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Sequence Wins HHS Challenge to Simplify the Medical Bill

Consider this: is there any other transaction we are engaged in our lives where we actually receive the product or service, and then we walk out not knowing how much we have to pay? This is what happens on a regular basis when most patients walk out of a doctor’s office or a hospital.

We verified this in a survey report we published in the spring, showing that fifty-six percent of patients don’t understand what they will have to pay when they leave the doctor’s office. And what comes after leaving the doctor’s office further exacerbates the confusion. Patients receive bills and seemingly contradictory paperwork from multiple sources and are left on their own to negotiate the labyrinth of undisclosed fees, uncertain payment responsibility and panoply of mysterious billing codes.

So when we heard about a design and innovation challenge put forth by the Department of Health and Human Services (HHS) and AARP that addressed the complex problems that individuals face when navigating the medical billing process, we were all in. The “A Bill You Can Understand” Design and Innovation Challenge was announced in May and Sequence quickly gathered a team to tackle this problem.

When challenged to improve the patient experience of health care bills and finances, we quickly realized the bill was only a symptom of a bigger problem to solve: the way we pay. We decided to take the solution one step further and created a prototype service experience that integrated information and pricing on patient services, payment and insurance and billing resolution.

We’re pleased to announce that Sequence’s submission, a prototype service called Clarify, won the challenge, receiving the award for best Transformational Approach.

The driving force behind the design of Clarify is Sequence’s belief that expectations for user-friendly experiences should be no different for health care transactions than in other aspects of our lives.

Clarify aims to connect patients, providers, and payers together in one place, to eliminate the confusion of three-way transactions. This enables consumers to access previously unpublished service fees, giving them a clearer snapshot of their costs and coverage – before service is rendered. They can pay directly through the app at the time of service or they can pay in advance, while scheduling an appointment, another feature of the app. Providers see fewer missed payments, resulting in improved cash flow and better patient relationships. And by reducing paperwork and policy confusion, payers save money and increase customer retention.

This is no small feat. The disparate nature of today’s health care system is the root cause of this confusing process. For our solution to be realized, we understand that it will take a spirit of cooperation between payers and providers, the willingness to expose hidden service fees, and a systemic change at an order of magnitude far beyond what a well-designed experience can do on its own.

That’s why we were encouraged by the fact that the winners of the challenge have the opportunity to work with health care organizations – including providers and payers – to test and implement our concepts in the real world. And kudos to HHS and AARP for being a catalyst for solving this problem, and bringing together leaders from the private and public sector to drive towards a solution.

To learn more about Clarify, including a video on the prototype service, click here. A big congratulations and thanks to our Customer Experience leads Cheryn Flanagan and Tim Fisher who worked with Jason Moll, Danielle Simpson and Courtney Sabo, all putting in tireless efforts and late hours to design and create this submission.

And stay tuned to our blog as we provide updates on turning this solution into a reality.

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