KHSC Newsletter Articles
Recovering Missed Revenue Opportunities

Altruis Retropay (April 2020) – Today, every collected dollar counts! Would it surprise you to learn that a typical hospital may miss collecting hundreds of thousands of dollars of Medicaid and managed care Medicaid payments annually? No matter how good your systems are, there are significant claims that simply fall through the cracks and are written-off to bad debt.

Consider a few lost revenue examples:

  • A patient who changes managed care organizations without your facility's knowledge.
  • A Medicaid patient who identifies as self-insured and later becomes eligible.
  • A patient who weeks after an emergency room visit enrolls in Medicaid.

RetroPay™ is a proven method of identifying, usually within one week, self-pay patients with encounters that are qualified for Medicaid and managed care reimbursements retroactively, so payments will be properly processed. These are dollars your facility is currently writing-off.

Whether the patient was eligible at the time of service and did not present the insurance information or became eligible after the visit, we are able to find these encounters and ensure proper reimbursement. These Medicaid and MCO visits can then be counted toward your disproportionate share hospital payment and qualify your organization for additional dollars beyond the straight reimbursement.

In the first month of using RetroPay™, a facility received an additional $500,000 of revenue. Working with Altruis™, this facility continues to realize $100,000 per month in increased revenue using RetroPay™.

In addition to RetroPay revenue, once the patient's eligibility is updated, the medical record reflects the correct payors. This allows future encounters billed by the facility to get paid properly with no Altruis fees. A study of 18 facilities showed an average increase of 38 percent in Medicaid collections from these patients.

RetroPay™ requires no set-up or integration fees and no software installation, making implementation fast, easy and cost-effective. Within 30 days, increased revenue can occur.

As a KHA member, you qualify for a no-cost analysis that will demonstrate projected revenue increases. Learn more at https://altruis.com/retropay, or contact Chris Miller at (816) 588-4650.