ShareHealthcare Billing Mistakes – How much does it really cost?
By Kevin Klump and Larry Coté, Lean Advisors Inc.
There's an undeniable curiosity surrounding the impact of billing errors on healthcare providers. Let's delve into how seemingly insignificant discrepancies can result in substantial financial losses. Billing errors are common in the medical field and sometimes accepted in the day-to-day operations. They arise due to various reasons, such as incorrect patient data entry or improper charges applied to both patients and their insurers.
Consider a tale from a known healthcare facility—part of a larger hospital network yet functioning as a local clinic. A patient completed an appointment, paid their insurance co-pay, and assumed their account was balanced.
To their dismay, they received a bill claiming an unpaid co-pay. Despite presenting proof of payment, the billing department insisted on the outstanding amount. The patient spent considerable time convincing the clinic to acknowledge the billing error was settled, which eventually they conceded was a minor oversight.
Yet, the issue resurfaced weeks later with warnings about delinquency and potential credit damage. Aggravated, the patient engaged in further back-and-forth communication before another assurance that the matter was resolved.
Regrettably, a debt collection notice soon followed, jeopardizing the patient's credit unless immediate payment was made. Driven to desperation, the patient sought legal counsel and subsequently filed a lawsuit against the provider, leading to an undisclosed settlement. Investigation revealed the blunder was due to an existing flaw in the billing procedure, overlooked by the team in the hope that such errors would be caught post facto rather than correcting the systemic issue.
The monetary repercussions are expansive:
- administrative expenses,
- legal costs,
- time lost by the patient dealing with the matter,
- diversion of staff attention from productive tasks, and
- compensation for the patient's grievances — including potential damages.
Furthermore, incidents like this erode the trust of patients in their medical practitioners, dishearten the clinic's staff, and potentially ruin the facility’s reputation when dissatisfied patients share their experiences.
Every type of healthcare system has process waste in all parts of processes within the organization. The key is to recognize the problems and ‘systemically’ do a proper analysis and design the new processes to ensure staff will not be able to make the mistakes in the future. The goal being that the standard processes are accurate and prevent recurrence and ensure smooth running efficient operations every time!
