High Deductible Medical Plans Creating Need for Upfront Billing

Back in the 1980s and 90s it was common to receive medical care without paying deductibles up front. Patients were billed for their portion and then given 30 to 90 days to make payment. Those days are quickly becoming a thing of the past thanks to high deductible medical plans that have created a need for upfront billing. Likewise, increased upfront billing means medical biller jobs are no longer what they were in the past.

According to RevCycle Intelligence, the number of patients with high deductible plans has increased from 1 million to more than 16.5 million since 2005. High deductible plans are considered those with annual deductibles of $1,250 or more for individuals or $2,500 for families. To see a 16-fold increase in just over eight years is astonishing. Yet the numbers make it easy to see why doctors’ offices, hospitals, and clinics are shifting to upfront billing.


Patient Awareness

Upfront billing ensures the healthcare facility is paid prior to rendering services. Without upfront billing, patients may not be prepared to make their payments because they have no idea how much treatment will cost. Having said that, RevCycle Intelligence contributor Ryan McAskill says billing offices need to do a better job of making patients aware of upfront costs ahead of time.

For example, it’s one thing to go to the doctor’s office with the expectation of a $50 co-pay. It is entirely different to be told you have to pay several hundred dollars for an inpatient procedure you assumed would be covered by medical insurance. Not being aware of charges ahead of time makes it very difficult for individuals to budget for healthcare expenses. Moreover, while high deductibles are not the fault of healthcare providers, they often bear the wrath of patients who came looking for treatment completely unaware of the costs.

Part of the responsibility for informing patients about upfront billing also belongs to insurance companies themselves. They need to make a regular practice of working with their customers to ensure individuals know how annual deductibles translate to out-of-pocket costs at the time of treatment. Insurance company involvement would make medical billing jobs easier and patient financial responsibilities more manageable.

At any rate, the idea of upfront billing is not going to go away. One of the main thrusts of healthcare reform is to bring down the cost of delivery so that it is more affordable for everyone involved. That cannot be accomplished without the upfront billing model. Healthcare facilities need to be paid promptly in order for them to continue offering care; consumers need to know their upfront expenses ahead of time so they can budget accordingly.

More High Deductible Plans

Healthcare reform is making the high deductible insurance plan more popular among employers looking to cut expenses. The reality is that such plans will increase in number at the expense of the lower deductible plans of the past. This suggests that the practice of upfront billing will grow proportionally as well. Simply put, upfront billing is the new normal.

Medical biller jobs across the country will be changing to accommodate the new practices. The changes will not be terribly drastic, as the overall function of the medical biller remains the same. However, a change in the way billers do their jobs will mean greater interaction with patients at the time of treatment.

If you are looking for medical biller jobs, Health Jobs Nationwide can help. Feel free to use our site to connect with employers, recruiters, and education providers around the country.

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