Identify hard-to-find health insurance coverage to maximize reimbursements
Maximize reimbursements from uncompensated care and underpaid accounts. TransUnion Healthcare’s market-leading methodologies scale to meet all insurance discovery needs, including complex cases involving multiple commercial and government payers. Our insurance coverage discovery solutions explore all possible avenues to identify hard-to-find coverage from third-party payers — resulting in a healthier bottom line.
Our robust insurance discovery platform helps identify incomplete, inaccurate or missing patient data to find maximum coverage for hospitals and health systems. This scalable offering delivers automated, customizable reports that identify billable government and commercial coverage.
Through built-in revenue cycle analytics, we find and prioritize black hole accounts, track KPIs for improved staff management and help reduce A/R days. These analytics are delivered directly through an interactive dashboard.
This insurance discovery solution can convert 1 – 5% of a hospital’s uncompensated care accounts.
Our insurance coverage discovery solution for hospitals and health systems:
This solution has industry-backed validation — it’s HITRUST CSF® certified, KLAS© reviewed and HFMA© Peer Reviewed1.
Maintaining complete and accurate demographic and insurance benefit information for patients — especially with EMTALA — can be a challenge, which can lead to lost revenue. Our insurance discovery solution identifies money owed to you from third-party payers by providing you with quick coverage results. This means less process disruption and strain on staff.
On average, our insurance discovery solution for ambulatory converts 5 – 7% of uncompensated care accounts to Medicaid, Medicare and/or Commercial insurance.
This insurance discovery solution is able to:
AMCs see large volumes of complex, high-dollar medical claims which can be at greater risk for lost revenue. Our Revenue Assurance solution — specifically customized for AMCs — goes beyond traditional insurance discovery to address complex billing issues head on and obtain the hardest-to-reach revenue. Through a combination of market-leading proprietary software and expert knowledge of billing processes, regulations and the revenue cycle, we won’t stop searching for additional payment opportunities until all avenues have been thoroughly reviewed.
Nearly two decades of extensive billing, regulatory and patient accounting system expertise for AMCs.
Revenue Assurance helps AMCs improve their net revenue:
Healthcare providers miss reimbursement opportunities due to complexities in verification and post-service processes. Emergency department visits, an unscheduled EMTALA setting, can further complicate the verification process. With TransUnion Healthcare’s streamlined, batch insurance discovery solution, you can offer your provider clients quick, accurate insurance coverage results to help:
5 – 7% of all uncompensated care accounts have billable third-party coverage unknown to the provider or its vendors.