More on Billing and Collections

Poor digital billing process associated with uncollected payments

Younger consumers are especially are willing to switch providers over a bad billing experience.

A new study shows a third of healthcare consumers are unsatisfied with their provider's digital billing process, an issue often associated with bills going into collections.

The study found that 34% of people have seen a healthcare bill go into collections. It does not take a very large bill to wind up in collections. Over half of annual medical collections are for less than $600, according to a 2018 study of more than four million U.S. credit reports, cited by Cedar, which released the recent 2019 U.S. Healthcare Consumer Experience Study.

Approximately 41% of those who took the Cedar study said they would stop going to their healthcare provider over a poor experience with online bill pay, digital pre-appointment forms and mobile and email bill delivery. About one in five said they had already made that change.

Obtaining information from their provider was a struggle for more than half of those who took the survey. Of the 60% who asked for it, 51% said they either struggled to get out-of-pocket cost information from their healthcare provider or did not receive it accurately. Fifty-six percent said they wanted their healthcare provider to improve this as part of their services, and 50% said they wanted more understandable bill explanations.

Thirty-eight percent said they wanted better customer support, and 33% would like better digital payment options. The study showed 74% of consumers are being notified about a healthcare bill via traditional mail; 55% through an online portal; 34% through email; and 15% through text.


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Uncollected hospital bills are expected to climb as consumers take on more of the financial responsibility for their care.

Bad debt is the result, with more hospitals going after the collections, resulting in recent bad publicity for some providers who aggressively pursued payment through lawsuits and garnished wages.

Negative reviews can result when digital service is poor, with younger people more inclined to voice their criticism, the study showed. Fifty-two percent said they would consult an online review site when choosing a provider, and 44% said the reviews were a top influencing factor in their decision.

Young people are also more likely to have their medical bills go into collections than the rest of the population. Of those aged 18 to 24, 44% said they had a healthcare bill go to collections, as compared to 26% of consumers aged 45 and older.

More than 60% of these younger consumers were willing to switch their provider and are four times as likely as older consumers to have already abandoned their provider.

While the digital billing process was a high priority for patients taking the survey, the most commonly sought improvement was more flexibility on the payment plans themselves, with 83% saying that was their biggest concern.

Having a bill go into collections often reflects a difficulty with the billing process, said Cedar, which recommends a congruent end-to-end administrative experience, out-of-pocket cost estimators, consolidated bills, digital payment options and more flexible payment plans.


The results show a slight increase in the number of people who saw their bills go into collections, according to Cedar.

Cedar offers a patient payment platform. Survata, an independent research firm, conducted the study based on 1,607 respondents who had paid a medical bill in the last year.


"Similar to the scenarios that have played out in other industries like e-commerce, healthcare providers are now being judged by the digital experience they provide their patients," said Florian Otto, founder and CEO of Cedar. "While technology has rapidly innovated how we treat patients on the clinical side, administrative processes have yet to catch up. Modern consumers - armed with new levels of data, treatment options and heightened expectations - now demand more and the industry must rise to the challenge."

Max Sullivan is a freelance writer and reporter who, in addition to writing about healthcare, has covered business stories, municipal government, education and crime.Twitter: @maxsullivanlive

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