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Revenue Cycle Optimization: Enhance the Patient Experience with Epic Patient Estimates

Posted by The HCI Group on August 22, 2018 at 1:05 PM

Rev Cycle
Consumers now shop for healthcare like they do just about anything else. Confused by complex insurance provisions and upset by post-care bills, patients want pre-care estimates.

Healthcare organizations that provide patient estimates are currying favor with this new breed of consumers, thus helping them to increase revenue through customer satisfaction and repeat visits. Providers also are covering a greater percentage of their costs by collecting upfront payments tied to estimates.

Estimating a patient’s portion has become particularly important as consumers have assumed a greater share of the responsibility for their care as high-deductible plans and self-payments have become more prevalent. Bad debts have risen as patients have assumed the burden of care.

Collecting co-pays is no longer enough. Tools like Epic Patient Estimates lets organizations determine how much a consumer will owe by calculating how much the insurer will reimburse for care according to the particular plan.

Instead of waiting 30 to 45 days to learn how much is owed and by whom, organizations can enhance reimbursement and deliver price transparency and pre-service financial counseling by estimating a patient’s responsibility in advance. The result is a happy patient, who is not receiving an unexplained bill months later.

Collecting payments upfront can mitigate losses for U.S. hospitals, which have provided more than $502 billion in uncompensated care expenses since 2000. The rate of bad debt for insured patients is increasing by more than 30 percent each year at some hospitals.

From increasing collections to reducing debts to pleasing patients, Epic Patient Estimates can help your organization optimize your revenue cycle and ultimately deliver better care.

Patient Estimates

How Epic Patient Estimates Works

Epic Patient Estimates determines a patient’s responsibility based on historical claims data, contracts, and the patient’s benefits information. The longer you have been using Epic, the more accurate your estimates will be now.

The process begins with verification of eligibility, which can be done through Epic Real-Time Eligibility (RTE). Epic Patient Estimates applies patient-specific benefits to and depends on an efficient RTE processes. Prior to or as part of an Epic Patient Estimates implementation, organizations should optimize the use of RTE to drive accurate plan selection and file benefits to the patient record.

How To Use Epic Patient Estimates

Providing patients with estimates involves more than software is a significant organizational change that extends beyond patient registration to include financial counseling as well as payment collection.

Your organization may already offer traditional financial counseling, like helping patients apply for charity care. But that historically has been for a small portion of your population that was having trouble paying their medical bills.

Now, a broader base of your patients is struggling. Patients don’t always understand what they’re being billed, but they know they can’t afford to pay it in full. You must work with them proactively, communicating their responsibilities clearly and assisting them in arranging payments.

What Epic Patient Estimates Does

Epic Patient Estimates can help you reduce uncompensated care through point-of-service collections. Estimates also provide price transparency, which may help you comply with regulatory mandates.

Modern Healthcare reports that price estimators can provide organizations with a marketing advantage as well by giving patients the transparency that they want. “There are enough examples now that show if providers want to offer better information to consumers, they can build the capacity to do it," Suzanne Delbanco, executive director of Catalyst for Payment Reform, told the magazine.

Patients do not want to wait to see what they owe for a visit, especially when it may be more than they can afford. Don’t keep them waiting.

Contact The HCI Group to learn how Epic Patient Estimates Estimator can help you please your patients and optimize your revenue cycle by collecting payments upfront.

Additional Revenue Cycle Training Sources:


Topics: Epic, Revenue Cycle

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