SurePayHealth® delivers an accurate statement of patient financial responsibility at point of service, and calculates statements based on chargemaster and payer contracts. SurePayHealth verifies identity, eligibility, benefits, co-pays, co-insurance, deductibles, and out-of-pocket totals. Hospitals using SurePayHealth collect millions of dollars annually prior to or at point of service.
More patients are presenting for service with high deductible Commercial Health Insurance, Consumer-Directed Health Plans, or High-deductible Health Savings Accounts. Recondo offers a unique approach for helping providers calculate and present an accurate statement of patient financial responsibility at Point of Service and helps hospitals collect that money prior to service.
SurePayHealth accurately calculates how much of the statement is owed by the patient and that calculation is available to the provider and patient before care is delivered. SurePayHealth provides the calculation and statement in real-time and is fully automated.
Today SurePayHealth is helping hospitals and other providers across the US to verify patient identity and insurance eligibility, and to calculate an accurate patient statement at Point of Service. By ensuring data quality on the front end of the revenue cycle, hospitals can reduce back-office rework as well as full time employees required to manage bad debt and write-offs.
As soon as a hospital elects to use SurePayHealth, Recondo experts gather the 837 Claim Submission and 835 Claim Payment Electronic Data Interchange (EDI) transactions and load them into the SurePayHealth rules engine.
SurePayHealth uses those transactions to create analytical reports showing the payer mix, accuracy of claims submitted against claims paid, as well as of analytic claims reporting.
Unlike other analytics services, SurePayHealth takes 837/835 transactions in any format: EDI, other electronic file(s), embedded in emails, or paper copies. Recondo can quickly load these various formats into the SurePayHealth rules engine and immediately create useful and meaningful reports.
Financial Assistance™, a component of SurePayHealth, helps patient access staff and financial counselors determine a patient's likelihood to qualify for charity and Medicaid. As with all Recondo services, Financial Assistance automates the patient encounter prioritizing each encounter and helping staff work accounts by exception, rather than manually evaluate every account.
During the eligibility process, Financial Assistance automates the assessment of Medicaid eligibility. Using advanced ReconBot® technology, Financial Assistance automatically checks the respective state Medicaid website and determines if self-pay patients are currently enrolled in that state's Medicaid program. For patients who aren't currently enrolled, Financial Assistance automates the patient encounter by displaying a series of questions to determine if that patient meets any qualifying criteria, then linking the financial counselor to either that state's online or paper application.
Owing to the increased requirement for nonprofit hospitals to demonstrate charity in excess of bad debt, hospitals must identify and substantiate a patient's likelihood to qualify for charity. Financial Assistance incorporates a proven indicator of a patient's ability and willingness to pay, allowing the hospital to shrink risk probabilities by analyzing charity programs for high-risk patients. This indicator is particularly helpful if a patient chooses not to participate in the charity evaluation process, which leaves the burden on the hospital to prove the patient's balance can be written off to charity, as opposed to bad debt.