Transparency about Billing in Nursing

Understanding Health Care Financing

It is important for nurses to understand healthcare financing simply because healthcare is so expensive and patients may not realize the extent of the cost, particularly in emergency situations as when an ambulance may be needed. For many cases, insurance approvals are needed for prior-approval before care can be given; if insurance denies coverage, the patient may be stuck with a large bill that he cannot or will not pay, and the healthcare provider may be left with no income for the service. That is why it is important for the nurse to be able to explain coverage to clients. Doing so can also help to establish greater trust, transparency and good will between the provider and the patient (Gupta et al., 2020). Patients do not like surprises when it comes to billing, so being up front and open about the billing process is important to maintaining patient satisfaction throughout the duration of the patient-provider relationship.

Payment reform is also important in nursing because it directly impacts the operations. Fee-for-service models are shifting in some cases to more value-based payment systems so as to be able to offer care while at the same time controlling costs (Wise et al., 2021). Payment reform also has spillover effects on all patients, because of how it frees up resources, staff, and access to care (Einav et al., 2020).