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How One Hospital Received $1.5 Million in Reimbursement in 3 Months

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hospitals, healthcare, health

How can a hospital reduce its workload and get paid faster? Workflow automation.

One specific automation solution is reCoverTM, a revenue recovery service developed by Databound Healthcare Solutions. This automation service locates third-party health care coverage—to which patients and hospitals are entitled—without needing to obtain additional information from patients.

Too often, healthcare facilities miss out on money from health insurance claims. And the reimbursements that are obtained, require extensive personnel time from administrative staff and IT personnel. With reCoverTM, healthcare facilities create files of patient healthcare encounters that need to be reimbursed (highlighting files with an outstanding balance or ones that were previously written off).

The reCoverTM service then takes these files and locates eligibility information from the specified third-party payers. That information is returned to the healthcare facility in a file that can be imported into their system.

reCoverTM makes it easy for healthcare facilities to:

  • Update their records and file claims.
  • Receive the reimbursements they are entitled to.
  • Bill future charges correctly (the first time).
  • Reduce accounts receivable moving forward.

Automating the collection of reimbursements with reCoverTM helped one hospital receive a $1,500,000 reimbursement in the first three months of use. In 2014, this hospital used reCoverTM to search for third-party coverage for 185,114 encounters. In these encounters, the patient was believed to have no coverage aside from the standard allocation provided by Indian Health Service (IHS). For this hospital, reCover:

  • Found valid third-party coverage for 12,294 of those encounters: a 3 percent success rate.
  • Collected an average payment of $1,054 per encounter—totaling nearly $13 million in revenue for the hospital.

Automation software helps healthcare facilities find money they otherwise may never see. Workflow automation reduces the facility’s workload, while also helping them get paid faster.

Databound Healthcare Solutions automates and streamlines hospital revenue management tasks and business processes to give our customers more efficient operations and increased revenue. Visit our website to learn more.

Written by Mike Burhans, MBA, CRCR - Relationship Manager

Mike Burhans, MBA, CRCR - Relationship Manager

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