How bill negotiation helps you and your members

June 2, 2021
Lindsey Logan

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When a patient is dealing with medical complications, it can cause a lot of stress. Adding outrageous medical bills into the equation only adds to the stress. Bill negotiation is a great way to help ease this financial pressure off your members, and will in turn lower costs for your organization. Point Health has saved patients upwards of $384 million through medical bill negotiation. In one case, a patient advocate reduced a member’s bill by $10,000, resulting in a bill of only $2,877. Savings like this are significant for individuals and add up for organizations too.

Medical bill errors are bound to happen, so be prepared.

Coding errors, double bills, or fees for services not received are a lot more common than you might think. In fact, 80% of medical bills have errors. Medical bills are confusing to read, so it’s tough to understand the full breakdown if you’re not well versed in medical billing lingo. Oftentimes, the coding is complicated and patients don’t know where to begin. And your busy teams may not have the bandwidth to review every medical bill in a timely manner. That’s why it can be useful to outsource a bill negotiation company with trained advocates to negotiate down medical bills. Although patient advocates don't typically review bills for actual coding errors, they know how to communicate with billing departments in healthcare facilities to potentially lower these bills, whether they're high from a coding error or not.

Reduces costs for members.

Members of health sharing organizations are usually cash pay, which means it's extra important for them to keep bills low. For discount medical plans, members are often responsible for a higher percentage of their care. In both cases, bill negotiation is essential to keep costs down, especially when pricey procedures are involved. Many people will avoid getting care or put it off as long as possible because they dread the payment process. Offering a service like bill negotiation encourages members to handle health matters sooner. This can also prevent their health conditions from worsening.

Financial resources for members.

Even if there are no errors, many members qualify for financial programs they’re not aware of. There are typically waivers, discounts, relief plans, or similar financial resources available at most hospitals. However, if patients aren’t asking about them or don’t already know to seek them out, hospitals often don’t openly tell them about these options. Bill negotiators know all about these programs and use them as a tactic to reduce medical bills.

Relieved members = happy members.

Medical bills are the second biggest source of stress according to 60 percent of patients. According to an analysis conducted by Credit Karma in 2020, 20 million of their U.S. members held $45 billion of medical debt in collections, averaging $2,200 in debt per member. Bill negotiation can take away great amounts of stress from members which will end up reflecting positively on your health plan and making your members happy with you. And a happy member is a retained member.

Final thoughts.

Bill negotiation can lead to huge savings for individual members, but it’s difficult to do on your own. Members might turn to you, their health plan, for help, but odds are that your internal teams are busy with other requests. But if happy members and cost-savings are important to your health plan, you absolutely should make bill negotiation a priority. Partnering with a third-party company to provide this cost-reduction service will save you and members thousands to millions in medical bills, and that’s a win for everyone.

Download The Patient Advocacy 2.0 White Paper

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Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

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