"Estimating benefits is something that we've struggled with from the Stone Age," Reiner said. "As a provider, you've got to decide whether to invest in additional technology beyond just pushing a button and sending a transaction to the payer or screen scraping [capturing computer screenshots and putting them into a database]. We should be so much better than this."
"We need what I would call real-time patient liability estimators—complete interconnectedness between health plans and the clearinghouses and the providers," O'Donnell said. "Patients should be able to log onto a portal to determine their unmet liability, he said, even if that means adding disclaimers that it might not be 100% up-to-date." It's so much better than having someone asking 20 questions to identify your possible out-of-pocket liability that may still be inaccurate."
At a hotel, your bill is computed before you check out—usually they've slipped it under your door in the night. And there's no walking out the door without settling up. So how can technology help hospitals catch up to dentists and hoteliers?
"As we move toward more EMRs, documentation will drive the charges," Reiner said. "If you're documenting a level 3 evaluation and management visit, you know that by the time the patient is ready to walk out the door. That claim could be adjudicated, as with the pharmacy model, and you would know your co-pay is $35. There's no reason that episodic physician visits can't be done like that.