated, high-deductible insurance plans or health savings accounts, nearly every family will increasingly face this potential paper tsunami of healthcare billing. I know for a fact that government and private industry can do a better job. My current employer, Microsoft, has worked closely with our health plan administrator, Premera Blue Cross, and community providers and partners to deliver a fairly seamless, on-line, paper-free way for employees to manage our health savings account, deductibles, and co-pays.  

Surely all government and private insurance plans and others involved in coordinating health benefits and medical billing could do a better job. The current system is costing all of us a fortune. It is absolutely a disgrace that we expect the elderly to endure this onslaught from medical billing, especially at a time when they are already feeling overwhelmed and vulnerable. Why can’t government, insurers, hospitals and clinics, labs, imaging centers, rehab facilities and everyone else involved in delivering care around the country, sort all this out and present the patient with a single, comprehensible account of what they own and to whom within a reasonable period of time ? It is intolerable in this age of “high tech” and electronic records that people are having medical bills still rolling in a year or more after medical services have been performed—intolerable not only for the patient, but for the health industry as a whole.