Health

Medical Bills Get a Smart Makeover

Competition nets innovative ways to tell consumers exactly what they owe

Some 42.9 million Americans currently have unpaid medical bills. While a certain segment of people may not make payments because the bills are too high, many people don’t pay simply because they don’t have a clue what the bills actually say.

Billing formats, collection, and design vary from state to state — there are no regulations for design consistency.

HHS sponsored a competition to solicit new ways to design medical bills.

“There are currently no uniform standards for consumer medical billing, and bills vary in content and presentation from organization to organization across the health care system,” said a spokesperson for the Department for Health and Human Services (HHS).

“One medical treatment or episode can lead to multiple bills from multiple providers, and consumers may not know or understand how much of these medical costs they are responsible for paying.”

That’s why HHS sponsored a competition this spring to solicit new ways to design medical bills. The agency wanted developers, digital tech experts, designers, entrepreneurs, and other professionals outside the stuffy health care system to share ideas. Winners of the competition would receive up to $10,000 and would test their designs in six health care systems.

RadNet takes first prize in a competition to create a more simple medical bill.
RadNet took first prize for a simple, clear presentation of charges (image courtesy of abillyoucanunderstand.com).

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Everyone seems to have a medical bills horror story. “It’s very common for Americans who do not work in the medical billing or health care industry to misunderstand their medical bills,” said Pat Palmer, founder of Medical Billing Advocates of America, based in Roanoke, Virginia.

“First, a summary bill is given that does not break down the charges. Second, when you receive a detailed, itemized statement [which you must request], it’s full of medical lingo, abbreviations, and codes that most people can’t interpret on their own.” Palmer recommends hiring a billing advocate to review your bills — but many people can’t afford that or don’t have the time to engage in it.

The vast majority of us have to learn through trial and error — lots of error. For Julia Jones, a heart transplant patient in San Jose, California, medical bills are just a way of life. She received a transplant as a teen but has needed regular checkups ever since. Her parents took care of the bills while she was in high school and college, but she took over shortly after graduating with her degree — without any training.

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She kept receiving documents in the mail that said, “This is not a bill,” so she filed them away as summaries. Then she received a call from a collections agency that said she owed as much as $5,000 in unpaid medical bills. The agency was going to take it out of her next state and federal tax refund if she didn’t start paying up immediately.

Sequence’s Clarify is a new online- and mobile-based service that took second prize for it's transformational approach.
Sequence’s Clarify is an online and mobile-based service that took second prize.

“A lot of expletives went through my mind,” Jones told LifeZette. It took her four years working as a caregiver for the elderly to dig her way out of that debt.

The submissions to the HHS contest could be a game-changer for Jones and other patients. Although Jones says she can now decipher the medical jargon, she still has to call account services to figure out her real balance.

HHS announced the winners this week. A Los Angeles company called RadNet won for the easiest bill to understand: It uses color-coded sections that make it easy for patients to locate key information. It also uses plain language to explain charges and has a clear section for payments due and payment options. The San Francisco company Sequence won the prize for most transformative approach. Its website “Clarify” allows patients to compare prices and browse payment options.

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This is arguably the best $10,000 the federal government has spent lately. If these new medical billing systems expand beyond the initial six-system test runs — the real winner could be everyday patients across America.

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