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Challenging Patient Financial Responsibility Uncommon, But Fruitful

Still, experts should consider whether it is truly the consumer’s obligation to challenge patient financial responsibility; rather, payers and providers should send correct bills.

Most patients don’t challenge their medical bills, but new survey data from YouGov conducted on behalf of AKASA shows that negotiating patient financial responsibility could be a fruitful pursuit.

In the survey of 2,000 healthcare consumers, 64 percent said they’d never challenged a medical bill. But of the 36 percent who indicated they have, those challenges were successful; 78 percent of medical bill negotiations have resulted in charges being removed or reduced, the survey showed.

These findings come as patients grapple with nearly insurmountable healthcare costs. Both men and women have shown to be reticent to access preventive care because of the high cost of healthcare, per separate reports. In December 2021, researchers from the Robert Wood Johnson Foundation and the Urban Institute showed that high healthcare costs negatively impact medication adherence for 13 million Americans.

Healthcare costs deter patients from taking care of themselves and attending to preventive care, resulting in higher acuity care episodes that usually beget an even higher bill.

When patients do incur that bill, it could be fruitful to challenge it, this latest data shows, with nearly three-quarters of healthcare bill negotiations resulting in a lower bill or even one that’s entirely removed.

People who are uninsured were less likely to challenge a medical bill, while those with high-deductible health plans or Medicare Advantage were more likely to challenge a medical bill.

But although challenging a medical bill can be effective, it puts considerable onus on the patient, who already feels as though the patient financial experience is worse than sitting in the DMV.

A quarter of those who have challenged a medical bill from their physician, hospital, or insurance company said it took between one and three months for the issue to resolve itself. Around one in five (18 percent) said it took between three and sixth months, and for 16 percent of respondents who’d challenged a medical bill, it took more than six months.

These findings add to separate 2021 surveying from LendingTree and Qualtrics, which found that 93 percent of the people who have negotiated their medical debt have seen it go away. This survey showed medical bill negotiations to be far more common than in the YouGov/AKASA survey, showing that 75 percent of those with medical debt have challenged their bills.

The LendingTree survey also showed that patients are turning to various avenues to pay off medical debt, with a third saying they dipped into their savings to pay off medical debt, the most common response from participants.

Others did things like work out a payment plan with their provider or payer, cut other expenses from their budgets, took on more credit card debt, or took on another job. More nuclear options included borrowing money (9 percent), filing for bankruptcy (8 percent), or tapping into retirement savings (5 percent).

Still, between the two surveys, questions about patient financial responsibility linger. AKASA VP of revenue cycle operations, Amy Raymond, indicated that the onus should not be on the patient to take months to challenge a medical bill; rather, it should be on the healthcare provider and health payer to ensure medical bills are accurate before being sent to patients.

“The survey results show that it pays to be a champion in your own care and take action when getting an inaccurate medical bill,” Raymond said in a statement. “However, advocating for yourself — and, in many cases, your loved ones — can require a lot of time and energy. To prevent sending incorrect bills — and lower the time it takes to resolve a mistake — hospitals and health systems need to focus on streamlining inefficient, manual, and error-prone processes and workflows in the revenue cycle. Automation technology can help with that by ensuring work gets done accurately every time.”

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