TransUnion Healthcare announced that its eScan healthcare service has identified more than $1 billion in insurance payments for its hospital clients and has helped hospitals recover more than $500 million in payments for unpaid medical services in the last three years.
Hospitals previously would have categorized the money as uncompensated care - the sum of a hospital's bad debt and charity care.
"Uncompensated care is a multi-billion dollar issue for hospitals because it's virtually impossible to account for all healthcare coverage upfront due to factors such as system interoperability issues and errors during the registration process," said Gerry McCarthy, president of TransUnion Healthcare.
Hospitals also may miss coverage because of confusion over status or a missing policy ID that prevents the querying of demographic data. Furthermore, Medicaid expansion, annual enrollment through the Affordable Care Act, changing rules for charity care and consumer choice are contributing to issues in properly validating insurance coverage.
TransUnion Healthcare offers ways for hospitals to help discover patients' coverage that initially wasn't verifiable or was inaccurately captured by hospital staff on the front-end of the revenue process.
TransUnion's products have helped more than 1,000 hospitals and thousands of physician partners identify over $5 billion in uncompensated care revenue, which has resulted in more than $1 billion in reimbursement delivered to its hospital clients.
"When looking to make improvements with our bad debt/charity care processes, we partnered with TransUnion who offered great insights and solutions to help us make the improvements we were looking for," said Warren Fuller, vice president of finance at Indian River Medical Center.
According to the U.S. Department of Health and Human Services, hospitals lost an estimated $27.3 billion in uncompensated care in 2014.
"We are very excited to support our hospital clients in recovering significant monies owed to them," said McCarthy. "This helps them to be more efficient and effective, and put their resources toward their true mission: providing the best patient care possible for the populations they serve."