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Readers Write: Why Can’t I Be Both Patient and Customer?

April 13, 2016 Readers Write 7 Comments

Why Can’t I Be Both Patient and Customer?
By Peter Longo


I love the clinicians at my local health system. However, I hate the bills from my local health system.

When the clinic staff helped last month with my knee, they were the best — rock stars. When I got their confusing bill, they were the worst. Is there any other industry where you love the service, but 30 days later, they go out of their way to take away all of your happy thoughts?

Yes, I did something stupid again. Over the holidays, I took some time off to go skiing with the family. Time with the family was not stupid; skiing in the trees was stupid. (note to self; you are not in your 20s any more and need to take it easy). The ensuing tumble, spin, twist, and crash resulted in an injured knee.

I entered the local university health system in search of a cure. In total amazement, I walked into the office and the entire staff greeted me. Just like in the Gap, the entire front staff looked up and said “hello” loudly.

Over the next month, the medical group and hospital went out of their way to make me feel at home … until the bill came. Or should I say “bills” (plural). They should have stamped on the envelopes, “Screw you” in an effort to be more honest.

Most of the bills appeared to be for my knee, based on the dates of service. But for the record, they decided to add some of my wife’s medical charges into the mix on one statement.

Having spent 25 years working in the healthcare tech world plus having two graduate degrees, it still did not give me the skills to make any sense of the bills. I decided to call them at 4:50 one afternoon. The very nice recording said, “The billing office closes at 4 p.m. Monday through Friday.” Seriously? What about people who work and don’t have time to call until after work, or on the weekend? The Gap has greeters, but they are open nights and weekends. Seems my health system copied the Gap only on the greeters.

A few days later, I was able to talk to someone. I started the call by saying, “I want to pay all that I owe, so please provide a summary and explain the charges so I can pay you.” Surprisingly, they did not understand half the statements. They indicated they could not access the “other system that has more information,” so they would need to call me back.

A few days later, someone from the billing office called. Together we figured out where there were some discrepancies and determined the correct amount owed. She indicated she would clean everything up and send me a new statement. Thirty days later, I got the statement and paid right away. As I was writing that check, I had already forgotten about how they “cured” me, as it seemed so long ago.

The cost for the billing staff involved in my bill was probably more that what I owed, so I did feel bad for them. That sympathetic feeling only lasted a short time. Last night I got a call at the house. My 15-year-old handed the phone to me. I owe $25 and they sent it off to their collection agency.

Is it too much to ask that my health system treat me both as a patient and as a customer?

Peter Longo is SVP/chief revenue officer of Sirono of Berkeley, CA.

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Currently there are "7 comments" on this Article:

  1. Imagine being the 75+ year old person who has no advanced education and trying to figure this out. With all the improvements we made to healthcare why we cannot produce a bill in plain English just befuddles me.

  2. Spot on Peter. Couldn’t agree more. Plus, how about consolidating the 5-7 portals you were probably given access to manage your injury to one convenient master portal?

  3. Exactly! What about people who speak English as a second language or simply can’t call during business hours?

  4. Welcome to the world of third party payment. When a third party pays your bill (or most of it) they call the shots and define the contract /billing requirements. If an insurance company (or govt) were not involved you would have received a very simple bill, some thing like:

    Total Charges= $1 million
    Pay his amount: $1 million.

    That would be simpler and you would have paid it straight away..right?

    Remember providers did not create the current payment /reimbursement system. The government and insurance companies did.

  5. For an industry that is so people and care oriented, healthcare has the worst user experience. It is still an industry where people say “I’m treated like a number!”. It is an industry that tries to work despite of polarity. One side, the strive to provide quality care and the other side, the business end to ensure sustainability. It would be great if an innovative startup comes along and disrupt the experience and process. It is certainly ripe for someone to do that.

  6. Why was a final price not negotiated upfront? Perhaps because a healthcare provider has leverage over consumer’s life and well being.

    For any other transaction a consumer will try to negotiate a best value upfront, while doing the same with your doctor can feel more like negotiating with an instructor who is packing your parachute.

    Docs, your consumer-facing role makes you primarily responsible for price transparency, and there is no hiding from it, regardless of what happens behind your office doors.

    Maybe under the current system a consumer should talk directly to the real deciders i.e. insurance reps and skip a middle man (you).

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