Jordan Levitt, EVPThe U.S. healthcare market has undergone a sea of change over the last decade. A large part of that makeover came following the proliferation of the ACA aka Obamacare initiative. Overnight, the country went from having a population that was either insured or uninsured, to a nation of underinsured patients. In other words, almost every American was suddenly covered by some form of health insurance, even if the coverage came with gray areas and a higher patient responsibility than the patient could afford. The medically indigent and uninsured, would now find themselves with coverage that would preclude them from the free or highly subsidized care they may have needed; an unintended consequence.
As healthcare plans have grown more convoluted, the industry has evolved, and the added regulations and data requirement have become more onerous. The technology used behind the scenes to validate a patient’s coverage, unfortunately, has remained stagnant, making it increasingly difficult for healthcare providers to verify insurance coverage, benefits and patient responsibility and keep up with the new theme of patients changing plans on an annual basis. Capturing and managing accurate data, now requires change more frequently than ever before.
This is where FrontRunnerHC started to become a standard. Through its neural network of data and scrubbing capabilities and advanced technology, they assist various providers in cleaning up inaccurate data that would otherwise lead to claim rejections and/or the inability for a statement to reach its intended recipient.
Today’s healthcare providers are at the mercy of the data that has been provided to them, a problem that they have struggled with for years. Depending on providers access to the patient, to confirm demographic and insurance data, nationally, the amount of inaccurate information entering the revenue cycle ranges from 10 percent to 30 percent. This inaccuracy leads to an increase in operating expenses, more challenging cash flows, and reduced reimbursement. It requires phone calls to referral sources, patients and payers that are time-consuming and create customer satisfaction issues.
JD Donnelly, President & CEOTraditional healthcare data providers still act as “toll takers” that focus on validating 70 percent to 90 percent of the accurate data that can be billed with limited intervention. FrontRunner focuses on the 10 percent to 30 percent requiring heavy lifting and fixes it, while letting the 70 percent-90 percent pass upon verification. The errors are the genesis for creating account rework, increased workload, and reduced reimbursement and patient payments.
“Today most organizations buy transactions to help them verify coverage and demographics, but the patients without coverage are left for the organization to fix themselves. At FrontRunner, we’ve flipped the coin over by building tools around the patients that do not have coverage, and we built a real-time network so our organizations can fix information in real-time” explains John Donnelly, President and CEO, FrontRunnerHC.
With so many different system architectures across various provider types, FrontRunnerHC focused on solutions that are easy to use, implement and integrate with virtually any IT system. This deep-rooted agnostic ability to exchange data is what separates them from other healthcare solution providers, according to Jordan Levitt, EVP, FrontRunnerHC. “Everything we do in our platform is in real-time. Therefore, our customers can still use their existing system, and with a click of a button, discover everything wrong with a patient. This means a registrar can perform that action if a patient is in front of them, or we can automate the process as an order presents in a laboratory,” says Levitt.
Going forward, FrontRunnerHC will persist with its plan to execute deep integration with all vendors drawing parallels to the infamous “Intel Inside” model. The organization intends to continue delivering the most reliable and accurate data, while also improving the delivery and integrated use of data, to maximize their customers’ revenue.