Hospitals Use RelayHealth's RevRunner Eligibility Services to Secure Financial Assistance for Economically Disadvantaged Patients
March 17, 2009
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OhioHealth helps patients take advantage of Medicaid coverage for their medical care

ATLANTA—RelayHealth, the leading provider of healthcare connectivity services, is helping hospitals with its RevRunner® eligibility services by identifying commercial insurance, Medicaid coverage or other financial assistance programs for patients.  Given the current state of the economy, sophisticated methods of automated support are becoming more important than ever to aid both the patient community and to support the financial stability of the hospital.

The financial challenge for hospitals is likely to escalate as unemployment rises: With every 1 percent uptick in the unemployment rate, a million people lose their health insurance, according to the Kaiser Family Foundation.  Along with the rapid growth of high-deductible plans, the rising number of uninsured and underinsured patients means that hospitals must extend the breadth and depth of their financial counseling services.  Many patients may actually be eligible for financial assistance, but are unaware of their coverage, lack personal identification documents, or are hesitant to ask for financial aid.

OhioHealth is an example of a hospital delivery system successfully assisting its patients in managing their payment responsibilities.

OhioHealth uses RelayHealth’s eligibility services at five hospitals in the Columbus, Ohio area to perform verification of patient’s insurance eligibility both pre-and post-service. Insurance is verified before service is provided and again post-service to identify any changes in the patient’s coverage status. For example, on a monthly basis, OhioHealth analyzes its self-pay accounts to identify those patients who have become eligible for Medicaid or other coverage. 

“We couple the ability to electronically review these cases with a very intense patient advocacy program to assist patients in obtaining Medicaid coverage.  This combination has resulted in a $24 million increase of gross patient charges being converted from self pay to Medicaid in fiscal year 2008 as compared to 2007,” said Jane Berkebile, vice president of Revenue Cycle, OhioHealth.  “Our ability to electronically identify eligibility for patients at any time in the billing cycle has allowed us to provide financial help to those we serve and reduce revenue loss from bad debt.”

“Hospitals need the support of sophisticated revenue cycle services with the increasing number of under or uninsured in communities across the country,” said Jim Bodenbender, senior vice president and general manager, RelayHealth. “RelayHealth’s financial eligibility services give hospitals the ability to verify insurance coverage for those have it, and identify potential financial assistance for patients who need it. The result is more patients who understand their financial responsibility before care is provided and a healthier bottom line for hospitals.”

About OhioHealth
Named by FORTUNE Magazine as one of the “100 Best Companies to Work For” in 2007, 2008 and 2009, OhioHealth is a nationally recognized, not-for-profit, charitable, healthcare organization serving and supported by the community. Based in Columbus, Ohio, it is a family of 17 hospitals, 23 health and surgery centers, home-health providers, medical equipment and health service suppliers throughout a 40-county area. OhioHealth hospitals in central Ohio are Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, Grady Memorial Hospital and Dublin Methodist Hospital. For more information, please visit our Web site at www.ohiohealth.com.

About RelayHealth
RelayHealth, McKesson’s connectivity business, operates as a neutral partner in an open network environment, offering connectivity services and integration among all organizations, systems, and solutions. Its intelligent network is designed to streamline clinical, financial and administrative communication between patients, providers, payors, pharmacies, pharmaceutical manufacturers, and financial institutions. RelayHealth works to accelerate the delivery of high-quality care and improve financial performance through solutions such as online consultation of physicians by patients, electronic prescribing, point-of-service pharmacy claims resolution by payors, pre-visit patient financial clearance by providers, and post-visit provider bill settlement by payors and patients. RelayHealth securely processes more than 12 billion financial and clinical transactions annually. For more information, call (800) 778-6711, or visit our Web site at www.RelayHealth.com



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