According to the United States Department of Health and Human Services, hospitals lost an estimated $27.3 billion in uncompensated care in 2014.
Uncompensated care is a multi-billion dollar issue for hospitals because it’s virtually impossible to account for all healthcare coverage upfront due to factors such as system interoperability issues and errors during the registration process.
Our eScan healthcare solution has identified more than $1 billion in insurance payments for its hospital clients. In the last three years alone, eScan has helped hospitals recover more than $500 million in payments for unpaid medical services. Previously, hospitals would have categorized this money as uncompensated care – the sum of a hospital’s “bad debt” and charity care.
Hospitals may also miss coverage due to confusion over status or a missing policy ID that prevents the querying of demographic data. Furthermore, Medicaid expansion, annual enrollment through the Affordable Care Act, changing rules for charity care, and consumer choice are contributing to issues in properly validating insurance.
“When looking to make improvements with our bad debt/charity care processes, we partnered with TransUnion who offered great insights and solutions to help us make the improvements we were looking for,” said Warren Fuller, vice president of finance at Indian River Medical Center.
TransUnion Healthcare provides hospitals with solutions to help discover patients’ coverage that was initially not verifiable or inaccurately captured by hospital staff on the front-end of the revenue process. TransUnion’s products have helped more than 1,000 hospitals and thousands of physician partners identify over $5 billion in uncompensated care revenue, which has now resulted in more than $1 billion in reimbursement delivered to its hospital clients.
I’m very excited to support our hospital clients in recovering significant monies owed to them. This helps them to be more efficient and effective, and put their resources toward their true mission: providing the best patient care possible for the populations they serve. To learn more about eScan, a post-service eligibility system designed to maximize reimbursements and reduce uncompensated care costs for a hospital or health system, visit www.transunionhealthcare.com.
For more on this topic, read our blog posts Digging into the Data: Trends in Uncompensated Care and Tips to Fight Uncompensated Care Losses or visit the TU Healthcare blog feed.
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Uncompensated Care Reimbursements: Navigating the Uncertainties of Worksheet S-10
How Utilizing SDOH Data Can Make a Big Difference in Predicting Risk and Managing Care
FY 2020 Hospital Inpatient PPS Final Rule Update: Worksheet S-10 and Uncompensated Care