Tips to Fight Uncompensated Care Losses

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In a recent Becker’s Health Review article by reporter Tamara Rosin, Gerry McCarthy, president of TransUnion Healthcare, shared proven solutions for arming hospitals against bad debt.

According to the United States Department of Health and Human Services, U.S. hospitals lost $27.3 billion uncompensated care in 2014. Although hospitals have systems to assist in identifying patients’ insurance at the point of care, capturing the identified coverage is not always possible. Unable to collect payment for services, hospitals are stuck with uncompensated care costs.

MCarthy noted that between 1 and 5 percent of hospitals’ bad debt is covered by insurance. However hospitals are unable to identify such coverage during the admissions and billing process and the amount of bad debt is increasing.

The question is: How can hospitals ensure collection of dues?

The answer is to improve the eligibility verification process.

Hospitals and health care providers can now access new tools that reduce the losses associated with uncompensated care through implementation of automated coverage discovery programs and patient education.

With TransUnion’s eScan platform of solutions and reports, hospitals can discover additional coverage after all other internal and third-party eligibility processes are exhausted. The coverage discovery solution leverages proprietary technology with hundreds of query permutations to deliver a series of automated and customizable reports that identify billable coverage for accounts that are not or cannot be captured initially. eScan’s platform identifies patient accounts covered by Medicaid, Supplementary Security Income, Medicare, TRICARE and commercial insurance at the time of service, and monitors accounts continuously for up to three years from the date of service.

“Data is processed by running an entire file of all uncompensated care accounts for a hospital against all potential payers. eScan utilizes proprietary technology to triangulate and find coverage for those patients ,” says Mr. McCarthy.

Another solution that helps hospitals identify billable coverage is ClearIQ, a platform that makes the patient registration process simpler and more efficient by automatically providing both the patient and hospital with clarity regarding patients’ financial obligations.

ClearIQ verifies patients’ demographic information through a standard registration interface. It confirms how much money is left on a patient’s deductible and aggregates the patient’s procedure and benefit information to produce a credible estimate of what he or she will likely have to pay out of pocket. ClearIQ runs a financial analysis to see what the patient can afford to pay based on this estimate, allowing hospitals to suggest reasonable payment plans to help ensure patients provide reimbursement for the services provided. Since patients gain more insight and confidence about what they owe up front, they are more likely to understand their financial obligations and hospitals can reduce bad debt.

“Hospitals are working on razor-thin margins, and uncompensated care can be the difference between profitability and not,” says Mr. McCarthy. “Hospitals want to provide the best care for the community. We want to help them achieve their goals throughout the system.”

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. In the last 15 years, TransUnion’s products have helped more than 1,000 hospital and thousands of physician partners recover over $5 billion in uncompensated care, which resulted in more than $719 million in revenue delivered to its hospital clients.

How can you recover uncompensated care costs? For further insights and proven solutions, see the full article and interview with Gerry McCarthy in Becker’s Hospital Review.

If you have questions or would like more information, please call 888-791-3088 or email hcsolutions@transunion.com.

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