The rise of patient navigators is a sign that medical billing needs to be reformed

To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. Others, eschew this dive bomb approach and prefer to wade cautiously into new experiences. Their comfort zones are narrower. They never break the china, but their personal growth is likely more stultified.

For some activities, we should simply call upon the professionals straight away. Here are some examples of jobs that we should pay others to do for us.

  • Cut down a huge dead tree on our front yard.
  • Replace damaged roof shingles.
  • Investigate why smoke is seeping out of the hood of our car.

I realize that not everyone may agree with my examples above. Many folks, for example, would have no hesitation to scamper up to the roof with a tool belt strapped on to do some reshingling. Have at it. If you ever spot a man on my roof, trust me, it’s not me.

There are some activities that we pay others to do, but we shouldn’t have to. It’s not our fault. Certain systems are so complex and byzantine that a normal individual simply isn’t equipped. Why should most of us have to pay someone to figure out how much we owe the government in taxes? I realize that this absurdity is employment security for the accounting and legal professions, but it indicates to me that the system is broken. The system should be simple enough that we can calculate our obligations ourselves.

Similarly, shouldn’t understanding and paying medical bills be a simple process, similar to paying all of our other bills? When I receive a plumber’s bill, leaving aside that his hourly rate might be higher than mine, I can easily understand the itemized services and how the total charge was calculated. Not so with medical bills. I’m a practicing physician, and I cannot reliably understand my own medical bills. Medical bills occupy a unique universe, which is not governed by reason or logic. I will assume that every reader has had similar experiences.

We need a modern-day Rosetta Stone to decipher our encrypted medical bills. Of course, we can always call our insurance company directly, which is guaranteed to be as relaxing and fun as undergoing a rigid sigmoidoscopy. Also, don’t you love the musical phrase, “please listen carefully as our options have changed”?

Enter the new profession of patient navigators, an emerging occupation that helps the confused citizenry understand their medical bills. We all know of many patients who have stacks of bills awaiting payment from physicians, hospitals, radiologists, pathologists, laboratories, emergency rooms, etc., that would overwhelm the most rugged among us. Grappling with medical billing is to tread onto a treacherous pool of quicksand with no bottom. Leaving aside the Herculean task of sorting through the morass, there is an inhumanity to expect sick or recovering patients to be forced into this maze of madness.

The existence and growth of the patient navigator profession is exhibit A that medical billing needs to be reformed. With all of the nonsensical “reforms” that have been forced onto the medical profession, Obamacare missed a target that was overripe for real reform.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Image credit: Shutterstock.com

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