Identifying & Securing Funding for Uncompensated Care
Since 2000, hospitals of all types have provided more than $367 billion in uncompensated patient care.* The amount of uncompensated care has increased incrementally by more than a billion dollars each year for the past 10 years, leaving no organization immune to the pervasive impact of care gone unpaid. There’s no doubt your organization is missing crucial dollars at the bottom line each and every month of the year.
This problem is so large and so familiar, there’s a perception that all hospitals can do is write off the uncompensated services and carry on. However, there are ways to right the wrongs and fight bad debt. With today’s technology and a range of programs for underinsured and uninsured patients, you can identify and secure funding to fill in at least some of the blanks on your bottom line.
1. Start at the beginning
Begin the conversation about payment at the first point of patient contact whenever appropriate, going beyond basic insurance verification to offer education about payment options and explore possible coverage opportunities. Let patients know right away that you offer payment plans and online and over-the-phone alternatives for their convenience. The more patients are informed, the more likely they will be comfortable to take action when the time comes.
2. Be the patient’s advocate
Remember that patients are typically unfamiliar with the workings of the healthcare system, especially the financial side of matters. Assume the role of leader, offering guidance and helpful ideas and information to patients who want to pay but may think they are unable to do so. Prioritize financial counseling and payment flexibility so that you can be an ally and advocate to patients.
3. Shine the light on coverage options
Many patients may be eligible for some kind of coverage yet not even realize it. Recent studies by the Foundation for Health Coverage Education (FHCE) found that nearly 80 percent of people surveyed who came into an Emergency Room were eligible for a publicly funded program, while 20 percent qualified for private coverage (including COBRA plans). As the provider organization, you should have and become nimble in using resources for identifying public and private coverage, as well as in helping patients enroll for coverage for which they are eligible. A good tool to start with is FHCE’s Health Coverage Quiz found at coverageforall.org.
4. Use data to manage bad debt
Use financial data you collect about patients to manage the risk of uncompensated care. With specific, detailed intelligence, you may be able to tailor interactions to garner more payment while putting patients at ease. For example, track patients by length of stay and frequency of encounters to identify those accruing more burdensome debts. Flag patients who have limited or high deductible coverage as they will be facing large out-of-pocket costs. In these cases, provide specialized financial counseling upfront and perhaps even wellness solutions after discharge to aid in the minimization of the need for prolonged care.
5. Don’t go it alone
Combating uncompensated care takes time and resources that you and your staff may not have to spare, though the effort is well worth the investment. Rather than increase staff, you can outsource your up-front eligibility screening, coverage enrollment and back-end reviews for undiscovered eligibility. Chamberlin Edmonds®, an Emdeon company, is a recognized industry leader and offers a range of tools, services and technology delivered turnkey to your organization, vastly reducing uncompensated care. Chamberlin Edmonds’ solutions work as an extension of your organization to seamlessly help capture compensation you might never have secured on your own.
Ready to fill in the blanks on your bottom line? Visit www.emdeon.com/eligibilityandenrollment today to explore solutions that will really add up for your organization...and your patients.
*American Hospital Association
Fill in the Blanks on Your Bottom Line
Will You Be Bracing or Facing Increased Demands in Patient Access?
Tips for Being Prepared for Changes Coming in 2014. By Blair Baker, Emdeon
For hospitals and institutional healthcare providers, 2014 is a pivotal year. That’s when a range of requirements related to the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Patient Protection and Affordable Care Act (PPACA) kick in. From meaningful use of Electronic Health Records (EHRs) to major changes in third party reimbursement, providers are at the forefront of the quickly evolving business of healthcare, starting with growing demands for the patient access process.
Of course, this year—2013—is equally as pivotal as the year to follow. The time is now for hospitals to bring on and integrate updated technology to be ready when the 2014 deadlines come. If measures aren’t taken immediately, providers stand to miss out on vital opportunities to capture the fullest and most complete patient data and revenue possible.
With 2014 in the not-so-distant future, are you bracing for the coming changes or are you ready to face them confidently?
If you’re presently leaning toward the “brace” position, it’s not too late. There are solutions that can be implemented relatively quickly, efficiently—and affordably—to empower your organization to face 2014 with confidence. Simply put, the best route to preparedness is to outsource services and upgrade technologies.
As your internal costs increase and time starts to dwindle, it’s best to turn to a vendor with the expertise and integrated services you can leverage for aspects of patient access. Outsourcing reduces your costs of human capital and can offer a maximum financial investment because you benefit from the advanced, turnkey technology that someone else has developed.
Emdeon is typically able to accomplish core aspects of patient access more efficiently and at lower cost compared to the expenses incurred by customers who attempt to purchase and manage solutions without the assistance of a third-party vendor. The right solutions for patient access can help hospitals run more efficiently by enabling them to reduce patient wait time, manage staff and collect payments promptly, resulting in increased cash flow. And all this happens on a single, consolidated budget line that packages service and technology costs together.
Of course, patient access is just one piece of the puzzle. There are several other aspects of the business of healthcare for which outsourcing is the way to go. Look for more ideas to help propel your organization to 2014 and beyond in our next issue of Emdeon Compass.
