Unbiased Analysis of Today's Healthcare Issues

Medical Billing: Taiwan vs. U.S.

Written By: Jason Shafrin - Jul• 30•12

How long do you think it takes for physicians and hospitals to bill an insurer for a service?  Uwe Reinhardt notes that the answer depends on where you live.   If you are in the U.S.:

In the United States, claims settlement for medical procedures under private health insurance can take up to three months; it takes about three weeks for Medicare. As I noted in my commentary for The British Medical Journal, “private health insurance companies in the United States count themselves lucky if high-priced actuaries can tell them in the middle of the year what the carrier ultimately will have to pay the providers of health care for services rendered in the previous year.”

That seems like a long time.  But is it possible for this process to be completed any anyone?  The answer is yes; Taiwan has already done it.  In Taiwan, virtually all of medical claims are billed electronically.  Further, almost all hospitals and physicians submit fully completed claims forms for encounters with patients within 24 hours of the encounter.

In health information technology, the U.S. has a lot to learn from other country’s systems.

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