Banner|Aetna Health Plan Streamlines Bill Format to Improve Medical Billing

Updated 11/14/2022: The title of this article has been updated to include the Banner|Aetna name. A previous version of the title referred to the plan as an Aetna health plan.

Banner|Aetna has introduced a new medical billing model that the payer expects will streamline billing processes for patients.

The tool aims to provide a comprehensive billing patient experience, as opposed to a fragmented experience. It incorporates an integrated statement.

The format includes four key pieces of billing information. It starts by detailing what the provider billed for a service or product. Then, it explains what the member has already covered, if they have already contributed to the cost. The document shares what the insurance company has covered. Finally, it offers the balance information, so that members know how much they owe.

The statement is available either online or in print format. Banner|Aetna will partner with Banner Health, a nonprofit healthcare system, to implement the billing model. Banner|Aetna leaders expect that offering this solution from the place of a joint partnership is more advantageous for members, since payer-provider misalignment often is a source of complication in billing along with transparency issues.

“In our joint venture model, both insurer and provider have a vested interest in working together,” said Joanne Mizell, Banner|Aetna’s chief operating officer. “In addition, all parties care deeply about members having a positive experience throughout the entire health care treatment cycle. As a joint venture, we have the benefit of complete transparency with our parent companies around data and information, which made it possible to effectively collaborate to develop frictionless billing.”

However, the program is more than bill reformatting. The payer added automated billing and claim payment status updates that are visible to members. The updates include bill creation, bill submission, and bill payment to give members insight into the entire billing process quickly and simply.

Also, members can reach out to a customer service line that is dedicated to answering billing questions for Banner|Aetna members—whether the billing question is related to the provider or insurer side.

“Recovering from a recent illness or hospital stay is challenging enough without the added stress and confusion related to understanding medical bills. That’s why we decided to create a solution that captures all the information patients need in one document, provides a simple status tracker, and provides dedicated customer support for both insurance and provider billing inquiries,” Mizell added.

Payers have taken a variety of approaches in their efforts to simplify billing for members.

Moving providers along the value-based care continuum is one key method of building a simpler system for the future. Health insurance leaders have advocated for offering payment support and technical support, in addition to pursuing primary care transformation and identifying areas for research.

Often, payers also have to rely on vendor partners that offer technological solutions to the payer-provider friction on payment. A KLAS report identified six vendors that payers have leaned on in these efforts.

Other payers have implemented tools that increase price transparency so that members can be aware of what they might pay before they receive the bill. Oscar Health implemented a cost estimator tool that allows members to foresee costs for primary care visits, specialty care visits, and other outpatient services.

But Banner|Aetna is not alone in seeking to rectify billing confusion by reformatting the medical bill itself. Blue Shield of California also updated its billing format to streamline information and allow members to pay in installments.