By Bill Bunker, Executive Vice President, SCI Solutions
Since 2000, hospitals have provided more than $459 billion in uncompensated care to their patients, according to the American Hospital Association (AHA). Uncompensated care is an overall measure of hospital care provided for which no payment was received from the patient or insurer. In 2013 alone, hospitals wrote-off $46.4 billion or 5.9 percent of their total expenses.
While these numbers are staggering, they are actually an improvement from years past. A projected $5.7 billion drop in uncompensated care for 2014 is expected thanks to the Affordable Care Act, according to the Department of Health and Human Services. (Data for 2014 still to be released). Contributing factors include wider healthcare coverage and Medicaid expansion states. Despite the $5.7 billion saved, there is still approximately $40 billion remaining that hospitals will write-off as uncompensated care this year.
With the expansion of healthcare coverage, there is a huge opportunity for hospitals to reduce write-offs through more efficient insurance authorization processes. By identifying and obtaining accurate authorizations prior to a patient’s appointment, hospitals are more likely to get paid and avoid extra operational costs down the road, such as appealing denials or seeking collections.
However, determining when and how to obtain authorizations in an increasingly complex payer landscape can be confusing and resource-intensive. Clarity Health is helping hospitals and practices reduce write-offs by quickly delivering consistent and accurate authorizations prior to a patient’s appointment to ensure a higher payment rate.