How to Comprehensively Explain a Medical Bill to a Patient

Talking about difficult medical situations and finances can be challenging for anyone. When a patient is suffering or attempting to process a potentially traumatic medical condition, it’s understandable they might get more easily upset or frustrated and have a harder time listening. Still, this is the territory that comes with working as a healthcare professional, and it’s important to be mindful of a patient’s situation when discussing certain topics.

Going over a medical bill, for example, can be incredibly confusing and stressful for a patient. In fact, studies have shown that 72% of patients in the U.S. are confused by their medical bills, which can undoubtedly cause them to be further upset on top of everything else they are dealing with.  Understandably, as a healthcare professional, your day is also exhausting and stressful, but reacting negatively to a patient who is potentially struggling never helps.

While the best scenario would be healthy communication where both the patient and the medical professional speak calmly, understanding that you are both under immense amounts of stress—this is not always the case. And as a healthcare professional, it is ultimately your job to help the patient.

Patients put their trust in you, so it can be upsetting for them when the person they trust is handing them an expensive bill they can’t afford or when their claim gets denied by their insurance. These things can easily damage the trust you’ve built, which can make it hard for the patient to remain calm and understanding.

This article will offer tips and considerations for healthcare professionals to help their patients better understand the medical billing process and how to make the conversation go as smoothly as possible.

Tips for Explaining Medical Bills

The medical billing process is extensive and complex, which is often why it is so confusing for patients. For them, they see things from a very removed perspective—understandably. They are not healthcare professionals, nor do they likely have experience in complex billing processes. So when a bill is much more expensive than they were expecting, it makes sense that they might get upset.

As a medical professional, you understand more thoroughly how the process works and why costs are so high, but the patient does not. So getting defensive is never helpful. It’s important to stay calm and remember that they are not experts in billing, and they are dealing with this stressful financial situation in addition to their medical condition.

Avoid talking down to them as if they are ignorant, but do try to help them understand. It would likely not be helpful to fully explain the medical billing process and how insurance costs work, but you can try to calmly walk them through the basics to help them better understand.

This can involve talking about front-end versus back-end costs, for example. Most patients likely understand where front-end costs come from, but as back-end costs are out of sight, out of mind, those are harder for them to understand.

For a quick refresher on the two, front-end costs are costs associated with patient registration, scheduling, initial patient collections, and administration of the patient’s care and files. Back-end costs are those related to medical billing and claims management and final patient collections.

You can also briefly go over how drug costs work, as this is another factor that can make a patient’s medical bill higher than they were expecting, even if they have insurance.

Additional tips for having conversations with patients about their medical bills include:

• Be mindful of your body language. Your words are not the only thing that can trigger a patient and make the conversation more difficult. How you use your hands, your facial expressions, and your posture can all communicate to your patient how you are feeling or even what you are thinking. So be careful and try to use friendly and open body language.
• Don’t dismiss their feelings. It’s easy to get defensive and treat a patient like they are overreacting, but this will just make the situation worse. Even if you don’t understand things from their perspective, acknowledge that their feelings are valid. Use phrases like “I understand why you’re upset or why this is upsetting” instead of saying things like “calm down” or using negative words such as don’t, can’t, or won’t.
• Be a better listener. Healthcare professionals often have a habit of always explaining things to their patients, and while this is necessary for some situations, it’s also important to let them speak as well. Even if you don’t agree with them or if they don’t fully understand why their medical bill is so expensive, it’s still crucial for you to hear them out and be a good listener. This can show them that you respect them and aren’t just trying to speak down to them.
• Offer them additional help. In some cases, you might need to seek out another coworker for help. If a patient has already decided that you are against them, it can be hard to change their mind. So offer to get someone else that you know might be able to more calmly talk to them. Having another person say the same things you did might also help the patient better understand that you were being honest with them and telling the truth. If available, you can also direct them towards financial programs that can help them handle their medical bills if they are low income and need financial assistance.
• Be kind and compassionate. Overall, the most important thing to remember is to be as kind and compassionate as possible. Kindness really does go a long way. If a patient is upset and being difficult, matching their attitude won’t help. It’s always better to rise above than to sink to someone else’s level, especially when that person is a patient dealing with a potentially traumatic condition. So always try to be as kind and understanding as possible.

Final Thoughts

Just because you are a medical professional doesn’t mean you should be an emotional punching bag for your patients. So it’s understandable that it may be challenging at times to remain calm when dealing with a difficult patient. Still, the calmer, happier, and more positive you are, the more likely your patient will reflect those things in return. Generally, happy staff equals happy patients.

Using health records software (EHR) can also help in situations where in-person communication is going nowhere. With an EHR, patients can return home and more calmly review their records on their own, which can allow them more time to process and potentially come up with more helpful questions that you can then better answer for them later. Just be mindful not to always rely on EHR to do the work for you. It’s important to still maintain a good relationship with your patients, as this can help establish that trust that is so important.