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Project HIE STANDARD
Pay Your Way
Pay Your Way
Interactive Healthcare Billing
With the overall cost of healthcare in the U.S. higher than that of any other country and rising, there needs to be reform in the current direction the healthcare system is going. Arguably, one of the largest problems is the discrepancy between the services we receive and the fees we pay.
- Findings have shown that on average anywhere from 30-40% of medical bills contain errors (Silver-Greenberg, Jessica). These errors have stemmed from many sources such as the lack of preventative medicine practices and the abuse of billing codes used by clinicians.
- Too many opportunities for an error to occur in medical billing. For example in hospital settings, more than 200 workers might play a role in generating a single bill for a patient, according to the VP of Summa Health Systems, Kevin Theiss (Tribble, Sarah Jane).
- A press release put out by Intuit revealed that 40% of Americans do not understand their medical bills enough to understand what they are paying for and if the charges are correct. (Intuit)
- Professionals, similar to patient advocates, hired by insurance companies or the respective health institution on site to meet with patients to discuss, understand, and check the accuracy of their bills.
- Online bills with a user portal so patients may access their most recent bills. Will provide supporting information and prediction of future bills based on trends in health history.
- A standardized manual available publicly online or in paper with general information on how to read medical bills and guidelines to the different codes that exist and when they should be used.
There exist many documents and websites that break down the sections of what is typically seen on medical bills with galleries of pictures. They can include explanation of benefits (EOB), lists of CPT and ICD codes, and adjustments made if there exists a co-pay or coverage from insurance. There are also firms that provide legal services where patients can hire professionals to handle their medical bills rather than see them themselves. All of theses are helpful options but are not completely comprehensive solutions. The first lacks depth and personalization. The second leaves patients still too detached from the responsibility of knowing the charges they pay for.
Chosen Approach/ Final Solution
We have decided to develop Pay Your Way, the interactive electronic billing, because it provides the most comprehensive and most user friendly solution for patients to review their medical bills. Because the root of the problem is the complexity of medical bills, and even for some just having access to their bills, the online portal will be very intuitive and informative. Besides explaining charges individually, Pay Your Way will also be able to predict what you're future bills will look like based on your past medical records, services received, and where the location of the services received.
Timeline for Completion
2/10 Meet and discuss further
4/10 Provide more evidence for our project
9/10 Propose our application
11/10 Meet and discuss further.
Team Work Load/ Roles
Brian: Problem statement and supporting evidence writer
Vince: Research similar solutions, solution contributor
Courtney: Content coordinator, editor
Anthony: Supporting evidence and solution contributor
Lauren: Group Leader, Wikispace editor, solution creator
Meeting 1800 23SEP12 Campus Circle Apartments
What was decided:
We decided that we would break the wikispace as well as the outline in to equal parts that each group member will work on.
Brian: Problem Statement, Evidence
Vince: Solution to the app
Courtney: Revise and edit the outline
Lauren: The wiki site
What we accomplished at the meeting:
We accomplished the plan to effectively and efficiently complete our project and app.
What we agreed to in terms of next steps
We created a timeline that we will be able to guide and measure our accomplishments in our work and goals.
Our next step is to come up with designing the website. This will include what the site will look like, the login process, how bills will be shown, what features will be provided, and what the patient can interact with within the portal. We will also finalize the details of the workings of our company like what the contracts made with insurance companies to have access to patient medical bills will entail, how we will generate profit, and how we will secure our information.
Tribble, Sarah Jane
Health Exec News
Third Party Billing and Patient Portals
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