Patients must assiduously document their out-of-pocket payments to assure that coverage kicks in once the deductible is met. For doctors, [Consumer Driven Health Care] means collecting fees directly from patients, many of them unable to pay, a task even costlier than billing insurers.
Although I still maintain that the administrative burden is no higher on doctors for patients with an Health Savings Account-compatible High-Deductible Health Plan (HSA/HDHP) than on doctors whose patients have a more traditional PPO plan with a deductible, I do agree that collecting fees is an issue for physicians. For that reason, I believe that CDH is the driving force behind United's (one of the largest CDH providers in the country) move. United chartered Exante Bank in 2002 as part of its efforts to provide an end-to-end CDH solution to its customers. One of its many projects is OnePay, in which Exante establishes a line of credit that is used to pay the member's portion of the cost of treatment. These are then consolidated into a single statement that can be paid directly from a Health Savings Account (HSA), Health Reimbursement Arrangement (HRA) or other account. In the event that a member can't pay the bill immediately, United will deduct monthly payments from his or her paycheck. I have to assume that the adjudication software will be incorporated into OnePay. Depending on how the system is implemented, it might just cause a major shift in provider expectations around the claims process. In other words, OnePay, or something similar from an insurer that licenses technology from United, could be coming to a provider near you in the not-so-distant future.
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