Collecting bills from patients has always been a pain point for providers, and it has created friction with payers, said Seth Cohen, co-founder and president of San Francisco-based healthcare billing-focused startup Ooda. “We want to get to a place where a patient can check out of a hospital like a hotel,” he said.
Executives from Ooda and Dignity say they’re creating an experience similar to a credit-card statement, where every provider encounter is listed on a single bill. Ooda then presents a consolidated invoice to the patient and handles reimbursement, claiming that it can better respond to patients with its access to payer and provider data and develop a long-term relationship.
Dignity and Ooda started the pilot at two Arizona hospitals and will bring it to two hospitals and a physician practice in Sacramento, Calif. Eventually they hope to expand the program across Dignity’s network. Dignity merged with Catholic Health Initiatives in February to form CommonSpirit Health.
“We have tried for over a decade to get a single bill and make it a one-stop shop. Now, a patient can make a single phone call and talk to someone” with access to the health plan and providers, Scharmann said.
That kind of transparency will be important to Atlanta-based Piedmont which last month began requiring uninsured, self-pay patients and those with high-deductible commercial policies to pay 25% of their bill before they can receive services.
“As much as people in healthcare want transparency, they get uncomfortable when you start talking about requirements for things, because requirements mean that a patient may hear ‘no’ to their healthcare,” said Andrea Mejia, Piedmont’s executive director of patient financial care and revenue cycle, “so that gets controversial.”
The new policy is the latest phase in what has been five years of improved patient education around out-of-pocket costs, including sending patients price estimates—even if patients didn’t ask for them—prior to almost all services.
“To move to point-of-service collections is a big shift,” said Joseph Fifer, CEO of the Healthcare Financial Management Association. “To do it even beforehand, that’s even a bigger movement, given where we’re starting from.”