|By Marketwired .||
|April 7, 2014 06:00 AM EDT||
CHICAGO, IL -- (Marketwired) -- 04/07/14 -- According to a TransUnion Healthcare survey of more than 700 insured consumers, 75% of patients said that pre-treatment estimates of out-of-pocket costs would improve their ability to pay for healthcare. However, nearly six in 10 patients (56%) either rarely or never received an estimate of out-of-pocket costs before they received treatment; 59% said they have been surprised by the costs they were responsible for when receiving their final bill.
Of patients who reported either paying a bill late, leaving a bill unpaid or letting a bill go to collections, three-quarters reported that they were always or often surprised by the costs they were responsible for in their final bills.
"These survey results tell us that consumers are less likely to have payment problems when they obtain more information about the cost of their healthcare services up front," said John Woody, vice president of product development for Transunion Healthcare. "Partly as a response to these issues, TransUnion Healthcare continues to improve payment experiences for patients and help ensure that healthcare providers capture all third-party reimbursements owed to them with the recent enhancements to our ClearIQ patient access platform."
TransUnion has enhanced its ClearIQ platform by adding Medical Necessity and upgrading its Insurance Eligibility and Benefits Verification solution. The ClearIQ platform now features customized business rules, an easy-to-read eligibility viewer, coverage discovery, alerts and work queue enhancements.
The improved Insurance Eligibility solution offers providers real-time electronic verification of patients' insurance eligibility and benefit levels for third party coverage. The update simplifies the payment experience for patients by enabling providers to comprehensively identify coverage options for specific procedures and customized to each patient's unique circumstances. By capturing accurate benefit information at the point-of-service, providers may be able to avoid errors and decrease claim denials while increasing collections from patients.
"From the patient's perspective, the latest enhancement equips them with accurate and essential information about their financial responsibility prior to treatment so they can make more informed decisions about their care and ability to pay," said Woody. "It arms providers with the tools they need to minimize claim denials, streamline front-end registration and, ultimately, reduce uncompensated care."
Medical Necessity, another integrated ClearIQ platform feature, automatically validates procedure codes against Medicare and Commercial Payer medical necessity rules. The solution may reduce the provider's financial-risk exposure for denied claims by identifying medical procedures which may not be covered by third party payors, before the provider submits the claim. Medical Necessity also improves patient satisfaction by enabling the provider to deliver transparent pricing information to the patient before the patient receives medical services.
The Medicare industry estimates that hospitals without a medical necessity program face an average of $960,000 annually in denials and an average staff cost of $53-$117 per denied claim to gather information related to the claim denial.
"Now, more than ever, it is critical that providers capture all reimbursements owed to them, given the impending changes to reimbursement structures under the Affordable Care Act and the introduction of healthcare exchanges," said Woody. "A failure to quickly and accurately verify patients' eligibility and benefits on the front-end can lead to costly billing errors and claim denials on the back-end and, ultimately, significant profit loss for healthcare providers and hospital systems."
Lincoln County Medical Center in Missouri will be one of the first hospitals to integrate Medical Necessity with ClearIQ's Patient Payment Estimation, Insurance Eligibility, ID and Address Verification and Propensity to Pay solutions, providing an improved patient financial experience. Lincoln will have the ability to clearly communicate to patients how much they will owe before receiving treatment and provide them with patient-friendly payment options, or financial assistance, based on their unique financial situation.
"We are excited about being able to provide our patients with the most transparent pricing information prior to receiving medical services," said Becky Kinsella, director of revenue cycle at Lincoln County Medical Center. "Combining medical necessity compliance checks with a contracts-based patient payment estimator and propensity to pay information empowers our staff with the tools necessary to educate patients' on their payment options. It also reduces our financial risk for claim denials post-service. We expect this to have a significant impact on our point-of-service collections and net revenue as we will know earlier in the process how much the patient owes, and what procedures will be covered by their insurance company."
TransUnion Healthcare's ClearIQ technology is an exception-based automated decisioning platform, which automates the work steps necessary to process a patient registration and provides the best possible patient financial experience. For more information about ClearIQ, visit: http://www.transunion.com/corporate/business/healthcare/emarketing/clearIQ_landing.page
TransUnion Healthcare, a wholly owned subsidiary of credit and information management company TransUnion, empowers providers with Intelligence in an Instant® by providing data and analytics at the point of need. TransUnion offers a series of data solutions designed to provide greater ease of use, accuracy and transparency in the revenue cycle process thereby assisting providers in lowering their uncompensated care. www.transunionhealthcare.com
E-mail Email Contact
Telephone (312) 985 3059
IoT is rapidly changing the way enterprises are using data to improve business decision-making. In order to derive business value, organizations must unlock insights from the data gathered and then act on these. In their session at @ThingsExpo, Eric Hoffman, Vice President at EastBanc Technologies, and Peter Shashkin, Head of Development Department at EastBanc Technologies, discussed how one organization leveraged IoT, cloud technology and data analysis to improve customer experiences and effi...
