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Shift Your Collections Strategy: Quick Tips to Maximize Reimbursements

Amending your overall collections strategy — to focus more on total collections versus average cost to collect — can help ensure you get the best return on investment.

According to a recent Advisory Board study1, the typical 350-bed hospital may be leaving $22 million on the table by concentrating on cutting costs over optimizing the revenue cycle.

By the numbers

Being fixated on the price of a solution can affect your overall yield. Take a look at the following scenarios:

Hospital System A decided to partner with a vendor that offered an up-front, fixed rate for their insurance discovery solution and projected to uncover $1.4 million in additional revenue. $120,000 was invested in the solution; however, the solution ended up producing only $1.2 million in additional reimbursement, yielding the hospital $1.08 million in net-revenue.

Hospital System B selected a vendor that only collected payment when reimbursement was received. This vendor projected they’d uncover $1.5 million in additional revenue, but ended up delivering $1.74 million, for a total cost of $295,800. This ended up delivering $1.44 million in net-revenue to the hospital.

While Hospital System A invested less money, it didn’t recoup nearly the same amount of revenue as Hospital System B. Here, the old adage that you get what you pay for rings true.

Quick Tip: Perform a long-term cost analysis on total costs compared to total promised revenue recovered. The more affordable partner may yield less desirable results.

Time is money and quality matters

Just as the payment structure for insurance discovery solutions can differ, so can the quality and depth of the results you receive for reimburseable claims. Through your own internal processes, you’re likely able to find up to 99% of coverage. That remaining 1% — which includes the hardest-to-find coverage from self-pay, Medicaid secondary and potential coordination of benefits accounts — can be the difference between a year in the red or in the black.

By only looking at self-pay accounts, you may be leaving significant reimbursement opportunities on the table. TransUnion Healthcare’s solutions dig deeper than other vendors to find more revenue.

When results aren’t properly vetted with an advanced proprietary technology, you may be paying to view inactionable accounts, such as those already found using internal processes, not recoverable or which have already been paid. An organized list saves your team time and money. When it comes to finding coverage, choose quality in addition to quantity.

TransUnion Healthcare’s insurance discovery solutions are designed to deliver value and maximize reimbursements. Learn more about our solutions and how to capture hard-to-find coverage in our quick guide.

1 2017 Advisory Board. You're probably leaving $22 million on the table. Here are 4 things to do about it.  https://www.advisory.com/research/Revenue-Cycle-Advancement-Center/at-the-margins/2017/06/22-million-opportunity

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