Solution

Patient Access

Improve the patient financial experience, streamline workflows and increase point-of-service collections

Engage patients early to improve satisfaction and likelihood of payment

As patients become the new payer, it's more important than ever to empower them with clarity regarding the financial aspects of their care. TransUnion Healthcare’s patient access solutions combine accurate data and insights, and leverage industry expertise to provide a comprehensive picture of consumer financial behaviors for improved patient engagement. Our solutions help make mutual trust possible by delivering greater accuracy to patients and providers during registration, and creating a more transparent and positive patient experience overall.

It's a win-win: Patients understand the costs associated with care to make informed decisions, and you get streamlined processes that often result in higher propensity for patient payments.

Patient access solutions to improve profitability

Patient Payment Estimation

Increase payment transparency by enabling healthcare providers to generate accurate, out-of-pocket costs for patients prior to treatment, and allowing consumers to quickly create highly-reliable, online estimates on their own. Our Patient Payment Estimation solution helps:

Enable upfront conversations and better understanding about patients’ financial responsibilities
Increase price transparency
Improve point-of-service payments

woman handing a card to a medical professional

Patient Identity Verification

Improve registration accuracy and collection efforts by verifying patient contact information at the point of service. Our Identity Verification solution validates patient demographic information in real time, and helps:

Confirm patient identity
Reduce mail costs
Help ensure HIPAA compliance

Patient Financial Clearance

Make quick, informed decisions about a patient's propensity to pay or likelihood to qualify for financial assistance during registration and financial counseling. Patient Financial Clearance solutions provide:

More fulsome picture of a patient's identity and monetary situation
Objective, automated charity program enrollment process

mother and daughter handing card to medical professional behind desk

Healthcare Insurance Eligibility

Use Insurance Eligibility to verify patients' insurance — including copays, coinsurance and deductible information — in real time to:

Avoid processing errors and denials
Eliminate costly reworks
Help ensure earned revenue gets paid

Claims Status helps accelerate claim resolution with up-to-date status information.

two women having a discussion while sitting

Medical Necessity

Accurately determine medical necessity prior to service to better inform patients of covered and non-covered services. Our Medical Necessity solution enables you to:

Validate procedure codes against Medicare medical necessity rules and determine diagnoses that pass or fail coverage rules
Generate Advanced Beneficiary Notice (ABN) when needed for patient signature

Social Determinant Risk Attributes

Determine risk factors that can impact population health programs with TransUnion Healthcare’s Social Determinant Risk Attributes. When used in conjunction with your organization’s clinical and claims data, these attributes help provide powerful insights into:

Segmentation
Enhanced predictive modeling
Care management

TransUnion Healthcare's patient access solutions ensure a more stress-free patient experience — helping you and your patients better navigate financial uncertainty.

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Quick Facts

98% of U.S. insured lives covered by our Insurance Eligibility solution*

Serving more than 1,850+ hospitals and health systems

Access to data on an estimated 500 million credit histories

* TransUnion Healthcare analysis

Accreditations

ClearIQ Insurance Eligibility

ClearIQ Patient Payment Estimation
ClearIQ Insurance Eligibility
Revenue Manager

Insurance Eligibility

¹ HFMA staff and volunteers determined that these products met specific criteria developed under the HFMA Peer Review process. HFMA does not endorse or guaranty the use of these products.

TransUnion: Products By Solution

Products For Healthcare Patient Access

All

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Healthcare Authorizations

Verify prior authorization and medical necessity upfront to ensure procedures are approved prior to service

Healthcare Claim Status

Receive timely feedback on outstanding claims, reduce cost-to-collect and improve cash flow

Identity Verification

Improve registration accuracy by verifying patient identity and contact information.

Insurance Eligibility

Verify patients’ insurance eligibility and benefits to increase point-of-service collections