The aged accounts that populate a diagnostics provider’s billing systems are a lot more complicated than they appear. If the appropriate information to bill the claim can be obtained, some accounts have the potential to generate revenue. For example, some accounts would be paid if the correct address information was located. There are patients who have received retrospective coverage for care previously provided that was either rejected or never billed. There are patients who may qualify for financial assistance programs, should they be able to provide their financial information.
These types of accounts overinflate accounts receivables (AR), create extra work for staff, and negatively impact the performance and KPI numbers of the billing department. The lack of access to updated information, an absence of automated processes, and the sheer volume of accounts make working these collections extremely cost prohibitive.
If AR is cleaned up, not only would it have an impact on KPI and performance indicators, it would also produce increased revenues to boost year-end financial performance. Manually resolving the data discrepancies would require significant staffing resources that most diagnostics providers do not have.
To make an end of year data cleanup easier, XIFIN and FrontRunnerHC offer data access capabilities to provide clients with real-time patient demographic and address data. This solution makes use of a variety of databases to cross-reference patient identification records as well as insurance information, helping diagnostics providers successfully clean up their database and generate additional revenues. Diagnostics providers who have performed year-end data cleanups have recovered nearly 20% of the uncompensated care in their AR.
With access to correct demographic and address data, FrontRunnerHC estimates that nearly 20% of self-pay/bad debt accessions can be converted into cash.
Since integrating FrontRunnerHC’s PatientRemedi solution with XIFIN RPM, we have identified more than $3.5 million in net new billable coverage.
Even with minimal data, strong insurance discovery solutions can identify coverage and the associated in or out of network benefits, regardless of the state where the patient resides. Insurance discovery reduces the need for human intervention and the associated workload on your staff. It also assists in maintaining compliance with your government and commercial payors’ rules and regulations.
Note from XIFIN: To learn more about FrontRunner and how its real-time, automated health insurance discovery is helping XIFIN RPM clients collect more revenue, click here.