Payer info accuracy is a challenge
However, patients can be allies
Registrars at Advocate Illinois Masonic Medical Center in Chicago don't typically have any problem giving patients accurate estimates, says Philip N. Quick, CHAM, manager of patient access & bed management that is, unless the benefit information their insurance company provides isn't correct.
"Many insurers don't have the latest updated information at the time we're retrieving benefits, causing a false estimate for the patient," he says. "The most frequent inaccuracy we come across is related to the deductible."
Incorporating scripting to determine if the patient has had other recent services aids the registrar in giving a more accurate estimate, says Quick.
"We know we can't control how often payers update, but we can influence it," he says. "We have very strong working relationships with our provider relations reps to keep the lines of communication open."
However, as out-of-pocket expenses are rise for patients, they are becoming increasingly savvy with their benefit information, reports Quick. Payment estimates show all remaining out-of-pocket expenses so patients can walk away more prepared for future services, he explains.
"It's important that we build and maintain the relationship with the patients," says Quick. "We are the patient's financial advocate. This allows them to concentrate on their clinical care."