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Welcome to the Empowered Patient Podcast with Karen Jagoda.  This show is a window into the latest innovations in digital health and the changing dynamic between doctors and patients.

Topics on the show include

  • the emergence of precision medicine and breakthroughs in genomics
  • advances in biopharmaceuticals
  • age-related diseases and aging in place
  • using big data from wearables and sensors
  • transparency in the medical marketplace
  • challenges for connected health entrepreneurs

The audience includes researchers, medical professionals, patient advocates, entrepreneurs, patients, caregivers, solution providers, students, journalists, and investors.

Mar 13, 2022

Steve Palma is the President of Medical Cost Solutions at Goodroot and we talk about what medical billing errors have to do with increasing healthcare costs. Steve also shines a light on hospital financial assistance programs and how they are not being used enough to help patients pay high medical bills.

Steve provides some details, "Well, the billing errors include the cost of payers overpaying or underpaying claims, and the cost to the providers in billing correctly and then dealing with all the administrative headaches around audits by payers, and getting that claim ultimately right. These add a tremendous amount of administrative cost on both sides. It ends up getting passed to the consumer."

"You'll hear some people on the health plan side say it's all abusive provider billing practices, whether it's fraud or potentially maximizing coding in a complex coding environment. On the provider side, often, they'll say it's health plans intentionally underpaying or playing their own types of games."

"I think, over the years, what I've really come to conclude, is that, for the most part, people on the health plans and the providers are trying to do the right thing, from a coding perspective, but it's extremely complicated. So, the complication of the billing, the regulatory environment where payers have to pay those claims very, very quickly and get them out the door, it just causes an error on both sides, frankly."

@Goodroot4 #goodroot #healthcare #healthcarereform #reinventinghealthcare #medicaldebt

Download the transcript here