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Drowning in a Sea of Paperwork: Toward a More Patient-Centered Billing System in the United StatesToward a More Patient-Centered Billing System in the United States

Hannah L. Semigran, BA; Ateev Mehrotra, MD, MPH, MS; and Ann Hwang, MD, MPhil
[+] Article, Author, and Disclosure Information

This article was published at www.annals.org on 2 February 2016.


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.

Requests for Single Reprints: 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.


Ann Intern Med. 2016;164(9):611-612. doi:10.7326/M15-2283
© 2016 American College of Physicians
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The current medical billing system is a common source of patient frustration with health care. Many are inundated with bills and insurance statements that are sometimes confusing or inaccurate and often arrive long after their health care encounters. This commentary proposes strategies for providing real-time, point-of-care information on health care costs to patients.

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True but not simple to fix
Posted on February 5, 2016
Victor G Ettinger, MD, MBA, FACE, FACP
Telehealthdocs Medical Group
Conflict of Interest: None Declared
I couldn't agree with you more, however your suggestion of a unitary hospital bill is neigh on impossible where the hospital is not allowed to hire physicians directly; therefore each physician encounter is like going to Macy's, then Kohl's, then Safeway, etc. where you will be billed for each store. Each physician group bills at a different time, the health plan then pays their part of the bill; the next week a second part of the total bill is generated by a different provider, and on and on and on. Once each office finishes corresponding with the health plan about underpayment, several months have gone bye. Only then when all the billing is completed does the confusing EOB go out. By then the patient has moved to a different country altogether and the EOB gets lost in the mail with the whole rigmarole begins again.
It would be both simpler and more efficient to have a bill from a universal payor
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