ANERI PATTANI | KAISER HEALTH NEWS

There’s no national data to indicate how often patients or their families receive medical bills that were previously paid or forgiven, but hospital billing experts say they frequently see it happen. Patients might receive bills for claims their insurers already paid. A reminder statement may arrive even after a patient has submitted payment.

Many bills result from human error

Many medical billing cases like this “boil down to human error,” said Michael Corbett, director of health care consulting for LBMC, a Tennessee-based firm that consults with health systems nationally on issues like billing and revenue. “Facilities don’t have a lack of tools [to avoid this.] It’s a breakdown in their processes.”

A billing agent may forget to mark the account as paid, he said. Or the hospital might contract its billing to an outside company and fail to inform them that the bill was covered under the hospital’s financial assistance program.

As hospitals and medical practices increasingly consolidate under large health systems, the chances for errors increase. Even hospitals and clinics within the same system may have different backend software, and within each hospital there can be separate programs for billing and electronic health records, Corbett explained.

Larger health systems may also have more people processing any given bill. If responsibilities are not clearly defined, multiple employees could unknowingly act on the same patient account.

The COVID-19 pandemic has exacerbated potential errors, Corbett said. New medical billing employees may have received quick, virtual training and are working remotely with little interaction with team members or oversight. Some billing departments are understaffed, leading to delays in patients receiving bills or follow-up notices, he added.

To curb mistakes, Corbett said, hospitals need to invest in more comprehensive training and supervision for billing employees; enact consistent processes for everything from how patients’ financial information is collected at registration to when they’re sent bills; and, perhaps most important, track whether those processes are being followed.

For patients who find themselves in a situation like the Rybak’s, Corbett advises calling the hospital billing department and asking to speak with a senior leader in its revenue cycle division. Unlike an account representative, this person could make decisions, Corbett said.

At the end of the conversation, ask to get the explanation in writing, he added.

“You’d anticipate and hope those notes are being recorded,” Corbett said, but that may not be the case. Or notes might get recorded in a section of hospital files that are excluded from a patient’s legal medical record, making it difficult for patients to access later.

Read the full article on NPR. Produced by Kaiser Health News.