Cost of Not Screening Uninsured Emergency Department patients

Most hospitals have processes in place to screen, engage, and successfully enroll uninsured patients that have an inpatient procedure. Coverage is much less robust when it comes to enrolling uninsured emergency department patients. In some ways this makes sense. More uninsured patients use the Emergency Department, emergencies occur 24/7, and uninsured balances in the Emergency Department are less than in inpatient. Having a financial counselor connect with and screen every patient is probably impossible. What though is the cost of not screening an uninsured Emergency Department patient?

The average balance for an uninsured individual using the Emergency Department is approximately $2,000. Compared to inpatient balances in the tens of thousands of dollars this is small. According to AHA Annual Survey Data and analysis by EY, approximately 60% of uninsured patients qualify for financial assistance, but aren’t being enrolled.

If a hospital engages with the patient early in the process, then there is a significantly higher success rate for completing a financial assistance application. Patients that are screened within 24 hours of receiving care are twice as likely to complete an application. And, based on a review of industry data once a patient starts an application, they are 90% likely to remain engage and complete the application. Thus, for every single uninsured Emergency Department visit that your system does not attempt to screen or engage with the patient, you are leaving $500 in reimbursement on the table. This is in addition to the positive impact that getting a patient enrolled in coverage has on their health outcomes.

Advocatia can help

Advocatia has streamlined the enrollment experience for financial counselors and uninsured patients. Instead of having counselors fill out multiple paper forms or asking patients to navigate confusing state websites, our platform allows financial counselors to focus on what matters - helping people connect to coverage. Advocatia can help you enroll more uninsured patients, reduce your bad-debt, and improve community outcomes.