Analytics is the Answer to Compliant Coverage Identification

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It’s a dilemma that challenges hospitals, physician practices, labs, and durable medical-equipment companies (DMEs) every day: How do you determine if a patient presenting as self-pay or charity care has undisclosed insurance coverage, without compromising compliance requirements? The liability of self-pay accounts is a growing problem, with providers incurring billions of dollars in losses each year. An American Hospital Association report shows hospitals provided $35.7 billion in uncompensated care (including bad debt and charity care) in 2015 alone. Providers need an aggressive-yet-compliant method for identifying sources of reimbursement in a timely manner, before filing deadlines, and before the only option left for recouping payment is to engage collection agencies a last-ditch strategy with traditionally low returns.

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Spotlight

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