DENVER - August 28, 2015 - A historic rise in high-deductible health insurance plans has US hospitals struggling to give newly price-conscious patients an accurate estimate of their share of healthcare costs. At the same time, with an increasing share of their revenue dependent on patients, hospitals are accelerating efforts to collect patient payments up front to prevent bad debts.
The dual focus on price transparency and patient collections is driving a search for new financial technologies to support this "consumerization" of healthcare. It's a tall order for an industry long accustomed to dealing only with commercial and government payers.
Now Recondo Technology (Recondo), a leading provider of cloud-based revenue cycle connectivity and applications, has moved to solve the problem through a first-of-its-kind collaboration with Epic Systems, one of the nation's premier providers of electronic health records (EHR).
At the request of a large multi-state health system that uses Epic, the two companies integrated Recondo's BenefitPlus™ patient estimation tool with the Epic Benefit Collector tool. Both tools are now in use across the health system's nearly three dozen acute care hospitals and in its clinics for several thousand physicians, enabling patient access staff to generate estimates of patient financial responsibility with unprecedented accuracy.
Using the new tool, the health system has increased point-of-service (POS) collections by 12 percent over 12 months, representing several million net-new dollars falling to the bottom line.
"With the rise in self-pay and high-deductibles, hospitals need to be able to accurately estimate patient financial responsibility so they can attract the growing number of patients who are price shopping and also reduce the likelihood of bad debt by collecting more up front," said Jay Deady, CEO of Recondo. "We're thankful that Epic was willing to work with us to quickly meet the requirements of our joint customer. Together, we've built a powerfully fast and accurate replacement for what is otherwise a highly manual process, and one that hospitals can no longer afford to overlook."
How It Works
The combined Epic and Recondo solution generates accurate patient estimates without forcing providers to take on the onerous and continuous task of custom rules development. Epic's Benefit Collector verifies a patient's insurance eligibility after registration via an electronic query sent to the payer through a claims clearinghouse. The Epic tool then runs the payer's response through a set of benefit collection rules to identify the benefits needed for a patient estimate.
