HHS Challenges Industry to Improve Medical Billing Process

HHS recently created the “A Bill You Can Understand” challenge with the goal of significantly improving the medical billing process.

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It’s no secret that the current medical billing process is deeply flawed. To face this issue, the Department of Health and Human Services (HHS) recently announced the “A Bill You Can Understand” design and innovation challenge, which strives to encourage healthcare organizations, developers, designers, digital tech companies to design a medical bill that’s easier for people to understand and use.

HHS will be giving $5,000 awards to the best submissions for two categories: the medical bill that is the easiest to understand and the most improved medical billing system. Submissions will be accepted until August 10, 2016, and winners will be announced in September 2016.

“This challenge is part of HHS’ larger effort to put patients at the center of their own health care,” said HHS Secretary Sylvia Burwell. “We are creating progress toward a medical bill that people can actually understand and a billing process that makes sense – progress that includes creating a forum that brings everyone to the table:  patients, doctors, hospitals, insurance companies and innovators.”

The “A Bill You Can Understand” challenge seeks to draw attention to the complexity of medical billing process as well as its impact on patients. Participants will be invited to reinvent the entire medical billing journey. The goal of the challenge is to improve patients’ overall financial experience.

At the moment, there is no standard for consumer medical billing documents. The medical billing process continues to be problematic because patients often receive bills from multiple doctors, hospitals and labs for the same episode of care. Many times, medical bills are also full of jargon rather than being simple and easy to understand. As a result, patients don’t always know exactly how much they owe, if their bills are 100 percent correct or what exactly their insurance plan covers.

According to the Federal Register, one award will be for the innovator that designs the bill that is easiest to understand. It will be for the most improved medical bill design. The second award will go to the innovator that designs the best transformational approach to improve the medical billing system.  It will focus on what the patient sees and does throughout the medical billing process. For the second award, judges will also look at the billing system’s alignment with modern consumer expectations.

For both awards, judges will examine if the entries contain all necessary data and information, their usefulness and understandability. Entries will also be judged based on plain language use, transparency as well as uniqueness and creativity of solution.

“Submissions will be judged based on understandability, creativity and how well they address the challenges outlined by patients, providers and payers, among other criteria explained on the challenge website,” HHS said.

Submissions are supposed to include the design concept for the redesigned medical bill and a journey map or wireframe for the redesigned patient experience. Additionally, submissions should include a written explanation as well as a video explanation. Specific criteria for the written and video explanations will be provided on the challenge website.

The “A Bill You Can Understand” challenge is open to any contestant that is a business or nonprofit entity or an individual or team of five or less US citizens or permanent residents who are 18 or older.

The entries will be judged by HHS leadership, who will consider input from an advisory panel of individuals who are in compliance with the requirements of the COMPETES Act.

The “A Bill You Can Understand” challenge is sponsored by the non-profit organization, AARP and administered by the design agency Mad*Pow. Winning designs are going to be featured at the Health 2.0 Annual Fall Conference in September 2016. They will also be featured on the challenge website.

According to HHS, the following organizations have agreed to test or implement winning solutions for their patients: Cambia Health Solutions, Geisinger Health System, INTEGRIS Health, The MetroHealth System, Providence Health & Services and University of Utah Health Care. Combined, these organizations have more than 10 million patient visits each year. Additionally, they cover almost 3.5 million people.