New Research Reveals Consumer Frustrations with Healthcare Billing and Lack of Processes for Correcting Errors

A Hanover Research survey of 800 U.S. privately and publicly insured adults, sponsored by Zelis, highlights opportunities to improve the healthcare financial journey.

BEDMINSTER, N.J.--(BUSINESS WIRE)--Zelis, a company modernizing the business of healthcare, today announced findings from a new study on consumer billing conducted in partnership with Hanover Research, an independent research firm. In the online survey administered to 800 U.S. consumers who had found at least one medical billing error in the last five years, 41% of the consumers are significantly frustrated trying to address billing errors.

According to the response data, half of respondents reported incorrect charges of at least $200, and a quarter saw a difference of more than $500 on their bills, adding up to a significant amount of unnecessary healthcare spending when translated at scale.

Key findings from the research include:

• The healthcare financial journey is complicated and opaque: According to survey respondents, knowing whom to contact and how to find the right contact information are the two biggest challenges during the bill correction process.
• Individuals find it challenging to understand the complexities of healthcare billing and high-cost bills: Only 30% of participants felt extremely confident in their ability to identify an error in their medical bill.
• Finances are a primary motivator for fixing incorrect bills: 62% of survey respondents said saving money motivated them to attempt correcting a billing error.
• Consumers typically noticed the error in one of three ways: They compared charges with estimated costs (32%), compared charges to explanation of benefits (29%), or noticed items on the bill that differed from their care experience (29%).
• The path to bill resolution can be time-consuming: Almost half of respondents (43%) spent up to one month getting bills corrected, and 70% of those who tried to resolve a billing error spent more than two hours on the process.

To address this frustration, 80% of consumers believe their healthcare insurance plan could have a clearer process for dealing with billing errors, better service, clearer options, and faster and easier resolutions.

“Our research reinforces that healthcare billing systems are complicated, and bills can be complex and with the potential for errors,” said Michael Axt, Chief Member Empowerment Officer at Zelis. “This negatively impacts healthcare consumers, particularly those with lower incomes or less health literacy. Healthcare organizations have an opportunity to reduce friction in the billing process to support consumers and create a more seamless healthcare financial journey.”

Incorrect billing is only on the rise as more healthcare providers are asking patients to pay in advance for services based on their estimates, which may not account for claims yet to be processed from other providers and may inflate costs to consumers unnecessarily.

By offering solutions that provide clarity, control and guidance, payers and providers can empower consumers in navigating their healthcare financial journey. The full results and insights are featured in the white paper, Healthcare Financial Journey: Reducing friction for consumers, and experts are available to speak to how Zelis is enabling its payer clients to improve the member experience with digital solutions. Contact [e-mail] to request a meeting.

About Zelis

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. Learn more at Zelis.com and follow us on LinkedIn to get the latest news.

About Hanover Research

Founded in 2003, Hanover Research is a global research and analytics firm that delivers market intelligence through a unique, fixed-fee model to more than 1,000 clients. Headquartered in Arlington, Virginia, Hanover employs high-caliber market researchers, analysts, and account executives to provide a service that is revolutionary in its combination of flexibility and affordability. Hanover was named a Top 50 Market Research Firm by the American Marketing Association in 2015, 2016, 2017, 2018, and by the Insights Association in 2019. To learn more about Hanover Research, visit www.hanoverresearch.com.