“I really like the provision of the Experian workforce. They’re fast to unravel any challenge and get you again up and working 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 workers. 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 prices 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 overview its charity coverage and processes. After analyzing 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 maintain UCHealth from accruing unhealthy debt.
Answer
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 capacity to pay by going past their reported earnings to take a look at the Federal Poverty Degree ratio and their propensity-to-pay. The expertise used highly effective analytics to create a Healthcare Monetary Threat 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, bettering the affected person and workers expertise and, finally, the underside line.
Uncover how UCHealth secured $62M+ in insurance coverage funds with Experian Well being’s Protection Discovery resolution.
End result
Because of Affected person Monetary Clearance, UCHealth achieved the next outcomes:
$26 million in disbursed charity care.
Greater than 1,700 sufferers lined.
600 charity circumstances 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 document (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 workforce from misclassifying them as unhealthy debt, minimizing monetary losses on the group whereas bettering their total expertise.
Andrew Pederson, Director of Affected person Monetary Expertise at UCHealth, extremely recommends this software program and the workforce that gives it, stating, “I really like the provision of the Experian workforce. They’re fast to unravel any challenge and get you again up and working very quickly.” For suppliers in search of 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 impressive expertise at each step of the encounter.
