Top 10 Healthcare Billing Trends to Anticipate in 2021

healthcare billing trends

Healthcare billing is a force to be reckoned within the USA. With almost next to no free-healthcare options, and insubstantial insurance coverage that is unavailable to most people, patients and consumers have to be constantly alert of changes in the status quo.

In that very spirit, we’ve highlighted the top healthcare billing trends that might actualize themselves in 2021. You can also keep yourself updated by visiting

Surprise billing to be abolished next year

A massive hit to healthcare billing and a win for patients across the USA, comes in the form of Congress recently outlawing surprise healthcare billing. Surprise billing, also labelled balance billing, enabled hospitals to charge patients extra for any care not explicitly covered by their insurance. A leech upon the already shaky American Healthcare System, its outlawing means consumers can have a sigh of relief. Moving on, healthcare corporations and professionals will no longer be able to charge patients extra under the protection of surprise billing.

Healthcare payments shifting to a more digital system

Considering how much the COVID-19 pandemic has shaken healthcare norms, and how much more online patient services have become, payment options might just take a new form as well. Considering how healthcare outlets usually take days to receive payments from insurance companies, new technology at hand and a higher reliance on online methods may just lead to more real-time payment, via the use of AI and algorithms to cut out delays brought on by human factors.

Virtual care is projected to keep rising

Virtual care saw a massive growth across 2020, owing to the pandemic. However, even as things return to normal, this seems like a feature that’ll stay relevant in 2021 and onwards. Healthcare billing itself will also show some projected changes, as online reliance will mean that patients will be able to successfully view bills and address queries from the comfort of their home. Virtual care also allows for hospital staff and doctors to give their patients more time, with factors such as waiting periods and traffic washed away.

Healthcare transparency takes further form

The Price Transparency of Hospital Standard Charges rule, expected to be enforced starting from the 1st of January, 2021, ensures that patients will be able to know how much money is expended for the treatment and services rendered. While hospitals could previously hide beneath the cover of exorbitant, unexplained prices, the new ruling pushed by the CMS will strong-arm them into revealing exact figures of expenditure. This will also mean that patients will be able to more freely contest billing charges and hospitals might be forced to whittle down customer fees to more manageable numbers.

The booming of platforms like GoFundMe as havens for medicinal billing

GoFundMe, a money-raising platform, reportedly has 1/3rd of its online campaigns related to healthcare. Unwillingly or not, the site has become the sole source of comfort for patients across America, insured or otherwise. With insurance companies also projected to provide less coverage, such platforms will only see more and more cases lobbying for help with their healthcare costs in 2021.

Number of patients expected to increase

One thing is for certain. Healthcare as an industry is revving up for a huge boost in the coming years. The ability to treat ongoing diseases such as chronic kidney and heart diseases has only improved. More and more baby boomers and an already massive demographic is entering their 60s and inadvertently stepping into the age-group for such health problems. Combine that with the gen Z demographic lining up to overtake boomers in terms of population growth, healthcare will draw lucrative profits from the years to come.

Asking patients to rely more on phone applications appointments and prescriptions

While not necessarily linked to billing trends, the usage of mobile devices has seen nothing but a steep climb over the past decade, with 2021 projected to keep momentum going. This could lead to hospitals using applications for consumer convenience. The ability to access appointments, prescriptions, refills, and medical records while sitting at home is definitely a plus point for patients. The process of billing the patients and insurance companies itself will also get easier with such tools, even allowing easy and cleaner access to their receipts.

An anticipated rise in healthcare costs might lead to less coverage

This, in contrast to prior points on this list, only spells bad news for patients. The pandemic rocked the healthcare system and forced hospitals and corporations to increase expenditure to compensate for the higher influx of patients, protective gear, and increased amount of testing. Insurance companies also felt tremors, as they would have to pay for customer care and the increased testing. Therefore, in order to make up for hefty losses in profit, insurance companies might change guidelines, giving their customers less healthcare coverage, and forcing them to pay for rather expensive hospital bills themselves.

Patients will be granted more agency and awareness

With the aforementioned rules and regulations being imposed, along with a projected shift to online methods, patients in 2021 will have a much clearer sense of hospital billing and how it works. With consumers also losing hope in the US healthcare system, employers might also give patients more freedom in how their money is expended. Instead of billing for procedures that consumers would rather not take, a shift towards more choice-based treatment might be the way moving forward.

A stricter crackdown on healthcare corporations

Online campaigning against the USA’s healthcare system is at an all-time high. With more transparency and online reliance, these numbers will only keep on rising. What this could lead to, with a very optimistic perspective, are more governmental bills and regulations forcing corporations to narrow down their billing. We’ve already seen these changes projected for 2021 in the form of the aforementioned transparency rules and abolishment of surprise billing. However, healthcare can only become a safe space when the government has further whittled down on unnecessary expenditure.

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About Theresa Duncan

Originally from Detroit, MI, Theresa has been offering health and fitness advice for the last 30 years while working as an engineer. She decided to turn her passion into a profession, and finds nothing more satisfying than helping others reach their health and fitness goals.

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