The Obama Administration reports more than eight million people have signed up for health insurance under the new healthcare law, but many of those newly insured are confused. Responses like this are common: “I have my card, now what?” or “I pay my premium, why am I getting a bill?”

Nonprofit advocacy groups and community organizations, such as Community Catalyst, a Boston-based advocacy organization that works with communities in over 40 states, are being flooded with consumer calls questioning their new insurance plans, according to a recent article in the Washington Post. The confusion comes in part because many of the newly insured are low income, have never had insurance, and have little knowledge of the healthcare system. Additionally, many do not understand that despite paying a premium, they will still receive a bill, often after having to meet a high deductible.

High deductible plans shift a large portion of healthcare costs directly to the consumer, who may or may not be aware. Better awareness and education is clearly needed on both health plan details and deductibles. While healthcare providers are moving toward offering more transparent healthcare costs to consumers, they are also, at times, left to educate patients about their financial responsibility for healthcare services.

As the healthcare environment evolves, physicians are shouldering more financial liability to collect for services from patients with these types of high deductible plans. While most consumer businesses can collect payment upfront, that option is not the expectation in healthcare. In fact, the opposite is more standard practice; patients expect to receive services, have their physician bill their insurance, and then receive a bill for the remaining balance. Providers have the opportunity to change the traditional collection model to work with their patients to better understand their coverage and convey the expectation that payment is due at time of service to avoid future misunderstandings about balances.