Patients like their care, but they say billing is a disaster

Patients may give their physicians high marks, but that goodwill tends to disappear when the bill arrives. A data brief from Tellex, a patient-experience intelligence company, scored patient sentiment on billing for all 48 contiguous states and Washington, D.C., and found that not one of them reaches 2 on a 5-point scale.

The analysis draws on more than 1 million billing reviews across 68,942 care locations. Those reviews are part of a larger body of 40 million first-hand patient accounts collected from public reviews, forum threads, comments and staff posts. Nationally, billing scored 1.75 out of 5, and 84% of what patients wrote about it was negative. California posted the best score at 1.87, while Wyoming came in lowest at 1.61. Overall satisfaction told a very different story, with every state scoring 3.79 or higher.

The gap matters for practices because billing shapes how patients judge their providers. Medical Economics has reported that patients weigh the billing process when choosing a provider, and that rising out-of-pocket costs are driving billing confusion and delayed care.

Tellex notes that its scores reflect how billing feels to patients, including the confusion, surprise charges and phone loops, rather than billing accuracy, pricing or fraud. Even so, the pattern held in every state and across the full range of care locations.

Here are the key findings: