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The First Step Any Hospital Should Take in Mitigating Uncompensated Care

UPDATED:
November 14, 2023
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Uncompensated care results in lost revenue that occurs when a hospital provides care and does not receive payment in return. It’s a longstanding problem for providers that has only grown in size. Between 2000 and 2020, uncompensated care in the U.S. rose by a whopping $745 billion.

Since then, uncompensated care revenue loss has continued to climb. The American Hospital Association (AHA) has reported losses in the billions consistently each year. Fortunately, there are tactics hospitals can use to start to reverse this trend.

How to manage uncompensated care

Insurance discovery tools use algorithms and machine learning to conduct an automated, expansive search for any existing insurance coverage a patient may have. Sometimes patients may not realize they have insurance, or may have omitted knowledge of their insurance for any number of reasons. Human error can also make it appear a patient does not have coverage.

To prevent these bills from ending up as uncompensated care, insurance discovery tools cross-reference an exhaustive list of government and commercial payors with patient account data to find active, billable insurance.

Insurance discovery is the foundation of any good revenue integrity program. It is also an easy first step to curve the national trend of growing uncompensated care costs. Quickly finding as much patient insurance coverage as possible helps providers find and bring in revenue that would otherwise remain uncollected.

Introducing: Insurance Discovery

Office Ally’s objective is to identify additional reimbursement opportunities for your organization. Our industry-leading team is constantly evolving and changing our Insurance Discovery solution to keep pace with a fast-moving industry.

If you’re considering auditing your current process and/or confirming existing vendor efficiency, try our 100% comprehensive review of governmental and commercial payors to expand your revenue recovery. To prove our concept will yield higher returns for your organization, we offer a free, no-risk Insurance Discovery assessment.  

This assessment is 100% risk-free. There is no upfront cost, and you only pay if Office Ally’s Insurance Discovery solution helps you recover revenue. Implementation is simple, and results in a complete and trusted back end revenue recovery loop with guaranteed results.

Here’s how it works:

  1. The Office Ally team gets to know the ins and outs of your organization, including its unique needs and challenges.
  2. We work with you to gather a basic file export, just like the one you’ve likely given previous vendors.
  3. Without the need for IT support or heavy lift from the hospital network, our team is able to set up the infrastructure in five days. The final product is a user-friendly centralized portal that makes it easy to manage your solution and view comprehensive reports.
  4. Insurance Discovery automatically does what it does best: completing an exhaustive search for potential coverage among government and commercial payors. 
  5. Office Ally sends a file showing exactly which claims to bill. Within 10-30 days, claims are re-billed with correct insurance, maximizing revenue recovery dollars while minimizing delays for claims submission. 

We keep it simple. If Insurance Discovery isn’t able to  recover any revenue, there are zero costs or fees associated with the assessment. 

Learn more about uncompensated care.

Insurance Discovery: A Case Study

A large health system on the East Coast was looking for a new vendor to audit the efficacy of their existing vendor, which they were concerned was underperforming. Specifically, the company was seeing more self-pay accounts, and trying to recover uncompensated care through the vendor was taking up valuable time and resources. 

The hospital used Office Ally’s Insurance Discovery to conduct a comprehensive review of over 87,000 or 100% of the facility’s self-pay accounts going back 1 year. The return for the facility was significant and swift. A report with eligible claims data was provided to the hospital within 10-days of receiving the initial data file.

Insurance Discovery found 21.2% of the 87,000 accounts already worked by another vendor had active, billable coverage that had been overlooked. In total, Insurance Discovery recouped $3.14 million in payments for the health system.

Get a free Insurance Discovery assessment

Insurance Discovery has helped providers recover, on average, 10-30% of accounts. Our industry-leading team is committed to innovation, ensuring the tool stays up-to-date with the fast-paced healthcare industry. 

After decades of mounting losses, it’s time to take control of the fight against uncompensated care. Take the first step with a free assessment. 

Get in touch! Click here to contact the Office Ally team and set up your free, no-risk Insurance Discovery assessment. 

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