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Patient Payment Estimation

Increase price transparency and point-of-service collections with accurate patient payment estimates.

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Our market-leading technology and data drive highly accurate and reliable estimates for both healthcare providers and consumers. Our contracts-based engine produces credible estimates from payer-specific negotiated contracts, charge master information, historical charges and patient-specific benefits.

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Patient Payment Estimation

Empower staff to more confidently address payment conversations upfront and improve collection efforts. Simplify the estimation process with an exception-based workflow that offers:

  • Touchless workflow — Automatically process steps necessary to complete a patient estimate.
  • Auto add technology — Automatically add procedure codes normally performed together in estimates, resulting in more accuracy.
  • Facility and professional charges — Combine both sets of charges into one estimate or break them out by group.
  • Medical necessity validation — Determine medical necessity prior to service to better inform patients of covered and non-covered services.
  • Easy-to-understand estimate letter — Help staff better understand and explain benefits and out-of-pocket costs to patients.

Our complementary solutions verify patient identity, eligibility and benefits, medical necessity and patient financial clearance.

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Online Patient Estimation

Allow healthcare consumers to easily obtain meaningful online estimates for improved access to transparent pricing information on common procedures with a self-service, web-based solution that offers:

  • Accurate and reliable estimates — Leverage information from payer contracts, encounters data, charge description master and real-time insurance eligibility verification to produce a credible estimate of patient’s out-of-pocket costs.
  • Simple steps — Guide patients through how to quickly create an estimate on the provider’s website.
  • Mobile compatibility — Accommodate various screen sizes and devices through a responsive user interface.
  • Adherence to the 2021 CMS Price Transparency mandate — Meet both provisions required, including ability to search for 300 shoppable services and the machine-readable, hospital standard charge file.
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Patient Engagement and Financing

Give patients more transparency and control over their medical payment options. Our unique partnership with VisitPay, empowers patients by offering:

  • Upfront views of costs associated with care.
  • Consolidated monthly bills and payments across household accounts in a single statement.
  • Customized payment options based on patient preference and financial ability.
  • Targeted patient engagement and adoption campaigns.
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