Study Reveals Shocking Lack of Medical Billing Quality in US Hospitals

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The Healthcare industry 2022 survey found that most hospitals fail to meet new billing measures.

There is a shortage of qualified billing representatives at most hospitals, and patient itemized bills are not issued on time.

Based on the Healthcare Industry survey’s new measures added in 2022, a study published in Healthcare media examined the quality of medical billing for over 2,200 hospitals.

According to the 2022 survey, hospitals are taking legal action to collect medical debt, sending patients an itemized billing statement on time, and offering patients access to qualified billing representatives. Two of the measures were intended for the healthcare industry, but were at least partially addressed in recent regulations, so the study analyzed hospital performance on those three measures.

There is a widespread lack of quality medical billing in the US, as demonstrated by the study’s findings that only 38 percent of hospitals in the sample reported meeting all three billing quality standards.

In 754 hospitals, about a third reported taking legal action against patients who were late or insufficient. 1,020 hospitals reported not sending itemized bills to patients within 30 days, nearly 45 percent.

Further, some hospitals (5.5 percent, or 125 hospitals) did not provide patients access to billing representatives who were capable of investigating billing errors, offering price adjustments, and establishing payment plans.

Despite a clear indication that hospitals are underperforming when it comes to medical billing quality, study authors from Northwestern University said a further investigation is needed to determine whether the new proposed billing quality measures and standards indicate ‘reasonable and fair billing practices.

The study’s authors wrote that standardizing measurement and reporting of hospital billing practices could improve accountability, reduce variation in billing practices, and reduce barriers to care in the US.

A major gap in quality and patient understanding has been addressed by better medical billing standards in the healthcare industry. Although some experts say hospitals can do more to improve their medical billing processes for patients, recent regulations like the No Surprises Act have attempted to bridge some gaps in quality and medical billing.

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