ELYRIA, OH – EMH Regional Healthcare System and Columbus Regional Hospital will tackle bad debt issues using TransUnion’s Healthcare Revenue Cycle Platform, which is designed to streamline problem areas in registration and collection processes and save money.
Executives at EMH, a 434-bed non-profit hospital system with campuses in Elyria, Amherst and Avon, Ohio, recently noticed a margin squeeze as a result of increasing patient liability for services.
Indiana-based Columbus Regional Hospital, a 325-bed hospital serving a 10-county market area in south-central Indiana, felt the pinch in another area – medical bills sent to the wrong address.
TransUnion’s HRCP is a Web-based solution designed to streamline hospital systems’ admission processes by helping staff verify patient identities, make objective payment determinations and match patients with assistance programs and charity care.
According to Philip Wells, director of Patient Financial Services at EHM, the hospital has experienced 17 percent growth in uncompensated care while reimbursement remained flat over the past two years.
“Over the last two decades, we successfully kept bad debt expense to a minimum,” he said. “However, recent changes in the local economy and the growing share of patient liability for services resulted in escalating delinquencies. To keep prices competitive while providing the service our patients have come to expect, we realized that we needed to reduce the financial impact of growing bad debt.”
TransUnion’s HRCP verifies a patient’s identity at the point-of-service by matching addresses, phone numbers and other contact information against its database to ensure the information the patient provides is accurate. HRCP also helps hospital registration staff determine a patient’s financial resources, including private or public insurance coverage, co-payment, deductible responsibilities and benefit limits. If the patient qualifies for charity care, then the appropriate forms are populated.
“Although we looked at several solutions, we selected TransUnion’s HRCP because we liked its real-time access to data and built-in charity determination,” said Wells. “By objectively and quickly identifying those patients who qualify for charity care that would otherwise be considered bad debt at the point of service, we’ll benefit in three ways. First, we can protect those unable to pay and our non-profit status. Second, we’ll significantly reduce administrative work involved in processing charity applications. Finally, we can identify those with an ability to pay and improve our collections.”
By being able to verify patient identities, the hospital can also reduce returned mail. Wells says 5 percent of the population EMH serves is uninsured, but represents 55 percent of the bad addresses in the hospital’s database. By confirming a patient’s identity at the point of service, the hospital will be able to reduce the occurrence of medical bills sent to wrong addresses and subsequently write that care off as bad debt.
Before turning to TransUnion’s HRCP platform, Columbus Regional Hospital found that it was processing approximately 250 pieces a month of returned mail.
“TransUnion’s Healthcare Revenue Cycle Platform is to assist us in the conversation we have with the patient during registration,” said Susan Rust, director of patient financial services for Columbus Regional Hospital. “We are focusing our efforts on the ED where we have the majority of returned mail and see many patients without insurance or insurance information on them. Patients are often distressed when they come to an ED or have no other means to get medical assistance. The use of TransUnion’s HRCP is to help us identify if the patient is someone that we should talk with about public assistance, and provide an application for assistance through the hospital or special payment arrangements.”
Rust says a financial counselor in the ED checks the TransUnion information on private pay patients and talks with patients as they leave the ED to establish payment arrangements or collect insurance co-payments. Medicaid eligibility specialists employed by the hospital assist patients in the Medicaid application process, she said.
She said the hospital has found that patients have become accustomed to the ED financial counselor and are appreciative of assistance offered.
Columbus Regional Hospital expects to see results from this initiative in about three to five months.