Insurance programs and benefits are constantly shifting eligibility requirements, application processes, web site navigation, and more. In Q1 of 2020, we saw 2,366 changes to programs, a record high compared to the last several years of data. This means that for a frontline team member screening patients for coverage, it is next to impossible to keep up with the latest requirements. Misinformation is harmful to the patient and the healthcare facility, leading to denials and preventing reimbursement for services rendered.
In the time of COVID-19 this is more true than ever, with changes being made to presumptive eligibility and other program features aimed at addressing the growing healthcare and unemployment crisis. Here are some of the most important changes we tracked in the second quarter of 2020:
Q2 Updates: April 1, 2020 - June 30, 2020
In Q2, we saw 2,485 changes impacting 737 programs across the country. Here are a few highlights:
- 314 eligibility requirement changes
- 689 changes to program applications
- 35 new programs added
COVID-19 and Eligibility
Data shows that when every patient is screened using PointCare, approval rates increase 53%. More approvals leads to more covered visits, resulting in more revenue.
With many patients losing employment based healthcare coverage, uninsured rates are rising across the country. Healthcare facilities need to qualify patients quickly and accurately while maintaining COVID-19 best practices. Finding all available coverage options over the phone is imperative, and PointCare’s 90 second screening tool can be used remotely. Our up-to-date national database includes options aimed at addressing the COVID-19 pandemic.
Developing Best Practices
Although team members may be well versed on the insurance landscape, over 2,000+ changes each quarter makes tracking all changes a daunting task. Standardizing screening processes using a current database is key to not only identifying coverage options accurately, but also increasing approval rates.
PointCare includes in-app reporting to assist in identifying qualification rates, operational opportunities and measuring efficacy. Compare data across sites to identify areas of success and opportunities for growth.
PointCare ensures a standardized and data-driven qualification process. Using our nationally curated database of all insurance and benefit programs nationwide, team members know that they are sharing up-to-date information with patients. Once this 90-second screening is complete, the patient can receive results via email, text, or print.
PointCare Qualify API is now available as a stand-alone product or as part of the Total Enrollment Management platform. Schedule a call with our team to learn more.
Want to learn more about PointCare's Best Practices? Check out our website, www.pointcare.com!
Note: Our Customer Success Advisors have implemented PointCare in over 600 health system sites nationwide who have decided to simplify their enrollment cycle. We are now providing free enrollment cycle assessments for those who qualify. Schedule a call with our team to learn more.