In an effort to offset rising healthcare costs, and subsequently, rising premiums, many employers shifted to High Deductible Health Plans (HDHPs), which now account for 81 percent of covered workers insurance plans.1 Not to mention, deductibles have quadrupled since 2003, and the average deductible for single coverage now surpasses the $2000 mark for most Americans at $2120.2
Hospitals do have options to help mitigate and control this disturbing trend. Below are three ways providers can help reduce uncompensated care: create patient financial risk profiles, combat fraud and create more effective back-end collection strategies.
Create patient financial risk profiles
Predictive analytics at pre-registration can create a comprehensive view of the patient's financial situation. For instance, such analysis draws on multiple external and third-party datasets, which can help hospitals mitigate patient financial risk and find the best financial assistance program for patients.
Combat Fraud
As health care became expensive, fraud and medical theft issues have grown significantly, as the stakes are higher. In fact, fraud costs the health care industry tens of billions of dollars a year, according to the FBI, so combating fraud is another opportunity hospitals can use to help stem their losses. Predictive analysis can also trigger fraud alerts when, for example a patient presents a Social Security number that has been linked to a death certificate. It can also detect red flag alerts and help with compliance audits, enabling medical theft to be identified earlier in the process.
Create More Effective Back-End Collection Strategies
Predictive analysis and automation help make back-end processes more efficient. In particular, automated claims work queue management quickly determines which claims were accepted, denied or are in process.
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As these examples show, hospitals can help improve their collection methods with data-driven strategies. Such strategies can increase efficiencies, and take a proactive approach to fraud and insights to likelihood of payment. Providers can benefit through worker smarter, not harder, and leveraging powerful data insights to protect revenue form leakage and optimize collections. Harnessing the third party data affords the staff the necessary expertise in this patient as payer environment.
Source: Becker's Hospital Review (View full article)
Posted by Dan Corcoran on November 8, 2017 06:31 AM
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