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In 2018, the number of uninsured rose to almost 28 million Americans. Enrollment in high-deductible plans with and without an HSA more than doubled, and with a new high of 1,579 data breaches in 2017, identity theft continues to rise. Just like that, unknown patient financial status has quickly become your organization’s biggest frenemy. But propensity to pay is here to help.

One of the leading causes for denials is failure to ensure data integrity pre-service. Additionally, return mail, fraud, and lack of ability to steer patients into payment discussions means your back office is absorbing hidden factories of rework. But your organization shouldn’t be taking uncollected cash and broken patient experience journeys in stride. 

It is now vital to your bottom line that patient contact data is accurate and standardized. Demographic data verification enables you to offer the best possible patient support and service, raises red flags for suspicious identities, increases registration accuracy, and reduces lost and unpaid billing statements. 

Although the importance of address verification is often overlooked, it is typically the patient’s first interaction with your healthcare organization. As such, it has a huge impact (both positive and negative) on the rest of the revenue cycle downstream. Verifying your patients’ addresses allows you to reduce costs and potential rework down the line, as well as improve patient communications. 

But that’s not all you can be doing to ensure smooth sailing later on in your revenue cycle. 

With the ever-changing healthcare landscape, health systems are feeling the squeeze of reduced cash flow — no doubt the result of decreasing reimbursements and increasing patient costs associated with rising premiums and copays. In 2014, nearly 20% of consumers had unpaid healthcare bills. That’s why propensity to pay profiles are so important. 

Propensity to Pay, a tool often used in banking to help determine where to focus resources, is becoming increasingly more used in the healthcare industry. And while it does require lots of historic claims data to achieve accurate scoring and segmentation, after implementation it can help both your front and back office determine the next best action to take when faced with a patient balance.

A high propensity to pay result may mean an earlier, pre-service payment discussion with the patient and early-pay incentive discounts to accelerate collection of cash, while a lower score may lead to a discussion of a payment plan option or charity care write-offs. 

Financial Aid Determination can also help with focusing payment discussions. It uses consumer data to determine a patient’s Federal Poverty Level (FPL) percentage to determine if your organization should have a charity application or a screening discussion with said patient, which can, in turn, alleviate bad debt.

3 Tools for the Patient Financial Profile That Save You Money

 

The Wrap Up

Combining Propensity to Pay and Financial Aid Determination tools builds an actionable patient financial profile, allowing your staff to create the ideal patient experience journey while still accelerating payment engagement and cash collection. Adding address verification to the mix increases registration accuracy, decreases denials, and accelerates your cash even more.

See how you can integrate propensity to pay and financial aid determination tools with EligibilityPlus and RegQA by Recondo.

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