“I like the provision of the Experian staff. They’re fast to resolve any concern and get you again up and operating very quickly.”
—Andrew Pederson, Director of Affected person Expertise, UCHealth
Problem
UCHealth, in Aurora, Colorado, is an built-in system of 12 hospitals and greater than 30,000 staff. When the state of Colorado launched knowledge on non-profit hospital charity care and group advantages, UCHealth’s spending was decrease than anticipated regardless of having insurance policies on equitable charity care in place. Moreover, the state was about to implement new laws on charity care, setting a cap on costs for low-income sufferers. UCHealth proactively sought to revamp how they dealt with charity care in preparation for increased affected person volumes sooner or later.
The group determined to evaluation its charity coverage and processes. After inspecting different suppliers, UCHealth decided that it lacked presumptive charity performance early within the affected person encounter. New expertise would assist sufferers keep away from the accrual of unpaid medical payments and hold UCHealth from accruing unhealthy debt.
Resolution
UCHealth added Affected person Monetary Clearance in 2023 after their favorable experiences with Experian Well being’s Protection Discovery®and Insurance coverage Eligibility Verification. Affected person Monetary Clearance allowed the supplier a extra nuanced understanding of every affected person’s means to pay by going past their reported earnings to have a look at the Federal Poverty Stage ratio and their propensity-to-pay. The expertise used highly effective analytics to create a Healthcare Monetary Danger Rating, encompassing historic credit score actions, together with cost of previous medical payments. Importantly, Affected person Monetary Clearance helped UCHealth workers decide choices for monetary help mechanically, with out counting on the sufferers themselves. Automation within the platform reduces time spent per encounter, enhancing the affected person and workers expertise and, in the end, the underside line.
Uncover how UCHealth secured $62M+ in insurance coverage funds with Experian Well being’s Protection Discovery answer.
Final result
Because of Affected person Monetary Clearance, UCHealth achieved the next outcomes:
- $26 million in disbursed charity care.
- Greater than 1,700 sufferers coated.
- 600 charity instances closed in a single month alone (August 2023).
Total, Affected person Monetary Clearance helped UCHealth create a extra streamlined method to offering charity care to sufferers who want it. The expertise integrates simply with the supplier’s digital well being report (EHR) system, eliminating the back-and-forth between a number of methods throughout affected person registration.
Figuring out sufferers who want monetary help saves the UCHealth staff from misclassifying them as unhealthy debt, minimizing monetary losses on the group whereas enhancing their general expertise.
Andrew Pederson, Director of Affected person Monetary Expertise at UCHealth, extremely recommends this software program and the staff that gives it, stating, “I like the provision of the Experian staff. They’re fast to resolve any concern and get you again up and operating very quickly.” For suppliers looking for to streamline the income cycle, Pederson says, “Get out of your personal manner and simply do it.”
Study extra about how Affected person Monetary Clearance streamlines affected person charity screening whereas sustaining an excellent expertise at each step of the encounter.