PwC Report: Medical Billing Industry Needs a Massive Overhaul


A new report from PricewaterhouseCoopers (PwC) notes that the medical billing industry is in definite need of an overhaul. There needs to be a more seamless way to bill patients that doesn't rely on paper records and statements.

"Businesses that make this shift – offering convenient, seamless, quality, reliable and transparent billing and payment – will be rewarded in the New Health Economy,” said Kelly Barnes, PwC's U.S. health industries leader. She believes companies that do this "will retain more customers and attract new ones.”

According to Healthcare IT News, here were the findings:

  • Patients and affluent consumers are most dissatisfied with the healthcare billing and payment system.
  • Cost-conscious millennials are more likely than the general population to judge healthcare organizations based on their billing practices. They also are more likely to challenge medical bills, search for better deals and make value-based decisions.
  • Consumers and new entrants are beginning to circumvent the claims-based healthcare payment system.
  • Four in five adults with commercial insurance paid less than $1,000 in out-of-pocket expenses in a year, according to an HRI analysis. Approximately half had medical claims of less than $1,000.

Bernie Monegain points out that consumers want "convenience, transparency, affordability, reliability, seamlessness, and quality." The report lists these strategies to implement this:

  • Accelerate the migration to digital. Commercial health insurers conduct just 15 percent of payments and 27 percent of payment remittance advice electronically. The rest of U.S. businesses average 43 percent for payment. This remains one of the system’s most critical bottlenecks.
  • Focus on simplicity and embrace it. Simplify the user experience.
  • Multiply payment options. Bankruptcies involve illness or injury can be devastating especially when dealing with medical bills. Being conscious of this can lower accounts receivable issues while reducing bad debt.

Summary by

To read more Medical Billing related content click here

To read more from click here