HEALTHPARTNERS’ CURE FOR INSURANCE VERIFICATION HEADACHES
HealthPartners is an integrated, nonprofit health care and insurance provider in Bloomington, Minnesota, founded in 1957. It offers patient care and coverage as well as medical research and education.
Faced with complex and expensive manual processes for verifying patient insurance coverage and eligibility, the company implemented a more efficient automated processes in order to support growth and control costs.
- Accelerated and uncomplicated insurance eligibility verification, eliminating payment guesswork and waiting
- Reduced the staff by 60% — through attrition — needed for insurance verification and account auditing
- Cut costs for billing and auditing by more than $900,000
- Increased revenue through government reimbursement by converting cases from bad debt to charity care by more than $800,000 in one year
- Lowered receivables from 48 to 38 days
- Decreased coverage query fees by over $250,000 per year and improved predictability of costs
- Obtained requested changes and enhancements to the software, usually within days
- Maintained round the clock operations with 24/7 expert human customer service from maxRTE
maxRTE PROVIDES BETTER OUTCOMES FOR INSURANCE VERIFICATION PAINS AT RIDGEVIEW
Ridgeview Medical Center is an independent regional health care network serving the Minneapolis-St. Paul west-metro area. It encompasses a variety of advanced health care facilities, including a Waconia-based acute care hospital and primary and specialty care clinics, as well as emergency services and specialty programs.
Frustrated with a decade-old cumbersome and costly system to verify patient insurance coverage and eligibility, the company was open to alternatives. Their objective was to simplify admissions procedures and offer pricing options to reduce costs, as well as to be supported with personal, responsive service.
- Simplified insurance verification processes, enabling pre-registration staff to take on significant new responsibilities with no increase in headcount
- Obtained requested changes and enhancements to the software usually within days
- Decreased coverage query fees by 50%, saving $60,000 per year while improving predictability of costs
- Enabled adoption of industry best practices in admitting and financial clearance
- Slashed coverage denials from 8% to 2%, consistent with nationwide best practice
ACUTE CARE FACILITIES ARE UNCOVERING INSURANCE SOURCES FOR SELF-PAY PATIENTS
The frenetic pace of emergency rooms in acute care facilities makes them especially vulnerable to missing insurance coverage during the registration/admission process. An established provider of self-pay conversion services uses affordable, efficient pre- and post-service processes that are helping hospitals, clinics, physician groups, and other healthcare providers strengthen their financial picture by uncovering commercial and government insurance coverage for self-pay patients.
- Automated processes dramatically reduce costs of unearthing unknown insurance coverage for self-pay patients to maximize ROI for healthcare providers.
- Converted uncollected bills from self-pay patients and unknown secondary insurance from primary insurance holding patients to revenue.
- Two acute care facilities (800-bed and a 40-bed) improved conversion of self-pay patients by an average of 348% with $576,000 per month in additional insurance payments.
- Flat monthly fee arrangement saves 800-bed facility $2.7 million in contingency fees and more than $80,000 in per-transaction fees.
- Flat monthly fee arrangement saves 40-bed facility $70,000 in contingency fees and $10,000 in per-transaction fees.