More on Claims Processing

RelayHealth teams with ERI to offer revenue recovery services to healthcare providers

In lieu of fees, healthcare organizations will pay a percentage of the recovered funds to ERI.

Henry Powderly, Editor-in-Chief

RelayHealth Financial on Monday announced plans to partner with Emergency Recovery Inc., a revenue recovery service provider, to offer participating health systems a solution to help recover unpaid claims.

The news comes a few days after ratings company Black Book filed a report showing the number of hospitals outsourcing these types of claims recovery services to third-party vendors is steadily rising, with nearly 40 percent saying they outsourced those functions in the third quarter of 2016.

[Also: More hospitals outsourcing complex claims to collect revenue, survey finds]

"There are a lot of ways to go after unpaid claims, many of which are distasteful to hospitals because they involve too much risk," said Marcy Tatsch, vice president and general manager of Reimbursement Solutions a RelayHealth Financial, in a statement. "After talking with our customers, we knew they needed an offering that posed no risk to the patient relationship or the bottom line.

According to RelayHealth, the deal means providers will be able to enlist ERI to help spot claims that may have gone underpaid, or unpaid altogether. If found, ERI will handle recovery efforts by directly working with the insurance companies. ERI will also help with collection on cash owed by patients.

ERI will also offer analytics around unclaimed revenue, so providers can track what is being collected.

[Also: McKesson healthcare information unit merges with Change Healthcare]

For example, claims such as those tied to motor vehicle accidents, can often be incorrectly field with insurance networks, which can account for a lot of lost revenue.

In lieu of fees, healthcare organizations will pay a percentage of the recovered funds to ERI.

RelayHealth Financial is part of McKesson Health Solutions, which announced its sale to Change Healthcare in June. That deal has not closed and it is unclear how the merger will affect RelayHealth's branding.

Twitter: @HenryPowderly
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