Chicago-based TransUnion Healthcare's eScan solution has identified more than $1 billion in insurance payments for its hospital clients.
eScan, an insurance eligibility analytics system, helps hospitals and healthcare providers discover patients' coverage that was unverifiable or inaccurately captured on the front-end of the revenue process. Within the last three years, eScan has helped hospitals recover more than $500 million in payments previously classified as uncompensated care.
System interoperability issues, errors during registration, missing policy IDs and shifting regulations for charity care and consumer choice have posed serious issues for providers in properly validating insurance coverage.
“Uncompensated care is a multi-billion dollar issue for hospitals because it’s virtually impossible to account for all healthcare coverage upfront,” said president of TransUnion Healthcare Gerry McCarthy. Five percent of costs signed off as uncompensated care can actually be covered by insurance, unbeknownst to payers, providers or patients, Mr. McCarthy told Becker's Hospital Review.
Since acquiring eScan Data Systems in 2013, TransUnion has expanded eScan's analytics tools, transforming eScan from a last-in-line solution to a tool that can be deployed from pre-screening through post-service.
As uncompensated care becomes an increasingly important issue to hospital finances, hospitals and healthcare systems must be able to more accurately determine charity care, provide appropriate financial estimates and expertly navigate insurance coverage, says Mr. McCarthy.
TransUnion Healthcare provides services to approximately 1,000 clients.