Office Ally's Uncompensated Care Checklist [With Actionable Steps]

Uncompensated care costs pose a significant challenge for hospitals and health systems. These costs impact financial standing and the quality of patient care. Of course, eliminating uncompensated care is a long way off in the healthcare industry. However, implementing a proactive approach can significantly reduce these costs.

This comprehensive checklist will help healthcare organizations manage and reduce uncompensated care costs. It will also help boost revenue recovery.

◻ Insurance Discovery: Leverage a Robust Solution

What is the first step in reducing uncompensated care? Ensuring that your team identifies all insurance information upfront is a great start. If a patient does not supply insurance information for any reason and subsequently does not pay their bill, the cost of care will end up as bad debt.

Action Step: Discover Any Undisclosed Insurance Coverage

Use an insurance discovery solution at patient intake. Doing so quickly uncovers any existing but undisclosed coverage. Insurance discovery tools are easy to use and scan available data sources to verify coverage in real time. This process can even be used for patients who present with insurance coverage to identify secondary or even tertiary payers to bill. By finding insurance now, hospitals can cover costs for patients now and down the line for future instances of care.

◻ Financial Counseling: Transparent Communication With Patients

Clear and transparent financial communication with patients plays a big role in reducing bad debt. Why do so many patients avoid seeking care or fall behind on payments? It is often because they don't understand their financial responsibilities or options.

Action Step: Offer Pre-Service Financial Counseling

Patients who understand healthcare costs and the available options for paying medical bills are more likely to pay on time. This reduces the chance of uncompensated care. Pre-service financial counseling sessions empower patients. This important step gives them the information they need to make informed decisions.

Financial counselors can explain payment options in these sessions. They can also discuss insurance coverage and clarify out-of-pocket expenses. Hospitals can also use these sessions to screen for eligibility in financial assistance programs.

◻ Payment Plans: Flexible Payment Options for Patients

Life happens; many patients cannot pay for care in a single installment. When patients can spread their payments out over time, they're more likely to stay on track and pay off their balances.

Action Step: Establish Payment Plans

Flexible payment plans make healthcare costs manageable and reduce patients' financial strain. As a result, they improve revenue recovery for hospitals. Flexibility enhances the chance of full payment, reducing the hospital’s risk of uncompensated care. At the same time, it builds patient trust. Remember, not all patients are created equal. Hospitals may need to take extra steps to determine fair payment plans based on individual circumstances. This may involve establishing internal policies and extra staff training.

◻ Claim Denial Management: Prevent Lost Revenue

Hospitals commonly face costly denials, often losing revenue when they fail to manage them effectively. Errors in submitted claims stall the entire billing cycle and extend the time to collect. Your team must ensure claim accuracy to reduce denials.

Action Step: Enhance Accuracy for Fewer Denials

Hospitals can reduce the frequency of denials by ensuring claims are accurate from the outset. They should establish a review process that flags errors before claims submission. Doing so decreases the probability of a claim denial. Automated software helps prevent human error.

◻ Monitor Uncompensated Care Data

Tracking and analyzing data related to uncompensated care provides valuable trend insights. This information helps hospitals make informed decisions to improve revenue recovery. Monitoring key revenue cycle metrics over time provides the foundation for process changes.

Action Step: Track Uncompensated Care & Revenue Cycle Metrics

Use reporting tools to monitor key performance indicators (KPIs). Focus on KPIs related to uncompensated care, claim denials, and overall revenue cycle efficiency. These key metrics help hospitals make data-driven decisions that directly impact their bottom line. For example, comprehensive reporting shows hospitals where uncompensated care costs are accumulating. Once they see the cause, they can adjust strategies accordingly.

Reducing Uncompensated Care

Navigating uncompensated care requires a versatile approach. Office Ally’s software solutions help hospitals and health systems manage these challenges. Our tools can achieve every action step mentioned above.

Office Ally’s comprehensive suite of digital tools is designed to accomplish your organization's goals. Some features include insurance discovery, screening software, and Medicare underpayment recovery. Our team of experts has perfected these elements to prevent revenue loss. They are also designed to improve patient satisfaction scores and increase staff retention.

Ready to tackle uncompensated care in your hospital? Learn more about Office Ally’s revenue recovery tools here.