President Trump and Congress are calling for an end to surprise and balance billing – you can have happy consumers by stopping it now

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Suffering a heart attack is bad enough. But how would you feel if, once you recovered, you received a bill for over $100,000 after the hospital said your insurance would cover your expenses? This happened in Texas in 2017.

Drew Calver, a teacher, married with two children, suffered a heart attack in his home on April 2, 2017 and wound up in the emergency room of St. David’s after his neighbor rushed him there. He was coherent enough to ask if his health insurance would cover everything. “He was concerned because St. David’s is out-of-network on his school district health plan,” according to NPR, who aired this story on August 27, 2018 in its ‘Morning Edition.’[1] “The hospital told him not to worry and that they would accept his insurance, Calver said.”[2]

NPR outlined the financial hit to Calver and why it happened:

Total bill: $164,941 for a four-day hospital stay, including $42,944 for four stents and $10,920 for room charges. Calver’s insurer paid $55,840. The hospital billed Calver for the unpaid balance of $108,951.31.

Following his heart attack, Calver fell victim to twin medical billing practices that increasingly bedevil many Americans: surprise bills and balance billing.”[3]

Surprise and balance billing are making news today, because President Trump has called for a crackdown on the practice. He wants patients to know “exactly what the cost is” before they receive care, according to an article in The Hill by Peter Sullivan.[4] And in what is “seen as a rare area of possible bipartisan action on health care,” members of both aisles in Congress are moving forward with bills to help consumers.[5]

Shannon Muchmore reports in HealthCareDive, that Senator Lamar Alexander, Republican chairman of the Senate Health, Education, Labor and Pensions (HELP) committee, “told reporters recently he expects pushback from the industry – but warned the industry to act before Congress does.”[6]

Why not proactively bundle your prices right now, before you’re forced by legislation?

HealthQRS is the solution to surprise and balance billing. Our ecommerce platform has a contract management system built in that allows for complex pricing when you have more than one provider part of a procedure. Our system is built to handle multiple procedures and complicated, multi-tiered contracts. We can integrate into your billing software. Our solution takes the claims data and ensures that the bill is squared up.

HealthQRS is different from estimators. HealthQRS has created a tool that provides actual pricing to people. And we’ve made that tool accessible in a platform that offers not just pricing, but a complete retail experience in healthcare, much like the Amazon experience. We’ve developed this solution using complicated algorithms that use real-time data: the actual payer contracts by provider + insurance verification information + charity + other business rules to provide consumers with a true out-of-pocket per patient per procedure.

In addition to solving the surprise and balance billing debacle, our solution allows you to differentiate yourself from others. For example, say you’re a community hospital and you want to stay independent. You can expand your patient base by using HealthQRS as a marketing platform to all individual consumers and employers and their employees in your market. You can give them the Amazon experience where they can use an app on their smartphones to find your hospital and see true prices for providers and procedures. They can schedule and pay for those procedures – and so much more – right from the app as well. Our solution keeps them in network so there are no surprise bills.

HealthQRS has the technology solution that allows you to do this for as little as $500 per month. We have developed the only complete e-commerce platform for healthcare on the market. You can publish price as well as a downloadable readable file that shows realistic pricing. Consumers can see their actual out-of-pocket expenses right on the app. This follows the intent of CMS’ price transparency rule by providing people with an easy, quick way to find services and procedures and immediately see what they will cost.

Our solution is simple to use. We invite you to see for yourself with this 2-minute video of the HealthQRS price transparency tool. Click on this link, then you’ll be instructed to download and watch: https://s3.amazonaws.com/hqrs.media/_misc/Screen+Recording+2018-11-29+at+17.30.45.mov

HealthQRS interfaces with virtually any existing practice management system and electronic medical record. Our solution helps you comply with CMS’ price transparency rule, but we are much more than a price transparency tool. We have over 30 modules that work independently or all together depending upon your needs to provide a holistic, seamless, total experience for the consumer from start to finish. We combine navigation, the capability to make an appointment, referral management (if needed), payment management and so much more than we can list here.

We enable telehealth connectivity as well. Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options and we keep them in-network. HealthQRS integrates fully to your EHR and can also enhance your existing portals and other patient engagement solutions and improve your meaningful use numbers and increase meaningful use funds. Consumers can access your retail site and shop, schedule and pay for your services via an easy-to-use app on their smartphones or tablets.

We are a software-as-a-service (SaaS), so you have no capital investment, just a low monthly fee. HealthQRS can provide this to you for as low as $500 per month and we can have you compliant by January 1, and not only that, your facilities will be much more attractive to consumers than your competition who is publishing charge master prices.

Developing a solution of this magnitude didn’t happen overnight. We started with the consumer experience in mind and spent years drawing on the knowledge of best-of-breed experts to perfect, fine tune and put together this complicated, yet complete solution for medical e-commerce.

In fact, HealthQRS has over 15 years of experience developing healthcare retail experiences for people and our founders have over 50 combined years of e-commerce experience. We also invite you to watch our user-friendly app video that you can use to win consumers as well as our point-of-service solution video that may interest you. You can also check out our E-Commerce Medical Marketplace Flyer for more information.

Contact us right now to schedule a personalized demo. We can help you go beyond the letter of the law to publish prices that are meaningful to consumers. We can help you bundle services and pricing, and we can get you entire system set up in a matter of weeks. Looking forward to helping you soon.

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[1] Chad Terhune, “Life-Threatening Heart Attack Leaves Teacher With $108,951 Bill,” NPR, Aug. 27, 2018, https://www.npr.org/sections/health-shots/2018/08/27/640891882/life-threatening-heart-attack-leaves-teacher-with-108-951-bill

[2] Terhune, “Life-Threatening Heart Attack,” NPR, https://www.npr.org/sections/health-shots/2018/08/27/640891882/life-threatening-heart-attack-leaves-teacher-with-108-951-bill

[3] Terhune, “Life-Threatening Heart Attack,” NPR, https://www.npr.org/sections/health-shots/2018/08/27/640891882/life-threatening-heart-attack-leaves-teacher-with-108-951-bill

[4] Peter Sullivan, “Trump calls for cracking down on surprise medical bills,” The Hill, Jan. 30, 2019, https://thehill.com/policy/healthcare/426667-trump-calls-for-cracking-down-on-surprise-medical-bills?utm_sourIce=Sailthru&utm_medium=email&utm_campaign=

[5] Sullivan, “Trump calls for cracking down,” The Hill, https://thehill.com/policy/healthcare/426667-trump-calls-for-cracking-down-on-surprise-medical-bills?utm_sourIce=Sailthru&utm_medium=email&utm_campaign=

[6] Shannon Muchmore, “Industry braces as more lawmakers seek to ban surprise billing,” HealthCareDive, Jan. 29, 2019, https://www.healthcaredive.com/news/industry-braces-as-more-lawmakers-seek-to-ban-surprise-billing/547015/

 

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