A medical billing and collections company is flipping the script between doctors and patients who don’t have health insurance to pay for care. Instead of writing off those bills as bad debt, physicians are hiring MedDirect to work directly with patients to help them find a way to pay. This allows physicians to continue to serve this growing population and patients to maintain access to care.
Chris Farrell, director of marketing at MedData, said that his company works with accounts that are labeled “not insured” or “balance after insurance.” MedDirect was acquired by MedData in 2011.
The accounts are analyzed based on demographics, insurance status, zip code and other factors to calculate a proprietary PROBO score. Farrell said this score helps the company figure out the best way to get a patient to pay.
“We are finding that we are 90% accurate in determining their propensity to pay and that sets the outreach method,” he said.
Employees at the company’s call center contact a patient a few days after the office visit. The first step is to confirm that the person doesn’t have insurance. Farrell said that about 15% of the time, MedDirect discovers that the individual does have coverage. Those accounts go back to the physician’s office to go through the normal channels.
Farrell said that company works with the patients to find one of three solutions:
- Full payment
- Finding insurance and returning the patient to the doctor’s billing platform
- Setting up a payment plan
“We have found that patients with a balance of $1,000 or less really do want to pay,” he said.
MedDirect reports a 30% increase in patient pay reimbursements and 15% additional found insurance on accounts categorized as uninsured.
Farrell said that MedDirect’s proprietary system is built around patient billing, not insurance billing.
“We sit on top of everything, so our clients don’t have to invest IT dollars to use our system,” he said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Farrell said that MedDirect also can conduct patient satisfaction surveys, set up appointments and make reminder phone calls.
“Even if a patient has a good relationship with a doctor, if an account goes into collections and it’s a bad experience, the patient attributes that to the overall experience,” Farrell said.
MedDirect will be among the 21 companies talking about improving healthcare for patients in the Innovation Showcase at ENGAGE. You can use the code VERONICA to get a $500 ticket.
[Image of insurance agent explaining coverage from BigStock]
