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Our View: Patients in Southwest deserve billing solutions

Seniors, especially, need clear answers, better service

“A patient should be able to call up, ask a question about their bill, get a straight answer and resolve that issue in a timely way,” said Stephanie Arenales, director of Consumer Assistance Program, in The Durango Herald on April 17. “It shouldn’t be so hard.”

We agree. Seems reasonable. Yet, local residents have slogged through texts, emails and paper statements from billing and collections agencies. When they come up for air, they all say the same thing – “I’ve already paid this bill.”

People interviewed in that news story are backed by many more who have contacted us. They share the same stories with varying layers of complexity.

We understand that Mercy Hospital and Centura Health, the corporation that owns Mercy, are not unique in our country’s fragmented and flawed health care system. The health care from a provider is completely separate from the billing and collections process. This is not news.

But the divide between the two looks like an abyss to patients – especially seniors – trying to understand why they continue to receive bills after making payments.

Companies that employ providers tend to see roles as just that. Health care industry representatives don’t champion protections for patients embroiled in billing matters.

Still, we expect more – and we’re asking for more – for patients who need assistance in the Southwest, limited in their ability to choose other hospitals for care.

We get that there is no singular problem, no easy way to pinpoint where something went wrong. When a procedure was coded incorrectly, when a computer glitch didn’t recognize payments and sent incessant bills. How a human erred, when so much of the insurance and billing is automated, complicated and siloed.

Bills and payments crisscross in the mail or online, contributing to more confusion in a system inherently dogged by confusion.

We understand the overwhelming challenges. But local patients deserve more readily available answers in this illegible system. We want solutions and better customer service.

Some legislation will help consumers. Senate Bill 23-093, which passed this legislative session, would bolster consumer protections by capping medical debt interest at 3%, pausing the collections process during an insurance appeal and mandating more transparency into the debt-collection process.

But we need more upstream help, before bills become debt.

Particularly disturbing is when seniors feel scared after confrontational communications from collections agencies. Apparently, most people acquiesce and pay up because these bills won’t break their bank accounts. It’s easier and less threatening to make the aggravation go away.

Experts in consumer health advocacy say this is a common practice. Thankfully, organizations such as Colorado Consumer Health Initiative work to address inequities in health care. CCHI’s free Consumer Assistance Program helps patients resolve issues with health care billing.

Maybe all this trouble in deciphering billing will spawn new jobs with a future for companies in the health care navigation system, in the way that tax preparers do for taxpayers.

But for now, we’d just like someone to pick up the phone or send an email, clearly showing bills and payments in real time.

Because this back-and-forth and the stress it causes has to be bad for our health.