Patient Anger and Churn from Surprises When Verification Is Wrong or Not Communicated

$800–$1,200+ per Medicare‑treating provider per month from patients discontinuing care after surprise bills, plus frequent write‑offs of non‑covered maintenance services to avoid patient complaints and negative word‑of‑mouth. • $800–$1,200+ per provider per month in lost care when patients stop rehab early or leave the clinic after surprise rehab bills, plus frequent discounts or write‑offs of uncovered rehab codes to calm conflicts and protect online reviews. • $800–$1,200+ per provider per month in lost future care from 2–3 patients churning or cutting care after surprise balances, plus lower collection rates and staff time spent handling complaints, re‑explaining benefits, and negotiating or writing off disputed charges.

Billing Specialist relies on verbal payer conversations without documented proof; stores benefits in mental notes or unstructured email threads; uses previous patient files as template without re-checking current plan year limits; no automated pre-authorization tracking • Calling Medicare or using portal eligibility, jotting a quick note like ‘active, pays 80%’ on paper or in a free‑text EMR field, then relying on experience and memory to verbally warn patients about coverage limits without a standardized script or signed acknowledgment. • Coordinator calls Medicare or uses publicly available online tools but does not systematically document Medicare-specific limits; unaware that Medicare only covers manipulation under specific diagnosis codes; may assume all chiropractic is covered; does not pre-verify prior authorization if required; documentation in paper or unstructured EMR notes