Live Webinar | Operations and Other Technology
Save
Live Webinar | Operations and Other Technology
Save
Live Webinar | Patient Financial Communications
Save
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

Sign up for a free guest account and get access to five free articles every month.

Advertisements

Related Articles | Technology ROI

Sponsored Content | Revenue Cycle

Reimagine your workforce to help overcome staffing shortages

For revenue-cycle functions, staffing shortage solutions can be found by improving efficiencies through automation and expanding the labor pool with remote and hybrid positions as well as off-shoring partners.

Article | Technology ROI

PMMC’s Contract PRO helps hospitals see an average 10 to 1 ROI

When the time comes to renegotiate payer contracts, one company’s contract management system “provides managed care leaders with the ability to model all commercial payer contract terms to quickly understand the impact on net revenue.”

Article | Technology ROI

PMMC’s Estimator PRO increases pricing transparency and upfront collections

Looking to invest in software? One company uses a patient estimation system, which has resulted in enhanced productivity for more than 500 hospitals with an average 10 to 1 ROI.

News | Payment Trends

Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.