According to TransUnion, a medical necessity software program can provide real-time verification of patients’ insurance eligibility and benefits, allowing providers to avoid billing errors and give patients information about their financial responsibilities before treatment. According to the Medicare industry, hospitals without medical necessity programs face an average of $960,000 in denials each year and an average cost of $53 to $117 per denied claim.
Here are three key takeaways from TransUnion’s survey of 700 insured consumers about upfront cost estimates and medical bills:
1. Of those surveyed, 75 percent said pre-treatment out-of-pocket cost estimates would improve their ability to pay their bills.
2. Fifty-six percent of patients rarely or never received an out-of-pocket cost estimate prior to treatment.
3. Nearly six in 10 (59 percent) said they have been surprised by what they owed when they received a final medical bill.
More Articles on Healthcare Finance:
In the Future, Will Hospitals Have a Chief Medical Financial Officer?
10 Hospitals and Health Systems With Strong Finances
5 Reasons to Participate in the CMS Bundled Payments for Care Improvement Initiative
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.