Drowning in a Sea of Paperwork: Toward a More Patient-Centered Billing System in the United States
Authors: Hannah L. Semigran, Ateev Mehrotra, Ann Hwang
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions3 May 2016Drowning in a Sea of Paperwork: Toward a More Patient-Centered Billing System in the United StatesHannah L. Semigran, BA, Ateev Mehrotra, MD, MPH, MS, and Ann Hwang, MD, MPhilHannah L. Semigran, BAFrom Harvard Medical School, Beth Israel Deaconess Medical Center, and the Center for Consumer Engagement in Health Innovation, Community Catalyst, Boston, Massachusetts.Search for more papers by this author, Ateev Mehrotra, MD, MPH, MSFrom Harvard Medical School, Beth Israel Deaconess Medical Center, and the Center for Consumer Engagement in Health Innovation, Community Catalyst, Boston, Massachusetts.Search for more papers by this author, and Ann Hwang, MD, MPhilFrom Harvard Medical School, Beth Israel Deaconess Medical Center, and the Center for Consumer Engagement in Health Innovation, Community Catalyst, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2283 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hospitals and physicians are working to improve the health care experience for patients. However, these improvement efforts frequently neglect a common source of patients' concerns: the medical billing system. Frustrations for patients abound, from the emergency department visit that prompts a seemingly never-ending and incomprehensible deluge of bills to the “This is not a bill” insurance statement that arrives 18 months after care is provided. This sea of paperwork costs time and money and creates confusion and frustration. We describe the problems with the current system and how providers, health plans, and policymakers may improve it.Problems With the Current ...References1. English A, BensonGold R, Nash E, Levine J. Confidentiality for Individuals Insured as Dependents: A Review of State Laws and Policies. New York: Guttmacher Institute and Public Health Solutions; 2012. Google Scholar2. Pollitz K, Cox C, Lucia K, Keith K. Medical Debt Among People With Health Insurance. Menlo Park, CA: Kaiser Family Foundation; 2014. Google Scholar3. 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Accessed at www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/Affordable-Care-Act/index.html on 18 January 2016. Google Scholar Author, Article, and Disclosure InformationAuthors: Hannah L. Semigran, BA; Ateev Mehrotra, MD, MPH, MS; Ann Hwang, MD, MPhilAffiliations: From Harvard Medical School, Beth Israel Deaconess Medical Center, and the Center for Consumer Engagement in Health Innovation, Community Catalyst, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2283.Corresponding Author: Ateev Mehrotra, MD, MPH, MS, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115.Current Author Addresses: Ms. Semigran and Drs. Mehrotra and Hwang: Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115.Author Contributions: Conception and design: H.L. Semigran, A. Mehrotra, A. Hwang.Drafting of the article: H.L. Semigran.Critical revision of the article for important intellectual content: H.L. Semigran, A. Mehrotra, A. Hwang.Final approval of the article: H.L. Semigran, A. Mehrotra, A. Hwang.Administrative, technical, or logistic support: A. Mehrotra.This article was published at www.annals.org on 2 February 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPatient-centred care is a way of doing things: How healthcare employees conceptualize patient-centred care 3 May 2016Volume 164, Issue 9Page: 611-612KeywordsDisclosureEmergency departmentHealth careHealth care policyHealth care providersHealth insurancePatient Protection and Affordable Care ActPatientsResearch laboratoriesShock ePublished: 2 February 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...