HIMSSCast: Collecting out of pocket expenses a challenge for hospitals
While 80% of a commercial bill is the plan's responsibility, 20% is owed by patients, says PayMedix CEO Tom Policelli.
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PayMedix CEO Tom Policelli knows the challenges faced by hospitals in collecting payments from patients after the procedure or service has been performed. This is not from uninsured patients, but from consumers who have employer coverage, but who may still owe hospitals and doctors a large percent of the bill due to deductibles, copays and other out-of-pocket expenses.
Employers are responsible for about 80% of the bill. The fastest growing part of healthcare expenses is the current 20% of the bill that commercial patients owe, says PayMedix CEO Tom Policelli.
For more on how hospitals can collect that 20%, listen to Policelli's discussion with Susan Morse, executive director of Healthcare Finance News.
Talking points:
- Hospitals are unsure whether to demand money upfront or chase it on the back end.
- 43% of people with commercial health insurance have avoided care due to worry over how they're going to pay for it.
- 52% of people say they're stressed about medical bills.
- 92% said that stress was affecting their physical health.
- PayMedix's business model is to step in, post adjudication, to match up the consumer balance with the plan pay expense and forward full payment to the provider.
- For people who can't pay, PayMedix writes off the bill faster and more cheaply than a hospital.
- Others are offered a no-interest, no-fee payment plan,
More about this episode:
Paying for healthcare creates mental and financial health concerns
Women pay $15.4 billion more out of pocket for medical expenses
Most providers seeking to outsource patient financing
The transactional revenue cycle no longer works: Here's what does
AI helps hospitals optimize their financial assistance programs
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
