KDnuggets : News : 2009 : n08 : item31 < PREVIOUS | NEXT >


Hospitals mine data to identify those likely to pay

By Andy Miller, The Atlanta Journal-Constitution, April 19, 2009

As an Equifax executive, Arvind Krishnaswami saw the chronic gap between what hospitals billed patients and what they received. Hospitals, collecting an average of 10 cents on a dollar, wrote off "a staggering amount of bad debt," he said.

That disparity gave Krishnaswami the impetus to form Roswell-based Medlytix in 2006, joining a wave of companies that use data to help hospitals improve their back-office accounts.

These services - including credit scoring - help nonprofit hospitals identify patients who qualify for charity or free care, those eligible for discounts and those who should pay the whole bill.


With the 2009 tax year, nonprofit hospitals will be required to give a detailed assessment and value of their charity care and community benefits on a revised IRS form 990.

The new IRS form has driven growth in the hiring of data-mining companies to calculate who deserves free care, said Bruce Nelson of Minnesota-based SearchAmerica.

"We take into account a whole lot of financial circumstances -- credit may or may not be a part of it," he said.

Krishnaswami said there’s a danger in pulling a patient’s financial data before a procedure because it could lead to a hospital denying elective services for the uninsured and underinsured.

Medlytix comes up with a data-driven score that rates consumers’ willingness and ability to pay their medical bills -- but only after the service is rendered, he said.

Read more.

KDnuggets : News : 2009 : n08 : item31 < PREVIOUS | NEXT >

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