Analytics is the Answer to Compliant Coverage Identification

It’s a dilemma that challenges hospitals, physician practices, labs, and durable medical-equipment companies (DMEs) every day: How do you determine if a patient presenting as self-pay or charity care has undisclosed insurance coverage, without compromising compliance requirements? The liability of self-pay accounts is a growing problem, with providers incurring billions of dollars in losses each year. An American Hospital Association report shows hospitals provided $35.7 billion in uncompensated care (including bad debt and charity care) in 2015 alone.