5 ways to maximize revenue on every claim

Hospitals and health systems have long struggled with creating, growing and maintaining healthy revenue cycles.

The pandemic introduced new challenges when many facilities were forced to cancel elective procedures, dealing a hefty blow to balance sheets across the country. As your organization regains its footing, what are some of the most impactful strategies for recovery?

First, find your revenue

Let’s start with a number that’s hard to ignore: $660 billion. That’s how much hospitals have lost to uncompensated care since 2000.¹

This means care was provided, revenue was earned, and it wasn’t collected. Ouch.

Adding insult to injury, nearly half of hospitals have experienced an increase in uncompensated care and bad debt resulting from the pandemic.¹

Now, the good news.

There are simple steps you can take to drastically reduce the odds of self-pay accounts resulting in uncompensated care or underpayments. In many cases, you can side-step the risk of self-pay altogether.

Identify all available coverage

When you have a full view of all active insurance coverage, you can be reimbursed directly from payers instead of patients. It’s easier than you think.

Inovalon offers a superior insurance discovery tool that can help providers find up to 20% more billable coverage for unpaid accounts.²

Submit claims with renewed confidence knowing that you can avoid downstream denials and rejections by identifying all coverage information from the point of initial patient access.

ABILITY Insurance Discovery delivers the following key advantages to providers:

1. Demographic information verification – Verify nine key elements in real time, note missing data and obtain complete, accurate info for each patient and claim.
2. Active coverage identification – Numerous database searches identify unique primary, secondary and tertiary coverage, rank that coverage, and reveal managed care and advantage replacement plans.
3. Expanded payer search – Run an average of 13 transactions per patient and find up to double the number of payers compared to other services.
4. Geographic payer search – Conduct national searches and query the most relevant payers using proprietary matching algorithms.
5. Customizable workflow capability – Create custom exclusions to eliminate false coverage and establish rules based on facility, patient, state and payer.

Discover how one customer leveraged the power of better insurance discovery

What kind of impact is this having on collection rates? Read the story of how an Inovalon customer in Florida experienced double-digit increases in insurance collections for hospitals and other providers.

Sources:

¹ “Hospital Uncompensated Care Costs Grew to $41.61B in 2019,” Jacqueline LaPointe, RevCycle Intelligence, January 26, 2021, https://revcycleintelligence.com/news/hospital-uncompensated-care-costs-grew-to-41.61b-in-2019

² Inovalon internal reporting, July 2021. Individual results may vary.

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