Article | Technology ROI

Helping healthcare organizations proactively verify and search for missed insurance coverage

Sponsored by TransUnion Healthcare
Article | Technology ROI

Helping healthcare organizations proactively verify and search for missed insurance coverage

How do you help healthcare organizations navigate the biggest challenges in healthcare?

COVID-19 disruptions, including a surge of unemployment and insurance plan transitions, have led to massive insurance coverage uncertainty. To assist in  overcoming these eligibility challenges, TransUnion Healthcare’s Insurance Discovery solution helps healthcare organizations proactively verify and search for missed insurance coverage throughout the patient lifecycle and stay on top of benefits coordination.

We deliver proven ROI results by converting 1% to 5% of a provider’s uncompensated care accounts to Medicaid, Medicare and/or commercial insurance. Additionally, the solution identifies Medicaid secondary coverage and reviews Medicaid accounts to identify Medicare or commercial coverage that can be billed as primary.

TransUnion piloted the first automated insurance discovery solution over 15 years ago and since then, our solutions have delivered over $7.6 billion in net revenue and cash to our clients — who include over 22% of all U.S. community hospitals.

What advice would you offer to healthcare leaders when choosing among vendors?

To maximize revenue recovery, providers should look beyond the basic insurance discovery features that most vendors can offer. Unlike competitors, our unique data matching technology searches beyond just self-pay. In fact, nearly a third of the revenue recovered by our clients has come from non-self-pay accounts — this is revenue our competitors would have missed. Our patented technology uses over 300 query permutations to continuously search for insurance coverage. We also offer custom reporting tools to help our clients improve their processes in order to capture more insurance through their own processes.

What is some advice you can give providers for a successful implementation of a new product or service?

Implementation is a joint effort. A vendor should be able to clearly communicate best practices, but also know how and when to customize processes. Knowing your specific integration and implementation needs, including desired end-user workflow and data strategy, can help accelerate the customization process and deliver the best overall return on effort. Choose a partner with an open line of communication and willingness to work with you to tailor an approach based on your requirements. A partner should be able to provide a clear and accurate picture of what’s needed — and be eager to support you throughout the onboarding process.

Quick Facts

  • Number of years on teh Short List: 9 years
  • 95% of survey respondents would recommend Insurance Discovery to a colleague

About TransUnion Healthcare

TransUnion Healthcare, a wholly owned subsidiary of TransUnion, makes mutual trust possible between patients, providers and payers by helping them navigate payment complexities. Our Revenue Protection® solutions leverage comprehensive data, accurate insights and industry expertise to engage patients early, ensure earned revenue gets paid and optimize payment strategies. TransUnion Healthcare helps over 1,850 hospitals and 570,000 physicians collectively recover more than $1.2 billion annually in revenue.

To learn more about HFMA’s Peer Review program, visit hfma.org/peerreview

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