Healthcare Business News

Osteopathic doctors to consider responsible billing resolution at annual meeting

By Andis Robeznieks
Posted: July 18, 2014 - 8:15 pm ET

Two physicians hope to use their personal experiences to help patients receive upfront estimates of all costs related to their medical procedures and be told the identities and number of ancillary providers associated with their care to whom they will need to make payments.

Drs. Jennifer Hauler and Cleanne Cass are responsible for an Ohio delegation submitting a resolution (PDF) to that effect for consideration at this weekend's American Osteopathic Association House of Delegates annual meeting in Chicago.

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“The patient receiving services has every reason to expect full disclosure of all costs that they will incur as a result of the procedure(s) involved in their care, including any ancillary costs such as imaging, laboratory, medications, and services provided by professionals other than the physician they have personally directed to provide their care,” the resolution states.

“It seems so obvious,” said Cass, the author of the resolution. “You wouldn't think of getting your garage built and then not ask about the cost.”

But Hauler said that's what happened when her husband had a surgical procedure performed at an Ohio hospital. After the co-pay was made, she said they were told everything else was covered. All that was actually covered, however, were the hospital costs. After the procedure, she said her husband was billed thousands of dollars for anesthesia and laboratory services that she thought had been resolved.

“We were told nothing,” she said. “I'm a physician, I asked what I thought were the appropriate questions.”

In her case, Cass said that after her son was hospitalized, he received a “huge” pharmacy bill that was totally unexpected.

In addition to catching patients off guard, she said, these experiences may cause them to forgo needed medical procedures because they are afraid of surprise costs appearing on their bills. People also are reluctant to ask their providers too many questions, Cass said, because they don't want to be labeled as difficult patients.

Such concerns create a rift between patients and their primary-care doctor.

“Patients will come back from the hospital upset because they have all these bills they weren't prepared for,” Hauler said. “That tears apart the relationship.”

Ideally, Cass would like to see the American Medical Association come up with a corresponding resolution and “both medical families” could put pressure on regulators, hospitals and insurance companies to lift the veil on hidden costs.

Cass, the director of community care and education for the Hospice of Dayton, has served as a long-time wordsmith for the Ohio delegation. Resolutions she has written have led to changes in hospice and home care licensing and regulatory oversight, she said.

She's optimistic that the same could happen with this resolution.

“There's no other field where we buy something without knowing what it will cost,” Cass said.

Follow Andis Robeznieks on Twitter: @MHARobeznieks

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