Compliant Healthcare Price Transparency
With the government price transparency mandates effective January 2021, leading hospitals and health systems are now putting their strategic focus on providing a more positive patient financial experience—one that enables patients to be more engaged in healthcare purchasing decisions and provides transparency into out-out-pocket costs, while improving the hospital’s bottom line.
As one of the nation’s premier healthcare price transparency companies, AccuReg ensures you meet final rule requirements. With the AccuReg healthcare cost transparency solution, your hospital can increase patient satisfaction by providing pricing insight that is meaningful to patients and answers the question “how much do I owe?”
Self Service Estimate
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Patients are able to see their out-of-pocket cost … that puts us at an advantage.
Former VP of Revenue Cycle Management, Mosaic Life Care
How To Meet the CMS Final Rule and Deliver Accurate Patient Estimates
The CMS final rule requires hospitals to post on their websites:
- 300 (70 CMS-specified and 230 hospital-selected) consumer-friendly “shoppable” services
- A comprehensive machine-readable file with extensive pricing components
AccuReg’s healthcare cost transparency solution solves for both final rule requirements using:
Estimate My Cost®
Provide meaningful price transparency by offering patient estimates of out-of-pocket costs. This self-service tool enables patients to shop by procedure and create accurate out-of-pocket estimates anytime, anywhere. Start the conversation around payment earlier so you’re more likely to be paid pre-service and reduce the cost to collect.
Provide a single data file that can be read by other computer systems, and enable consumers, employers, providers and software tool developers to download the five types of standard charges required by the final rule: gross charge, discounted cash price, and payer-specific and de-identified maximum and minimum negotiated charges.
Both solutions are powered by our hospital staff-facing Price Estimation solution—a core product from our award winning and market-leading patient access suite. AccuReg healthcare price transparency solutions combine machine-readable file compliance with a patient-facing tool that meets the requirement to display shoppable services in a consumer-friendly manner. Not only will your hospital be compliant with all government requirements, more importantly, you’ll enable your patients to be consumers.
We are able to provide more transparency with the patient so they can either pay up front, if they can–or if they can’t, they’re not surprised by the amount that comes on their bill later.
Patient Access Director, Sierra View Medical Center
Why Choose AccuReg Patient Estimation Software
By enabling patients to shop using a patient-facing estimation tool built on the same platform as your staff-facing tool, you provide a consumer-driven financial experience, similar to the consumer experience patients are accustomed to when shopping for a variety of other items and services online.
AccuReg patient estimation software goes beyond typical solutions in the market by:
- Using your negotiated contract rates along with historical claims analysis to begin the estimate process
- Analyzing real-time eligibility transaction data to validate service-level benefit coverage including the relevant co-pays and co-insurance
- Factoring in up-to-the-minute deductible balances, which enable AccuReg to deliver highly accurate prices estimates
- Conducting pattern analysis to determine actual services provided and compare that to estimates to predict even more accurate estimates
- Deploying real-time alerts and scripting, within our work queue, to help your hospital staff communicate out-of-pocket cost obligations and process payments
- Utilizing our proprietary intelligent workflow and rules engine platform to deliver the most comprehensive accurate estimates that give your patients insight to their actual out-of-pocket costs
A consistent patient financial experience is critical to creating a high level of satisfaction and trust, mitigating frustration and retaining and attracting patients and their related revenue. To achieve alignment and accuracy across price estimates, you must use the same platform for meeting price transparency requirements as used for staff-generated estimates.
Price Transparency Compliance is Not Enough
Regardless of how the government ultimately defines price transparency and what is required of hospitals, revenue cycle executives shouldn’t be distracted from what’s most important to the hospital as a business: attracting and retaining patients and improving revenue capture.
The benefits are clear:
- Collecting in part or in full prior to service ensures maximum revenue
- Pre-service is the lowest cost place to collect, otherwise there is added expense to bill and possibly go to collections
- When payment isn’t collected up-front, hospitals may not receive full payment or any payment
Meet compliance and help your hospital communicate out-of-pocket obligations to secure more revenue up-front when your chances of collecting are the greatest and the cost is the lowest. Change the way your hospital starts the conversation around payment.