Low-cost eligibility tool places hospitals "on the patient's side" during billing
SAN MATEO, Calif., Sept. 19, 2012 /PRNewswire/ -- To help hospital Emergency Departments enhance revenue from government and private insurance reimbursements and improve their relationship with self-pay patients, PointCare has launched PointCarePA. The patient advocacy platform allows hospitals to combine best practices with the use of a low-cost eligibility tool to strengthen the moment when patients are questioned about their plan of payment.
Unlike other reimbursement software in the marketplace, PointCarePA captures the patient data using a five question, 90-second eligibility assessment at point-of-care, which engages the patient as part of the solution and introduces patients to coverage options that will assist with retroactive and future medical costs. The patient's information is instantly evaluated by a robust health coverage database, which is populated with information on every single public and private plan option in the country. After prioritizing a communicable list of coverage options for each self-pay patient, based on the hospital reimbursement rates and patient's qualification level, PointCarePA then provides the patient with appropriate application documents and next steps for securing the coverage.
"Hospitals win in two major ways. They perform a tremendous assist for patients by bringing them into the system and educating them about coverage options they didn't know existed," said Phil Lebherz, CEO of PointCare. "They are also able to improve the facility's level of reimbursement. No other product on the market does this."
Solving the enrollment dilemma is a growing concern that can drain a hospital's resources. PointCarePA enhances the emergency department personnel's ability to effectively assist self-pay patients with navigating the U.S. health finance system to discover their health coverage options and help patients choose the best program options while communicating in a compassionate and empathetic manner. "At the same time, it gives the hospital a better road map and documentation for the funding entity that is actually liable for paying for the care provides," said Lebherz.
In a 25-month beta study, PointCarePA successfully assisted over 32,000 self-pay patients in four Emergency Departments at Sharp HealthCare in San Diego, California A surprising 80% of patients discovered they were eligible for free or low-cost public health coverage, 16.6% were eligible for private coverage, and 2.8% were eligible for California's state and federal high risk pool programs. Of the effort, Gerilynn Sevenikar, Sharp's Vice President of Patient Financial Services said, "Most self-pay patients want to contribute toward their bill, but because of the laborious nature of qualifying for assistance on both the patient's and the hospital's end, they often had to give up and leave the hospital unfunded. PointCarePA helped to solve this problem."
Founded in 2012, San Mateo, Calif.-based PointCare is a patient advocacy company that helps hospitals educate self-pay ED patients about their eligibility for health coverage at point-of-care. PointCare's mission is to strengthen the dignity of self-pay patients through the effective, empathetic, and compassionate communication of health coverage options from the hospital to the patient.
For more information or to request a demo, visit www.PointCare.com or contact PointCare at 650-762-1928.