If you’ve ever walked out of your doctor’s office puzzling over the “superbill” you’ve been handed, you aren’t alone. And if, like most of us, you think that bill is incomprehensible, forget trying to analyze a hospital bill.
But analyze we should, as estimates of the number of medical bills containing errors range from 30 percent to a whopping 80 percent.
Stephen Parente, a professor of health finance at the University of Minnesota who has studied medical billing extensively, told the Wall Street Journal his research suggests that between 30 and 40 percent of all medical bills contain errors.
Consumer Reports notes that Medical Billing Advocates of America, a national association that checks bills for consumers, says 8 out of 10 hospital bills its members scrutinize contain errors.
Not only do those errors have the potential to cost you money you didn’t really owe, according to Consumer Reports, overcharges also bring you closer to the lifetime spending caps imposed by most insurance plans.
And if that incorrect bill goes unpaid — even in some cases while you are still trying to straighten it out — it could seriously damage your credit score, affecting everything from your ability to get a mortgage to your status with a potential employer.
So, how do we know if we’re being overcharged or inaccurately charged?
Unless you have specific knowledge of bill coding and practices, sometimes it’s nearly impossible, says Buddy Claborn, founder and CEO of Healthpac, a Savannah-based medical billing software firm with a national reach.
Claborn has been a pioneer in the medical billing software community since founding Healthpac in 1981 and currently provides comprehensive medical billing and practice management solutions and support services to medical professionals, practices and partners throughout the United States.
One way to approach the issue, he said, is to reduce the number of errors by improving the efficiencies of the medical billing process. And that starts with the software.
To that end, Claborn has accepted an invitation to serve on the board of the Healthcare Administrative Technology Association and the advisory board of the Electronic Healthcare Network Accreditation Commission, putting him on the front lines of an effort to create certification standards for the medical billing software industry.
The accreditation guidelines and requirements currently being developed are aimed at forming a universal benchmark across the industry that will establish a level of trust for medical practices and other health care providers who have the overwhelming task of choosing from among the more than 600 medical software billing companies for their organization.
“There are so many software providers out there – some big, some small, some good, some not-so-good,” said Claborn, who has been honored as the National Healthcare Billing Software vendor of the year by the Healthcare Billing and Management Association.
“Hopefully, I will be able to have an influence on the creation of the certification standards, particularly for specialty products in specific medical fields, as well as help define what it will mean to be certified,” he said.
“What we’re working on is the next phase in the evolution of the medical billing software and practice management systems industry, and the end product will help health care providers make intelligent decisions to best meet their needs.
“The accreditation process will protect the medical industry from fly-by-night companies and vendors with inferior products, and those efficiencies will be reflected in the way patients throughout the country are billed for medical services.”
In addition to utilizing his expertise in the field, the study group has invited Claborn’s Healthpac to be a beta-tester for the certification process.
As a newly formed advocate for the medical billing software industry, the Healthcare Administrative Technology Association is 100 percent onboard, according to HATA executive director Tim McMullen.
“One of our primary functions will be to introduce a certification process for medical billing software providers that will protect medical practices from fraud and inferior medical billing products,” he said. “HATA is a key stakeholder in the $40 billion physician revenue cycle industry and will be an active and influential voice promoting the goals and values within the health administrative industry as well as driving administrative efficiencies.
“Administrative simplification of claims processing is a key factor in influencing the cost of health care in the United States, and HATA will lead the movement in this area.”
ON THE WEB
Go to www.hata-assn.org to learn more about the Healthcare Administrative Technology Association.
Go to www.healthpac.net to learn more about Buddy Claborn and Healthpac.
POSSIBLE PULL QUOTE:
“Administrative simplification of claims processing is a key factor in influencing the cost of healthcare in the United States.”
- Tim McMullen, Executive Director, Healthcare Administrative Technology Association