As the number of self-pay accounts increases, hospitals and health systems should use technology and data to efficiently identify active insurance coverage, according to Riley Matthews, product manager at ZirMed.
Mr. Matthews shared the following tip with Becker's Hospital Review.
"Since the ACA exchanges started offering health insurance in 2014, more Americans are covered than ever before. The trouble is, patients don't always know what coverage they have. The result is a growing number of self-pay accounts — the No. 1 contributor to bad debt for hospitals and health systems.
"This growing problem is difficult to tackle because tracking down patients' missing or unknown health insurance coverage is time-consuming, costly and can involve multiple functions in the revenue cycle.
"At the front end, patient access staff try to verify coverage before scheduled appointments. If they can't, either the billing staff will write off the accounts, the accounts receivable staff will start the collection process or the accounts are outsourced to a third-party company for collection. Unfortunately, after all this, 49 percent of patient responsibility is written off as bad debt, which negatively impacts cash flow, profit and patient relationships.
"Identifying active coverage faster allows earlier and more complete collection but without the proper data and technology, searching for active health insurance coverage on self-pay patients is like looking for a needle in a haystack. Advanced coverage detection solutions can eliminate manual processes and increase staff productivity while also capturing more revenue. In addition, these technologies help providers to put patients first — increasing patient satisfaction by not only finding coverage they weren't aware of but also avoiding an unpleasant and unnecessary collections process."
Read more about identifying hidden insurance coverage here.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.