Challenging a Medical Bill Usually Pays Off, Study Finds

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Nearly 8 in 10 people who challenge a medical bill — 78% — end up getting the charges lowered or removed, according to a recent survey by Akasa.

The company — which bills itself as a “leading developer of AI for healthcare operations” — asked YouGov to survey more than 2,000 Americans and ask whether they ever had challenged a bill.

Nearly two-thirds — 64% — said they had not. But among those who did fight the validity or accuracy of a bill, an overwhelming percentage prevailed in having the charges at least partially reversed.

The survey also found that two groups of people were especially likely to challenge their medical bill at some point:

  • Those with high-deductible health plans (45%)
  • Those with Medicare Advantage plans (43%)

Akasa notes that people with these two types of health coverage are most likely to be responsible for large out-of-pocket expenses compared to people with other types of coverage.

In a summary of the company’s findings, Amy Raymond, vice president of revenue cycle operations at Akasa, says too many patients who get surprise bills have been “conditioned not to question or challenge medical bills”:

“While providers need to take a close look at their revenue cycle department to prevent those billing mistakes in the first place, we also need to drive awareness among consumers that they can indeed push back on a bill that is simply incorrect.”

Although those who challenged bills were usually successful, things didn’t fall in their favor overnight. Among survey respondents, 27% said it took one to three months to resolve the issue.

An additional 18% said it took three to six months to reach resolution, and 16% said it took more than six months.

Raymond says those numbers are a reminder that it often takes “a lot of time and energy” to resolve such disputes in your favor. While the effort is still worthwhile, she says health care providers need to take the initiative to make sure such disputes don’t arise in the first place.

In the summary of survey findings, she says:

“To prevent sending incorrect bills — and lower the time it takes to resolve a mistake — hospitals and health systems need to focus on streamlining inefficient, manual, and error-prone processes and workflows in the revenue cycle. Automation technology can help with that by ensuring work gets done accurately every time.”

For more on fighting back against medical bills, read: