Welcome to the Empowered Patient Podcast with Karen Jagoda. This show is a window into the latest innovations in applying generative AI, novel therapeutics and vaccines, and the changing dynamics in the medical and healthcare environment. One focus is on how providers, pharmaceutical companies, and payers are empowering patients. In addition, conversations are often about how providers, care facilities, pharmaceutical companies, and payers are being empowered by technology to improve patient outcomes and reduce friction across the healthcare landscape.
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The audience includes life science leaders, researchers, medical professionals, patient advocates, digital health entrepreneurs, patients, caregivers, healthcare solution providers, students, journalists, and investors.
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Identifying and Resolving Errors in Healthcare Billing with Michael Axt Zelis TRANSCRIPT
Download PDFApr 13, 2023
Michael Axt, the Chief Member Empowerment Officer at Zelis, is focused on helping healthcare payers and clinicians provide more information to patients about expected costs for procedures and visits to providers and hospitals. A recent survey conducted with Hanover Research revealed insights about patients' challenges in understanding healthcare billing and correcting errors. Driven by the move to transparency, Zelis acquired Sapphire to offer the Sapphire Digital solution to enable patients to better understand insurance benefits and the correct amount the patient owes.
Michael explains, "We found some interesting insights. Over 40 percent of the consumers in our study indicated that they were significantly frustrated in trying to find the right person to resolve an error. So they might have found an error, but they didn't know how to do anything about it. For those individuals, it took a month or more for nearly half of our respondents. For 70 percent of them they spent over two hours of their own time trying to work to correct this."
"To the extent that there's greater clarity for the member or the patients in understanding the bill and what they owe, they're more likely to pay it more promptly. So we all know that cash flow is a challenge, and collections on patient liabilities are frankly atrociously low in the healthcare space."
"For the health insurance companies and payers, there are options as well. Obliviously improving the member experience helps to improve retention and reduce churn in the plans. Also, if they're bringing tools that help to accelerate payment to the provider, it has opportunities for them to improve their relationships with their provider networks, which is a huge strategic asset for the health insurance companies."
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