Case Research: How UCHealth wrote off $26 million in charity care with Affected person Monetary Clearance


Case Study How UCHealth wrote off $26 million in charity care with Patient Financial Clearance

“I really like the supply of the Experian staff. They’re fast to unravel any challenge and get you again up and operating very quickly.”

—Andrew Pederson, Director of Affected person Expertise, UCHealth

Problem

UCHealth, in Aurora, Colorado, is an built-in system of 12 hospitals and greater than 30,000 workers. When the state of Colorado launched knowledge on non-profit hospital charity care and neighborhood advantages, UCHealth’s spending was decrease than anticipated regardless of having insurance policies on equitable charity care in place. Moreover, the state was about to implement new laws on charity care, setting a cap on expenses for low-income sufferers. UCHealth proactively sought to revamp how they dealt with charity care in preparation for greater affected person volumes sooner or later.

The group determined to assessment its charity coverage and processes. After analyzing different suppliers, UCHealth decided that IT lacked presumptive charity performance early within the affected person encounter. New Technology would assist sufferers keep away from the accrual of unpaid medical payments and maintain UCHealth from accruing dangerous debt.

Resolution

UCHealth added Affected person Monetary Clearance in 2023 after their favorable experiences with Experian Health’s Protection Discovery®and Insurance coverage Eligibility Verification. Affected person Monetary Clearance allowed the supplier a extra nuanced understanding of every affected person’s potential to pay by going past their reported earnings to have a look at the Federal Poverty Stage ratio and their propensity-to-pay. The Technology used highly effective analytics to create a Healthcare Monetary Danger Rating, encompassing historic credit score actions, together with fee of previous medical payments. Importantly, Affected person Monetary Clearance helped UCHealth workers decide choices for monetary help mechanically, with out counting on the sufferers themselves. Automation within the platform reduces time spent per encounter, bettering the affected person and workers expertise and, finally, the underside line.

Uncover how UCHealth secured $62M+ in insurance coverage funds with Experian Health’s Protection Discovery resolution.

Consequence

Because of Affected person Monetary Clearance, UCHealth achieved the next outcomes:

  • $26 million in disbursed charity care.
  • Greater than 1,700 sufferers coated.
  • 600 charity circumstances closed in a single month alone (August 2023).

Total, Affected person Monetary Clearance helped UCHealth create a extra streamlined method to offering charity care to sufferers who want IT. The Technology integrates simply with the supplier’s digital Health report (EHR) system, eliminating the back-and-forth between a number of techniques throughout affected person registration.

Figuring out sufferers who want monetary help saves the UCHealth staff from misclassifying them as dangerous debt, minimizing monetary losses on the group whereas bettering their general expertise.

Andrew Pederson, Director of Affected person Monetary Expertise at UCHealth, extremely recommends this software program and the staff that gives IT, stating, “I really like the supply of the Experian staff. They’re fast to unravel any challenge and get you again up and operating very quickly.” For suppliers in search of to streamline the income cycle, Pederson says, “Get out of your personal approach and simply do IT.”

Study extra about how Affected person Monetary Clearance streamlines affected person charity screening whereas sustaining an excellent expertise at each step of the encounter.



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