About Blair Baker
Blair is Director of Product Management for Emdeon's Provider Services. He has over 11 years of Healthcare IT experience in developing payer connections and system integration as well as product management and business operations. For more than 10 years, Blair focused on Healthcare Revenue Cycle Management, leading teams through implementation and integration for large hospitals, health systems and physician practices nationwide. He’s a Certified Patient Accounts Manager (CPAM) and a graduate of Indiana University.
Emdeon Awarded Health and Human Services Contract to Define Process for Electronic Healthcare Transaction Standards
Project to test HIPAA and ACA electronic transaction standards to identify and correct technical issues prior to adoption by HHS
Emdeon has been awarded a contract to define the processes and tools needed to move electronic healthcare transaction standards to a new version. Under the contract, Emdeon will develop and execute an analytical methodology for the Centers for Medicare and Medicaid Services (CMS) to estimate the industry impact of moving to a new version of electronic transaction standards. The recommended process will be submitted prior to the standards development organization proposing adoption by the U.S. Department of Health and Human Services (HHS) to the National Committee on Vital and Health Statistics.
The purpose of the project is to define the activities when new HIPAA and ACA transaction standards are adopted to avoid the implementation issues that have been associated with revised transaction standards in the recent past. According to CMS, the intent of the project is to greatly reduce the likelihood of technical issues going undetected until after the standards are adopted and to eliminate the negative impacts such technical issues would have on the healthcare industry. Under the terms of the agreement, Emdeon will analyze the functionality, usability, interoperability and business usage of a sample of draft versions of HIPAA standards for the following healthcare transactions: claims, claim status, claim payment/remittance advice, eligibility and referral authorizations, as well as any new standard that HHS may consider for adoption during the term of the project.
"We are pleased to work with HHS on such a high-visibility project and lend our industry experience to help avoid costly implementation interruptions that could potentially save the healthcare industry millions of dollars," said Debbi Meisner, vice president of regulatory strategy for Emdeon. "As the single largest clinical, financial and administrative health information exchange in the U.S. healthcare system, Emdeon's extensive experience will enable us to identify and correct potential technical issues during all phases of the transition to a new version of the transaction standards."
Read more about this initiative.
Attend an Upcoming Webinar!
Collaborative Team Building to Optimize Medicaid Enrollment
In this session, Sky Lakes Medical Center will share their experiences and strategies for optimizing eligibility verification and enrollment for qualified patients to improve the providers’ bottom line.
Register now to attend March 27th, 12–1 CDT to hear more about this topic!
Speakers
Kara Kaefring
Director of Patient Access
Sky Lakes Medical Center
Ezra Segura
Regional Vice President of Operations
Chamberlin Edmonds®, an Emdeon Company
After This Webinar You Will Be Able To:
• Build a collaborative team designed to share and reapply eligibility and enrollment best practices
• Describe why most patients who are qualified for government and charity care won’t ever apply without your help cutting through the red-tape
• Discuss how to put staff and workflow processes in place to assist indigent patients in qualifying for public assistance programs
Strategies to Conquer Returned Mail Issues to Gain Real ROI
In this session, Jason Bailey with Holland Hospital will share strategies providers can use to streamline return mail management and even eliminate 100% of return mail handling by routing undeliverable mail to Emdeon’s processing facility.
Register now to attend April 9th, 2-3 CDT to hear more about this topic!
Speakers
Jason Bailey
Collections and Customer Service Coordinator
Patient Financial Services
Holland Hospital
Trish Darcy
Product Manager
Emdeon
After This Webinar You Will Learn About:
• Strategies for preventing undeliverable mail
• Automated alternatives to a hands-on, piece-by-piece approach
• The hidden impact of undeliverable mail on your A/R days
Streamlining Eligibility to Offset the Impact of Reduced Medicaid and Medicare Disproportionate Share Hospital (DSH) Program Payments as a Result of Medicaid Expansion
In this session, Slidell Memorial Hospital will share strategies providers can use to streamline Medicare eligibility and enrollment at their organization to maximize revenue.
Register now to attend April 24th, 2–3 CDT to hear more about this topic!
Speakers
Cathleen Gebo
Director, Patient Accounting
Slidell Memorial Hospital
Amy Doyle
District Manager of Operations
Chamberlin Edmonds, an Emdeon Company
After This Webinar You Will Be Able to:
• Understand the myriad of changes to Medicaid eligibility guidelines
• Estimate the number of patients in your community that will be newly eligible for Medicaid
• Identify where your state currently stands since each state's decision to participate is in the hands of the nation's governors and state leaders
Emdeon in the News
6 Healthcare Revenue Cycle Management Systems to Watch
Healthcare professionals look to the latest RCM platforms to help them process patients efficiently while satisfying new regulations. Read more.
Why outsource? Enhance the revenue cycle with third-party eligibility and enrollment specialists
As hospitals continue to struggle with declining reimbursement rates and an increasing self-pay population, many have begun outsourcing their eligibility and enrollment programs. Read more.
Million Dollar Metrics: KPI That Build the Bottom-line
Eligibility and enrollment programs at hospitals and health systems are often a costly mess. Fixing these problems can come down to setting the right metrics and monitoring the data in real-time. Read more.
