Bundled Payments Save Money on Healthcare
Updated: Sep 11, 2019
Being an ER doctor, I am typically the professional providing medical care, and don’t necessarily deal with billing and insurance from the patient perspective. However, when my role was reversed and my son needed to have an endoscopy, I was surprised at how disorganized and confusing the medical billing process was.
Not only was I asked to pay upfront for the facility fee portion but I was also asked to pay a portion of the doctor bill upfront.
Afterwards the bills kept rolling in, even 6 months after the procedure, I was getting new bills. I received 4 separate medical bills from the gastroenterologist, the hospital, the anesthesiologist, and the pathologist. In between the bills my insurance company would send me statements and explanation of benefits (EOBs) that looked like bills. It was a very stressful time trying to deal with my son’s illness and digging through EOBs and medical bills.
For the typical patient, they are overwhelmed not only by the bills themselves, but also the fact that some bills are processed by the insurance company slower than others and can even be rejected by the insurance carrier. Usually this is can be a frustrating time for the patient, both because they now have to appeal to their doctor to submit the correct paperwork, and they also need to appeal the denied insurance claim. This is stressful for the patient, especially if they are concerned about being sent to a collection agency.
Because the whole billing process is shrouded with vague secrecy, patients only find out how much a surgery or a procedure costs 6 months after the surgery when the bills have finished rolling in. This is one of the many reasons that bundle payments might be a positive solution.
Bundled payments are when medical providers and healthcare facilities are paid a single payment for all the services performed to treat a patient undergoing a specific episode of care. An “episode of care” is the care delivery process for a certain condition or care delivered within a defined period of time. You basically pay one bill and all the healthcare providers and the facility divide that payment amongst themselves.
Negotiating a bundled payment for a surgery or procedure can drastically decrease the cost of that surgery. A gallbladder surgery that might cost $17,775 with a traditional insurance payment but will cost $7,700 with a negotiated bundled payment. My son’s endoscopy cost me $3,870 (after my deductible and coinsurance were met) but could have been lowered to $1,987 had I had a service to help me negotiate a bundled payment. I could have not only saved money, but also had financial peace of mind, leaving me able to focus 100% on my son.
So how do you negotiate a bundle payment?
MediBookr can help !
MediBookr can help negotiate a bundled payment between your doctors and the facility. To find out more, go to www.MediBookr.com.
-Dr. Ronnie Shalev is a board certified emergency medicine physician and the Chief Medical Officer at MediBookr