iSolutions Self-Pay Platform
UCB has developed a breakthrough Self-Pay management technology called iSolutions. The iSolutions Platform provides financial evaluation and validation tools designed to integrate into a healthcare providers revenue cycle workflow processes without intensive I.T. involvement. This process improvement technology will increase and accelerate cash collections, improve operational efficiency and reduce operating costs. The iSolutions Platform provides the following solutions:
- Patient ID Verification
- Automated Presumptive Charity
- Bad Debt Write Off Validation
- Financial Assistance Evaluation
- Total Payment Estimation
- Payment Forecasting – Propensity for Payment Scoring Model
- Point of Service Payment Assistance
iSolutions utilizes a four phase validation process which confirms the accuracy and assumptions produced by the platform. Unlike many self-pay models which use demographic modeling to compute payment predictability and identify charity eligibility, the iSolutions platform leverages patient data, public and proprietary demographic databases, over 15 million actual patient 1st and 3rd party collection accounts and then cross validates the data with a non-derogatory “soft credit inquiry” to ensure accurate, verifiable results. This unique algorithmic data modeling provides statistically valid predictions for the granting of charity care, financial assistance and reliably indicates what a patient can pay and their propensity for payment of their self-pay balance.
The platform is calibrated for the economic indicators of your hospital trade area and integrates data from both credit active and non-credit active patients. iSolutions can be implemented in a real time mode at the point of registration utilizing an HL7 interface to seamlessly populate the system with your patients’ demographics. Alternatively, the iSolutions technology can be applied in a (next day) batch mode at any point in the revenue cycle.
iSolutions Meets the Standards for: Statement 15, AHA’s Credit Reporting Guidelines and the Classifying and Reporting for IRS 990
The iSolutions Platform methodology meets all of the standards of HFMA’s Statement 15, the Valuation and Financial Statement of Charity Care and Bad Debts by Health Care Providers and the American Hospital Association Legal Advisory regarding accessing patients credit reports. In addition, iSolutions assists tax-exempt hospitals for compiance with the new IRS Form 990 by accuratly classifing and reporting community benefit. The IRS Form 990 Schedule H requires not-for-profit hospitals to clearly report charity care, un-reimbursed costs from financial assistance programs and bad debt.
Uncompensated care must meet strict reporting criteria to be reported as charity. iSolutions automated charity process eliminates the subjectivity typically found in manual systems designed to determine a patient’s eligibility for charity care. iSolutions automated charity process ensures the consistent and uniform application of each hospital’s charity care policy for all patients. This charity determination is calibrated to match hospital’s policies and accurately identify a patient’s eligibility for charity care, even in the absence of supporting patient income documentation. The iSolutions reporting package provides emperical evidence, documentation and justification to comply with charity care regulations.
Medical fraud is becoming one of the fastest growing issues facing providers today. iSolutions accurately detects medical fraud by validating a patient’s demographics and financial capability through its algorythims. Every year, providers grant millions of dollars of charity to recipients who should not qualify, however they lack the tools to investigate their patient’s financial situation thoroughly. Utilizing the iSolutions Platform ensures that your community benefit grants are awarded to the right patients’ – the ones who really need assistance.
iSolutions is also frequently utilized to analyze bad debt accounts and retroactively re-classify them as charity care where appropriate.
Payer Search “Safety Net” Technology
In addition to iSolutions, UCB offers a new technology designed to identify undiscovered Medicare and Medicaid claims through Payer Search, a proprietary data mining technology. At the point of registration, obtaining accurate demographics can often be a challenge. Even with today’s sophisticated software platforms, patient data accuracy can be easily compromised by human error. UCB’s Payer Search rapidly matches patients with unidentified Medicaid and Medicare payers, correcting and returning billable claims to providers in ways other automated third party payor validation services do not. This technology is designed specifically to increase reimbursements for the health care industry.
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