In the complex and tedious world that is health care billing, those who pay the bulk of the bills–insurance carriers and health plans–have always had their hands full managing bill payment to physicians practices and hospitals of all sizes and types.

But with the latest trend–consumer-driven health care–taking center stage in recent years, managing bill payment is growing more, not less, complex–even as simplifying bill payment continues within the industry.

Consumer-directed plans typically mean more choices of health plans and providers, as well as more financial risk, for employees and health care consumers. Simply stated, health care users, typically employees and their dependents, must pay for medical services for a defined amount with dollars in a flexible spending account, a health savings account or a health reimbursement arrangement.

Health savings accounts, for example, can be used by workers to pay for routine medical expenses, which count toward the deductible of accompanying catastrophic health insurance. Ultimately, consumer-driven plans shift more of the responsibility for health-spending choices onto the patient.