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Even with some 15 million Americans covered by high-deductible health plans, health organizations are “not prepared to meet consumer payment expectations,” according to the fourth annual payment trends report by InstaMed, a Philadelphia-based payment network company.

Between more out-of-pocket costs, scant availability of pricing information before getting a service and, in many places, a reliance on paper-based payment notifications, “consumer dissatisfaction is becoming a growing problem,” InstaMed’s report argues.

Among Americans surveyed by InstaMed last year, 72 percent did not know their payment responsibility during a provider visit, and among providers surveyed, 42 percent could not tell patients what they owed at the point of service — trends that are leading to consumer angst and debt for providers.

In 2013, 76 percent of the health systems and medical practices surveyed by InstaMed said it took more than one month to collect bills from patients.

“As a result, providers are spending more money and more time to collect from consumers than in other industries, yet still accumulating a large amount of bad debt,” according to InstaMed’s report.

Indeed, more than half of the providers surveyed rated patient billing collections as their top revenue cycle concern.

More than half of providers reported collecting at least some of the amount due from patients at the point of service for most visits. But when they did not collect immediately, about a third of the time it was because they did not know exactly how much was due, and another third of the time it was because patients were hesitant to pay.

Amid those issues, three-quarter of the providers surveyed are offering payment plan options to patients, with the number of transactions from patient payment plans increasing some 284 percent in InstaMed’s network between 2011 and 2013.

Desiring digital

What isn’t clear is how many providers are still relying solely on snail-mail patient billing and how many are offering online payment options, although it seems mail is still prevalent. According to InstaMed’s survey, 78 percent of providers mailed more than one paper statement to collect a patient payment.

It is clear, though, that patients would prefer the digital option: Almost 80 percent said they would pay healthcare bills online through provider or health plan websites and almost half said they would pay online through their bank portals.

Meanwhile, among insurers, at least those in InstaMed’s network, scaling up to electronic remittance advice and funds transfer has also been lagging.

In 2013, about half of payers were not using the Council for Affordable Quality Healthcare’s CORE phase three ERA/EFT operating rules.

And among those that are offering ERA/EFT, it’s sometimes been challenging onboarding providers. About 60 percent of the insurers offering ERA/EFT reported less than half of their providers actually accepting the digital option.

Click here to read the article originally published by Healthcare Payer News.

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