6 Strategies to Support Revenue Recovery Efforts in 2024

Often, in the emergency department, a significant percentage of patients will present as uninsured despite having insurance. When all is said and done, industry statistics show between 1% and 5% of these accounts will be written off as bad debt despite having eligible coverage.

Why? Because finding active coverage isn’t easy! If a patient doesn’t disclose their coverage, it’s difficult to find the correct payer. It’s also becoming more common for patients to spread their treatment(s) across multiple facilities, which can result in data errors and complicate the reimbursement process.

Share these statistics with relevant team members and ensure everyone knows the cost of lost revenue and the number of accounts that are likely to be written off despite having coverage. Tailoring these numbers to your hospital will help your team understand what’s at stake.

On the flip side, patients who present as insured may have undisclosed additional coverage. Insured patients can be impacted by open enrollment changes and retroactive Medicaid coverage or qualify for Medicaid eligibility and other sources of secondary (and even tertiary) coverage.

Most providers tend to stop looking after the patient’s initial source of insurance is verified. But it’s in the best interest of the hospital’s revenue recovery efforts to conduct an exhaustive search for additional coverage. 

The longer the hospital waits to collect relevant patient data, the harder it is to find the correct payer to bill. Asking for this information in the midst of treatment can be stressful for patients and care teams, so it’s best to gather it as early in the process as possible.

Hospitals that offer online portals allow the patient to provide the information themselves before they even enter the hospital’s doors. Communicating the availability of the portal through email, text and hospital signage empowers the patient to provide relevant data with the incentive of getting their medical bills covered.

If a patient has never entered the hospital before, the portal is less likely to be effective. Work cross-departmentally with hospital registration teams as a backup. Make sure processes and paperwork are in place to gather patient insurance and billing data as soon as possible. 

An estimated 90% of denials are preventable, with many occurring due to simple clerical errors. This means some legitimate claims end up denied by the payer and become uncompensated care.

Instead of accepting these denials at face value, re-evaluate how you handle them. Conduct an exhaustive search to make sure every available payer is identified for a claim and streamline your internal response process.

Some hospitals use outdated, paper-based systems or third-party vendors to manage claims. To avoid allocating high levels of human resources to improving processes like denials management and coverage discovery, automate these tasks instead.

Using revenue recovery solutions can help relieve the burden of resolving uncompensated care cases and help patients avoid self-pay scenarios. Technology can also eliminate human error while reducing the time investment required by your team.

The strategic planning process for the coming year is a great catalyst to implement strategies to improve your financial health. There is no time like the present to investigate new partners and technology solutions to make it happen.