Jul. 24, 2016 10:00 PM EDT Reads: 1,940
Let’s face it, embracing new storage technologies, capabilities and upgrading to new hardware often adds complexity and increases costs. In his session at 18th Cloud Expo, Seth Oxenhorn, Vice President of Business Development & Alliances at FalconStor, discussed how a truly heterogeneous software-defined storage approach can add value to legacy platforms and heterogeneous environments. The result reduces complexity, significantly lowers cost, and provides IT organizations with improved efficienc...
Jul. 24, 2016 09:45 PM EDT Reads: 1,902
Organizations planning enterprise data center consolidation and modernization projects are faced with a challenging, costly reality. Requirements to deploy modern, cloud-native applications simultaneously with traditional client/server applications are almost impossible to achieve with hardware-centric enterprise infrastructure. Compute and network infrastructure are fast moving down a software-defined path, but storage has been a laggard. Until now.
Jul. 24, 2016 09:45 PM EDT Reads: 1,624
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform and how we integrate our thinking to solve complicated problems. In his session at 19th Cloud Expo, Craig Sproule, CEO of Metavine, will demonstrate how to move beyond today's coding paradigm ...
Jul. 24, 2016 09:45 PM EDT Reads: 2,116
Internet of @ThingsExpo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with the 19th International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world and ThingsExpo Silicon Valley Call for Papers is now open.
Jul. 24, 2016 09:00 PM EDT Reads: 2,457
"We view the cloud not really as a specific technology but as a way of doing business and that way of doing business is transforming the way software, infrastructure and services are being delivered to business," explained Matthew Rosen, CEO and Director at Fusion, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 24, 2016 09:00 PM EDT Reads: 1,463
Big Data engines are powering a lot of service businesses right now. Data is collected from users from wearable technologies, web behaviors, purchase behavior as well as several arbitrary data points we’d never think of. The demand for faster and bigger engines to crunch and serve up the data to services is growing exponentially. You see a LOT of correlation between “Cloud” and “Big Data” but on Big Data and “Hybrid,” where hybrid hosting is the sanest approach to the Big Data Infrastructure pro...
Jul. 24, 2016 07:45 PM EDT Reads: 1,846
A critical component of any IoT project is what to do with all the data being generated. This data needs to be captured, processed, structured, and stored in a way to facilitate different kinds of queries. Traditional data warehouse and analytical systems are mature technologies that can be used to handle certain kinds of queries, but they are not always well suited to many problems, particularly when there is a need for real-time insights.
Jul. 24, 2016 07:30 PM EDT Reads: 1,687
"My role is working with customers, helping them go through this digital transformation. I spend a lot of time talking to banks, big industries, manufacturers working through how they are integrating and transforming their IT platforms and moving them forward," explained William Morrish, General Manager Product Sales at Interoute, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 24, 2016 07:30 PM EDT Reads: 2,049
In his session at 18th Cloud Expo, Sagi Brody, Chief Technology Officer at Webair Internet Development Inc., and Logan Best, Infrastructure & Network Engineer at Webair, focused on real world deployments of DDoS mitigation strategies in every layer of the network. He gave an overview of methods to prevent these attacks and best practices on how to provide protection in complex cloud platforms. He also outlined what we have found in our experience managing and running thousands of Linux and Unix ...
Jul. 24, 2016 07:30 PM EDT Reads: 1,706
Continuous testing helps bridge the gap between developing quickly and maintaining high quality products. But to implement continuous testing, CTOs must take a strategic approach to building a testing infrastructure and toolset that empowers their team to move fast. Download our guide to laying the groundwork for a scalable continuous testing strategy.
Jul. 24, 2016 07:15 PM EDT Reads: 1,854
With 15% of enterprises adopting a hybrid IT strategy, you need to set a plan to integrate hybrid cloud throughout your infrastructure. In his session at 18th Cloud Expo, Steven Dreher, Director of Solutions Architecture at Green House Data, discussed how to plan for shifting resource requirements, overcome challenges, and implement hybrid IT alongside your existing data center assets. Highlights included anticipating workload, cost and resource calculations, integrating services on both sides...
Jul. 24, 2016 07:00 PM EDT Reads: 1,926
"We are a well-established player in the application life cycle management market and we also have a very strong version control product," stated Flint Brenton, CEO of CollabNet,, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 24, 2016 06:45 PM EDT Reads: 1,756
In his session at @DevOpsSummit at 19th Cloud Expo, Yoseph Reuveni, Director of Software Engineering at Jet.com, will discuss Jet.com's journey into containerizing Microsoft-based technologies like C# and F# into Docker. He will talk about lessons learned and challenges faced, the Mono framework tryout and how they deployed everything into Azure cloud. Yoseph Reuveni is a technology leader with unique experience developing and running high throughput (over 1M tps) distributed systems with extre...
Jul. 24, 2016 06:45 PM EDT Reads: 2,034
"Software-defined storage is a big problem in this industry because so many people have different definitions as they see fit to use it," stated Peter McCallum, VP of Datacenter Solutions at FalconStor Software, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 24, 2016 06:15 PM EDT Reads: 1,376