TransUnion Survey Finds Patients Willing to Pay More of Their Bills With Improved Billing Information at the Time of Service - Seite 2

Medical Necessity, another integrated ClearIQ platform feature, automatically validates procedure codes against Medicare and Commercial Payer medical necessity rules. The solution may reduce the provider's financial-risk exposure for denied claims by identifying medical procedures which may not be covered by third party payors, before the provider submits the claim. Medical Necessity also improves patient satisfaction by enabling the provider to deliver transparent pricing information to the patient before the patient receives medical services.

The Medicare industry estimates that hospitals without a medical necessity program face an average of $960,000 annually in denials and an average staff cost of $53-$117 per denied claim to gather information related to the claim denial.

"Now, more than ever, it is critical that providers capture all reimbursements owed to them, given the impending changes to reimbursement structures under the Affordable Care Act and the introduction of healthcare exchanges," said Woody. "A failure to quickly and accurately verify patients' eligibility and benefits on the front-end can lead to costly billing errors and claim denials on the back-end and, ultimately, significant profit loss for healthcare providers and hospital systems."

Lincoln County Medical Center in Missouri will be one of the first hospitals to integrate Medical Necessity with ClearIQ's Patient Payment Estimation, Insurance Eligibility, ID and Address Verification and Propensity to Pay solutions, providing an improved patient financial experience. Lincoln will have the ability to clearly communicate to patients how much they will owe before receiving treatment and provide them with patient-friendly payment options, or financial assistance, based on their unique financial situation.

"We are excited about being able to provide our patients with the most transparent pricing information prior to receiving medical services," said Becky Kinsella, director of revenue cycle at Lincoln County Medical Center. "Combining medical necessity compliance checks with a contracts-based patient payment estimator and propensity to pay information empowers our staff with the tools necessary to educate patients' on their payment options. It also reduces our financial risk for claim denials post-service. We expect this to have a significant impact on our point-of-service collections and net revenue as we will know earlier in the process how much the patient owes, and what procedures will be covered by their insurance company."

TransUnion Healthcare's ClearIQ technology is an exception-based automated decisioning platform, which automates the work steps necessary to process a patient registration and provides the best possible patient financial experience. For more information about ClearIQ, visit: http://www.transunion.com/corporate/business/healthcare/emarketing/clearIQ_landing.page

TransUnion Healthcare
TransUnion Healthcare, a wholly owned subsidiary of credit and information management company TransUnion, empowers providers with Intelligence in an Instant^® by providing data and analytics at the point of need. TransUnion offers a series of data solutions designed to provide greater ease of use, accuracy and transparency in the revenue cycle process thereby assisting providers in lowering their uncompensated care. www.transunionhealthcare.com

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