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Jason Considine, commercial director of Experian Health, said regulations on price transparency and the No Surprises Act were among the topics discussed at the annual Health Financial Management Association conference in Denver last week. .
Both regulations are creating challenges, he said.
“With the Unsurprising Act, a lot of work needs to be done to provide an accurate estimate of the patient,” Considine said.
As of last January, the No Surprises Act protects people without insurance or who pay on their own from unexpectedly high medical bills.
At a future date to be determined, providers also expect to be asked for a good faith estimate from insured persons.
Obtaining these estimates involves having information about the patient’s benefits and the insurance plan to create an accurate estimate, Considine said.
Price transparency requires hospitals to provide clear and affordable price estimates online for at least 300 different services that can be purchased. Hospitals can face civil monetary penalties for non-compliance.
Hospitals are concerned about the major challenges surrounding deployment, especially the resources needed, according to a recent KLAS survey of 66 revenue cycle leaders. Hospitals turn to third-party solution providers, including Experian Health, Vitalware and nThrive, according to the KLAS report.
In addition, for most vendor organizations, there is an expectation of increased spending on technology as regulations are expanded, Considine said.
Recently, Experian took a look at what consumers want in terms of price transparency and payment and found that 21% want a digital experience.
The survey confirmed what he and others already thought, according to Considine.
Twenty-one percent said they interacted with digital technology, but reported difficulties in obtaining accurate cost estimates for appointments.
Twenty-seven percent would use digital wallets to pay their health care providers if the option were available.
Currently, the most common way to pay patients is when they are in the office, Considine said. But at least a quarter would prefer to pay online, which makes providers pay faster. Online payment also reduces the cost of charging.
“The more money we raise in advance, the less statements we will send,” Considine said. “And you get a better financial experience.”
Some consumers prefer to pay bills out of hours, and others may opt for financial aid.
“Suppliers need to find the right financial route,” he said. “You need to leverage data to know the right financial experience.”
Email the writer: SMorse@HIMSS.org