Since starting cost estimations for a wide range of inpatient and outpatient services a decade ago, Oklahoma-based INTEGRIS Health has achieved a 22-fold increase in point-of-service collections.
Providing pre-service cost estimates to patients has markedly increased point-of-service collections at INTEGRIS Health, from $900,000 in 2007 to $20.55 million last year.
"It most definitely contributes. Providing financial information prior to the scheduled appointment gives the patient an opportunity to pay during the pre-registration call or at the time of service," says Veronica Hughes, administrative director for patient access services.
The Oklahoma City-based health system started providing out-of-pocket cost estimates for patients manually in 2006.
The majority of cost estimates are partially automated because fully automated estimates available through the health system’s website have not been widely adopted, says Brent Grimes, administrative director of revenue cycle. Most patients get cost estimates either over the phone or in person at inpatient pre-registration or when they appear for outpatient services such as laboratory tests.
Providing cost estimates has become a standardized procedure for patients at INTEGRIS' seven acute-care hospitals, Hughes says, noting estimates not only boost point-of-service collections but also engage patients as financial partners.
"We have an access center with centralized pre-service financial counseling and pre-registration. They contact upcoming scheduled patients to notify them of potential financial liability."
Technology and specificity
The key technological component of both fully and partially automated cost estimates is Franklin, TN-based Experian Health's Passport platform, she says.
Passport has most of the data required to make accurate cost estimates such as payer contract information, patient benefits, medical procedure pricing, CPT codes, and physician information.
"It looks at all of those elements for an estimate," Hughes says.
Christopher Cheney is the senior clinical care editor at HealthLeaders.