September 10, 2014
With most consumer services, a bill is sent from a service provider, and the consumer will know immediately the amount that needs to be paid and when the payment is expected to be made. Medical bills, on the other hand, can be difficult for consumers to decode. Bills may be generated from multiple sources, may not reflect the adjusted price, may not include payments from insurance, and may not indicate items like copays, coinsurance, deductibles, and out-of-pocket maximums. After receiving statements from numerous providers (e.g., physician, lab, hospital facility) a patient will receive an Explanation of Benefit (EOB) from their insurance company, and the price of services rendered listed by the insurance company may not reflect what is on the bill from the medical providers. Eventually, an adjusted statement will be sent to the patient for each provider, however any questions a patient has about their bills may be handled by disparate customer service and billing departments.
The process can cause headaches for patients and providers alike. In an effort to reduce the complexity of the patient billing process, many organizations are implementing Epic’s Single Billing Office (SBO) model.