Simplified Medical Billing

May 15, 2016
Seattle—Providence Health & Services has been selected by the Department of Health and Human Services to serve on an advisory panel that will evaluate, test and implement winning solutions from the agency’s “A Bill You Can Understand” challenge.

During her keynote at Health Datapalooza on May 9, HHS Secretary Sylvia M. Burwell announced the challenge to encourage health care organizations, designers, developers, digital technology companies and other innovators to design a simpler medical bill. Providence’s partnership in the challenge stems from the health system’s innovative revenue cycle best practices, deploying strategies that engage and empower consumers and improve the overall patient billing experience. For many years, Providence has been improving its medical billing and sees this work as a fundamental part of care as a mission-driven organization.

“Bills received by our patients should not reflect the complexity in health care today,” said Rod Hochman, M.D. , president and CEO of Providence. “The patient experience, from making the appointment to the clinic or hospital visit, should be seamless and simple. What happens after the visit, outside of the care setting, should be no different.”

The patient-centered philosophy for billing is reflected across Providence’s integrated, five-state system. As an example, Providence has an agreement with insurers to work on resolving issues between the payer and provider before ever involving patients. The priority to keep patients out of the middle is part of the health system’s focus on patient experience. That same focus led Providence to stop a common medical billing practice of automatically sending 90-day overdue bills to collection.

“We spent a lot of time listening to patients through focus groups and what we discovered drove us to take even more practical steps to improve their experience,” said Dr. Hochman. Such steps include extending hours in call centers and providing bilingual materials and bilingual customer service. And, as part of its mission-centered care, Providence has for years helped patients with insurance denials, provided flexible and longer-term payment plans, and not charged interest on payment plans.

With nearly 4,000 physicians and over 3 million patients served in 2015 alone, the health system understands the challenges felt by patients, providers and payers. Providence is well positioned to provide expertise as a member of the advisory panel developing criteria for solutions and evaluating challenge submissions.

“Sometimes solutions are as simple as a clean, universally formatted bill that clearly outlines what insurance covers and what the patient owes,” continued Dr. Hochman, “but sometimes solutions are more complex and require cross-industry collaboration. This challenge is a great way to engage many experts to find solutions. Providence is thrilled to be a part of the challenge and to share in our commitment to simplify health for everyone.”

Providence was selected alongside Northwest health care organization Cambia Health Solutions based in Portland, Ore. Other partner health systems include Geisinger Health System (Danville, Pa.), INTEGRIS Health (Oklahoma City, Okla.), The MetroHealth System (Cleveland, Ohio) and University of Utah Health Care (Salt Lake City, Utah).

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Providence Health & Services is a not-for-profit Catholic health care ministry committed to providing for the needs of the communities it serves – especially for those who are poor and vulnerable. Providence's services include 34 hospitals, 600 physician clinics, senior services, supportive housing and many other health and educational services. The health system and its affiliates employ more than 82,000 people across five states – Alaska, California, Montana, Oregon and Washington – with its system office located in Renton, Washington. In 2015, Providence provided more than $951 million in community benefit. Providence Health & Services continues a tradition of caring that the Sisters of Providence began nearly 160 years ago.