Dive Brief:
- Hospitals are being forced to reconsider their billing and collections processes as a result of the Affordable Care Act.
- With patients often confused about the product they bought on the exchanges, many hospitals are taking a more active role in helping them understand their benefits and fees, in some cases using scripts in order to convey a consistent message.
- One of the most difficult issues for hospitals is questions of patient eligibility for insurance and charity care. Health leaders are struggling with whether they should offer charity care if the patient was eligible to be covered through the exchanges but didn't buy a policy.
Dive Insight:
Hospitals are trying a number of strategies to cope with new charity care issues created by the ACA. To address the issue of which patient should have charity care, some hospitals are offering so-called presumptive charity, in which they contract with the credit scorer. If the score reaches a certain level, hospitals automatically writes expenses of care off to charity care and let the patient know. But most hospitals are still executing their usual billing and collection practices, experts say. It may take a long time before hospitals adjust to the ACA and its impact on their charity care programs.