Consent Language: A New Way to Fight Surprise Billing from Hospital Visits

by Sarah Gunter

We know consent is always a good thing, but who knew it applies to healthcare?! Knowing when to use the right language can potentially protect you from surprise billing, which can devastate even the well-insured patient. In fact, around 70% of those filing bankruptcies due to medical bills have “insurance.” Opaque, convoluted practices related to hospital billing is one factor behind this statistic; a lack of transparency coupled with exploitive contracts means patients end up responsible for paying exorbitant and often unnecessary costs out of pocket. And it’s not by accident—Michael Lewis, author of The Big Short, says it best:


“If it wasn’t complicated—it wouldn’t be allowed to happen. The complexity disguises what is happening. If it’s so complicated that you can’t understand it—then you can’t question it.”


         If you think you’re safe from surprise billing, you might want to reconsider. Let’s go over a common scenario. You are admitted to the ER with a life-threatening emergency to an out-of-network provider. But it’s okay, your plan covers emergencies regardless of whether or not the hospital is in network, right? Yes, but the moment your status changes from emergency to non-emergency, you lose all coverage and are responsible for the entire bill with no cap on costs. To receive treatment, you filled out paperwork affirming your consent aaand in doing so, you also agreed to be responsible for any and all costs (hospitals have this nifty little trick of grouping the treatment consent form with the financial consent form, so it’s unclear exactly what you’re agreeing too). So, let’s say after you’re stabilized, the hospital keeps you for observation for a few days (for which, of course, you will be financially responsible). They also want to administer some blood tests to rule things out, just in case. Conveniently, they don’t mention the price, which you only find out is in the thousands when you receive your bill a few weeks later.


Versions of this scenario are frustratingly common, meaning high costs claims are, too. The average allowed claim for an ER visit (including physicians) is over 2,000$!


            Quizzify2Go empowers patients to advocate for themselves with their “Prevent Consent” feature, which provides instructions for using Quizzify’s unique financial consent language. Users can quickly download these passes to their apple wallet, along with a list of important questions concerning their treatment. Quizzify’s compilation of questions ranges over 85 categories, including questions about specific medications, operations, diagnoses, etc. And, the consent language also includes protection against upcoding, another common issue inflating costs. Should the hospital object to the language or contract at any point, Quizzify offers live support. These tools can help dramatically reduce bills, illustrated by a number of testimonies to their success. One user explains, “Following the guidance, I crossed out the entire financial consent and signed 'I consent to charges of up to 200% of Medicare.' This was for CPT Code: 99285 -- 'A comprehensive, high-severity issue requiring collaboration with other attending physicians and posing an immediate threat to the patient.' I was charged $478.’”


            The cost of care isn’t going down anytime soon, and neither are its drivers, including convoluted contracts, a lack of transparency, and price gouging. Quizzify2Go arms employees with the information and language necessary to navigate a system that’s purposely designed to be confusing. As a tool that teaches health literacy, it’s able to both improve health outcomes and cut costs.


We are proud to feature Quizzify on The Granite List.
To learn more, check out Quizzify here.


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