nTelagent Announces New Contract Calculator for Hospitals

Last month, Nashville-based nTelagent, Inc. announced the release of its “Contract Calculator,” which consolidates a hospital’s individual insurance contracts into one actionable database. It’s the latest module in the company’s Retail Application for Healthcare.

With the new module, patient access and registration staff members can instantly and accurately perform some of the most complicated calculations related to patient financial accounts — finding the approved charges and accurate patient co-insurance. Due to the complexity in calculating co-insurance rates, facilities often opt not to request a payment on the front end. However, nTelagent CEO Earl Winter maintains this approach leads to a gap in the revenue cycle and often results in lost dollars and increased bad debt.

“The rollout of our Contract Calculator allows nTelagent clients to completely close the loop on resolving patient accounts at point of service. Most importantly, patients can rest assured that their accounts are handled consistently and accurately, and that amounts requested for payment are in accordance with their insurance provider contract,” explained Winter.

He also noted the calculator makes it easier to comply with healthcare reform … specifically, the new “limitation on charges” regulation. The Patient Protection and Affordable Care Act (PPACA) requires amounts charged to individuals eligible for assistance under the hospital’s financial assistance policy be limited to no more than the amount generally billed to individuals with insurance. The nTelagent app addresses those generally billed amounts and consistently identifies patients who qualify for assistance. The company’s real-time scripts tell the registrar whether the patient qualifies for assistance and what steps to take next.

onFocus Healthcare Expands Client Base With Addition of Provider Organizations

Brentwood-based onFocus Healthcare, Inc., a provider of web-based enterprise performance management solutions for the healthcare services marketplace, recently added four new provider organizations to its client roster. These additions more than double the number of hospitals using the company’s innovative new “Enterprise Performance Management” (EPM) software solution called onFocus|epm^TM, which combines performance data from many disconnected sources into a single solution that links together critical objectives and targets with action plans, progress tracking and just-in-time communication to drive and sustain better financial and clinical outcomes.

 The new clients, which include Nashville-based Ardent Health Services and Vanderbilt Medical Group, Fox Chase Cancer Centers in Philadelphia, and a major for-profit health system, join a growing list of healthcare organizations using onFocus|epm to ensure higher levels of financial, clinical and operational performance required in order to more effectively compete in the new healthcare business model. Together, the new onFocus|epm customers operate more than 60 hospitals and healthcare facilities.

Passport Adds to Software Suite with Payment Navigator

Passport Health Communications Inc. recently launched a new healthcare revenue cycle solution called Payment Navigator. The software enables hospitals to avoid bad debt and reduce uncompensated care by performing an in-depth financial analysis for uninsured patients prior to service and recommending the best payment avenue – Medicaid, charity care, up-front collection or payment financing.

“There are 46 to 48 million uninsured Americans, the majority of whom depend on hospitals as their healthcare safety nets. Healthcare organizations must be proactive in managing their self-pay volume and properly categorizing patients who qualify for certain programs,” said Scott MacKenzie, CEO of Franklin-based Passport. “Payment Navigator assures that every patient is placed in the correct payment category during patient access, before treatment.”

In a recent American Hospital Association survey, 87 percent of hospitals reported increased bad debt and charity care as a percent of total gross revenue. Overall uncompensated care, according to AHA, has risen 69 percent since 2000. Passport research has shown, however, that approximately 10 percent of self-pay patients actually qualify for Medicaid, and other self-pay patients have the financial means to pay for their own care either in full or through a finance plan.

Payment Navigator performs a thorough up-front financial triage on all patients who say they are unable to pay and alerts patient access staff when patients qualify for Medicaid or charity care. By automatically assessing every registration, hospitals should be able to catch 100 percent of Medicaid-eligible accounts pre-service, even in the emergency department and for high-volume outpatient procedures. When patients don’t qualify for either Medicaid or charity care, Payment Navigator will check their ability and propensity to pay to and recommend whether full payment should be collected or an interest-free payment plan should be offered.

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