Insurance Card Image Processing With Eligibility

Collecting payments on the payer side and going to the doctor during COVID-19 has become increasingly complex and disconnected.
Find out more about insurance card image processing with eligibility in the following infographic deep dive below:

Insurance Card Image Processing With Eligibility

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  70% of consumers say healthcare makes payment more difficult than any other industry  
  • High Costs & Confusion
    • When it comes to healthcare, most Americans want price estimates upfront
      • Millennials & Gen Z: 84%
      • Baby Boomers: 65%
      • BUT only half of upfront estimates are accurate
  • Many Struggle With Unexpected Medical Bills
      • 67% of Amerians worry they could not afford a surprise medical bill
        • 4 in 10 with employer-sponsored insurance struggle to afford healthcare
      • In 2019, 40% of consumers were surprised by a high medical bill — down from 59% in 2018
        • Nearly half came from hospitals
        • 1 in 5 came after a surgery
  • Why Are Medical Costs So Unpredictable?
      • High deductible health plans (HDHPs) are growing in popularity
        • 19.7 million Americans are enrolled in high deductible plans
          • From 2007 through 2017*
            • HDHP with a health savings account: +450%
            • HDHP without a health savings account: +231%
        • HDHPs bring
          • Higher out-of-pocket costs
          • Confusion about payment responsibility
          • Increase in unexpected medical bills
  • When Patients Can’t Pay
    • When patients aren’t sure about their cost responsibility
      • 69% attempt to learn about costs before or during their appointment
      • 42% simply wait for the bill to arrive before they address it
  Every year $190 billion in unnecessary spending goes toward administration of healthcare payments — Accepting a $20 copayment in cash can cost $50 to process   The Problem Of Payments
  • Nearly 25% of wasted spending in healthcare relates to time and money spent of collecting, processing, posting, and reconciling payments
      • Payments are collected from
        • Insurance payers
        • Consumers
        • Mix of both
        • Each is processed at a different time in the payment cycle
  • Denied Claims Raise Costs
    • Up to 10% of insurance claims are denied
      • 35% of denied claims are reworked and resubmitted
      • The work required to resubmit claims costs up to 18X more than a claim correctly filed the first time
Eliminating rework for 100 claims a month would save an average practice $37,000 a year — For a hospital it could save $149,000
    • 90% of denied claims are avoidable
  • Common Mistakes That Cause Denial
        • Incorrect patient identifier
        • Services not covered
        • Out-of-network provider
        • Prior authorization required
      • Mistakes occur when systems aren’t interoperable
        • Manual data transfer between systems
        • Difficulty verifying insurance eligibility
  • “Even though billions of dollars have been invested in EMR interoperability, it’s still not there today . . . If everyone’s not on the same EMR, then going outside your four walls, on the provider side, is really an immense challenge.” — Chris Goldsmith, President of Landmark Health
  From February to March 2020, contactless transactions grew at 2X the rate of non-contactless transactions   The Solution For Connected Healthcare Management
    • Contactless Check-In & Payments: Responding To COVID-19
      • Amid the pandemic healthcare organizations switched to contactless check-ins and payments to slow the spread of the virus
        • Patients complete digital registration documents including
          • COVID-19 screening questions
          • Consent forms & insurance documentation
          • Review of outstanding balance and copays
        • At the time of service, patient call or text to let the office know they have arrived and wait in the parking lot until the clinician is ready
        • Minimizes patient to patient interaction and contamination of paperwork, pens, and other surfaces
      • As vaccines become available, providers will need to efficiently process a flood of insurance claims
        • Eligibility must be processed before applying for federal funds
  • Insurance Eligibility Verification: The Key To Upfront Cost Estimates
      • Pre-Registration Collects Necessary Data
        • Photo ID & Insurance Card
        • Demographic Data
      • Confirms Insurance Coverage
        • Coverage is valid on the date of service
        • Patient responsibility for copays and coinsurance
        • Prior authorization and referral requirements
      • This data can then be used to calculate accurate, upfront pricing estimates for individual patients
  • Connecting Healthcare Systems: PracticeSquire
  • Benefits To Patients
        • Easily check-in from anyway without risk of infection
        • Know cost responsibility before receiving services
        • Save information with a single login — No need to carry cards
  • Benefits To Providers
        • Reduce administrative workload for greater productivity and cost savings
        • Accurate data capture and digital insurance verification for faster claims
        • Fewer mistakes, administrative headaches, and reduced turnover
  • Benefits To Office Staff
      • Reduced risk of infection through exchange of document and payments
      • Eliminates mistakes and rework of claims from misread insurance cards
      • More time to focus on other tasks
  Automated insurance eligibility verification can an average physician practice 11 hours of administrative time every day — Up to $4500 per month   Getting paid is fast and simple with PracticeSquire   Sources: https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm https://www.physicianleaders.org/news/how-many-patients-can-primary-care-physician-treat https://www.aafp.org/fpm/2017/0100/p26.html https://www.elavon.com/content/dam/elavon/en-us/documents/st-referrals/elavon-healthcare-report-2020.pdf https://newsroom.transunion.com/news-reports-about-a-weakening-economy--impacting-how-some-patients-seek-medical-treatment/ https://www.pnc.com/content/dam/pnc-com/pdf/corporateandinstitutional/Treasury%20Management/Healthcare/patients-take-wheel-Whitepaper_cib-healthcare.pdf https://www.instamed.com/blog/the-disconnect-in-our-healthcare-economy/https://www.cdc.gov/nchs/products/databriefs/db317.htm https://mitsloan.mit.edu/ideas-made-to-matter/health-care-data-disconnected-heres-how-to-change https://cleargage.com/blog/the-rise-of-contactless-checkout-in-healthcare/ https://www.healthleadersmedia.com/clinical-care/how-implement-curbside-check-and-contactless-registration-patients https://www.outsourcestrategies.com/medical-billing/patient-eligibility-verification.htm Learn more about WiFi 6