Maximize Revenue via Health Insurance Marketplace

One of the ideal ways to ensure good revenue cycle management is to work with self-pay medical facility patients who need help understanding and enrolling in a health insurance plan offered through the appropriate federal or state marketplace exchange. The exchanges are portals for accessing a variety of insurance options that include private health insurance, Medicaid and the Children’s Health Insurance Program (CHIP).

The Affordable Care Act (ACA) makes it easy to identify accessible health benefits and patient subsidies. The reason many people are still not insured, despite eligibility and legal mandate, is that they find the enrollment process too difficult for many reasons, including language, cultural and technology barriers.

There is also still much confusion as to how the enrollment process works, and people who have never had health insurance frequently have difficulty understanding deductibles and copays. Per research conducted by Transamerica Center for Health Studies, approximately 15 percent of Americans remain uninsured. The people most likely to not have health insurance are between the ages of 18 and 34 or are Latino.

Hospitals and other medical facilities continue to incur billions of dollars in uncompensated care for uninsured patients despite the ACA. An ideal course of action is to have people onsite who are versed in the health insurance registration process, can communicate with diverse patients, and can answer complicated questions concerning coverage.

 

Patients can get assistance with selecting a health insurance plan that best fits their financial and health care needs. This is one practical answer to the question, “What is revenue cycle management?”

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