Insurance discovery: The revenue recovery tool your organization needs

For many healthcare organizations, strong financial performance requires more than clean claims and efficient patient payment processes. A commitment to efficiency, accuracy and ongoing innovation are also essential for a healthy bottom line.

To help capture every dollar earned, many healthcare leaders are adding coverage discovery software to their revenue cycle management toolbox. When executed well, this can lead to better financial outcomes – just one of the many benefits possible with an effective discovery approach.

The following is a closer look at three key results available by implementing a strong coverage determination strategy.

Maximize reimbursements

It’s no secret that having multiple streams of income supports positive financial performance. By better identifying additional billable insurance coverage from third-party payers, providers can create an innovative new way to realize revenue.

To best leverage this channel, it’s worth going beyond the traditional practice of tracking down missed revenue opportunities manually after the point-of-service. Instead, a technology-driven approach can uncover missed insurance on self-pay patients, charity or bad debt in a more simple, effective way.

In fact, providers using ABILITY COMPLETE Coverage Discovery, on average, receive an additional 20% of insurance identification1 to maximize reimbursements. They’re better able to identify additional coverage for Medicaid, Medicare and commercially insured patients, capitalizing on both primary and secondary coverage to most accurately bill for – and receive – payment.

Simplify the intake process

As beneficial as coverage discovery can be for recovering bad debt, it’s also effective for front-end improvements. When staff is better equipped to identify all applicable coverage – primary and secondary, public or commercial – the lifecycle of each claim is likely to be shorter and smoother.

Additionally, the time that would have been spent re-working each inaccurate claim or tracking down the potentially lost revenue afterward, is now saved.

Improve the patient experience

By easing the financial burden on patients, better coverage determination allows healthcare providers to improve the overall care experience.

Identifying coverage helps providers create relief for patients who may be dealing with personal financial challenges. It’s a welcomed addition, considering 14% of Americans live in a household facing challenges with paying healthcare bills2 and an estimated 39% of Americans aren’t able to pay a $400 emergency expense without taking out a loan.3

Take the first step to better results

When viewed holistically, effective insurance discovery is about much more than improving short-term finances. It’s a strategic method to ensure better long-term outcomes across your entire organization, from care delivery to revenue cycle management

To learn how ABILITY COMPLETE Coverage Discovery can help your organization succeed, contact our team at 866.662.0512.

 

Sources:
1ABILITY internal reporting; average of customer results.
2 “Problems Paying Medical Bills, 2018,” Amy E. Cha and Robin A. Cohen, National Center for Health Statistics at the Centers
for Disease Control and Prevention, February 2020, https://www.cdc.gov/nchs/data/databriefs/db357-h.pdf
3 “2 ways hospitals can help Covid-19 patients with their bills (without suspending billing),” Rachel Matthews, Advisory Board, March 30, 2020, https://www.advisory.com/research/revenue-cycle-advancement-center/at-the-margins/2020/03/covid-19-billing

 

ABILITY and design®, ABILITY® are trademarks of ABILITY Network, Inc.

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