12 blog posts tagged "Healthcare"

International healthcare is complex. Inaccurate or unverifiable international addresses make it worse by delaying claims, increasing compliance risk, opening the door to fraud, and frustrating members. Healthcare companies need global healthcare address verification that’s scalable. Here's how to get there. Why global address verification is especially complex for healthcare companiesHealthcare depends on addresses. While just one datapoint, addresses are foundational to so many critical healthcare management processes and vital to get correct.

When it comes to address verification, getting a match every time might seem like the goal. After all, a system that always returns a validated address must be working perfectly, right?Wrong. If your address verification API always forces a match, no matter what, it’s not being helpful. It’s actually introducing risk. In fact, getting a “no match” result can frequently be the smarter, safer outcome. Let’s talk about why. What is a "no match" telling you?A “no match” means the input address doesn’t align with any known, valid address in the reference database.

Let's start with a number that should make every hospital administrator do a double take: $17. 4 million. That’s how much the average hospital loses annually—just from denied claims due to patient misidentification. This isn’t from equipment costs, not from staffing shortages, and not even from insurance negotiations—just from keeping bad patient data. Surely, our forms aren’t that bad. (Yes, they are, and stop calling me Shirley. )But here’s the reality: According to the 2016 Ponemon Misidentification Report, 30% of hospital claims get denied, and over a third of those denials are caused by inaccurate or incomplete patient information.

Healthcare is experiencing a dramatic shift in how patient information is stored and managed. Electronic medical records (EMRs) and electronic health records (EHRs) have become the new standard, driven by two powerful forces: everyone has mobile devices and the increase in the human population. A growing problem with clean address data in EMRs and EHRsWhile EMRs and EHRs offer amazing accessibility and storage capabilities (way better than a filing cabinet), they've also exposed a critical weakness in many healthcare organizations: address data quality.

In any industry that’s regulated and works with PII (personally identifiable information), a simple address error can cost more than just a returned letter. With HIPAA violations ranging from $100 to $50,000 per incident and the possibility of criminal charges, getting patient addresses wrong is more than an administrative headache—it's a serious compliance risk under HIPAA, ACA, and other mailing regulations. Our new ebook explores how address data quality directly impacts regulatory compliance, patient privacy, and health equity requirements, among 12 other hot topics.

In healthcare, the havoc an inaccurate address can wreak on your financial results is significant in more ways than one, and the boost in overall profitability from maintaining a clean address database is equally worth noting. Accurate healthcare address validation improves operational efficiency, patient engagement, and compliance and builds revenue to heights that couldn’t be met without it. Here’s what we’ll be covering:Healthcare address validation pros and consCon: Increased claim denials and organizational costsPro: Reduced claim denials and reprocessing costsCon: Increasing patient match error ratesPro: Improved patient matching and data qualityCon: Complicated billing and collections processesPro: Streamlined billing and collections capabilitiesCon: Exposure to legal liabilitiesPro: Enhanced regulatory compliance and risk aversionCon: Misplaced market strategyPro: Data-driven decision-making and market insightsEpilogue: Avoiding the pain (see our summarized financial savings)Healthcare address validation pros and consThere’s a pro and a con associated with having (or not having 🫣) accurate address data in your healthcare systems.

In our previous post, we prescribed solutions to the problems associated with having bad address data in the software side of healthcare. If you would like to go over those again, or if you stumbled upon Post 3 before the previous blogs, you can read Post 1 or Post 2 now. In this third and final installment, we hope to provide even more solutions to healthcare hiccups on the SaaS side. Software and real-time data go hand in handPreviously, we discussed how many healthcare companies are struggling to keep up with their data storage and why it’s essential to clean up the mess.

Software in the healthcare industryIn our previous post, we diagnosed the problems associated with having bad address data in the world of healthcare. If you would like to go over those again, or if you stumbled upon Post 2 before Post 1, you can read about those problems here. In this second installment, you'll learn about the solutions to those problems from a software development standpoint. As you may already know, the healthcare system often relies on robust software systems to keep patient’s electronic health records and billing in the same place.

Why accurate addresses matter to healthcare professionalsThe healthcare system typically relies on human entry for its data entry. Whether the information is added by the customer, a receptionist, a nurse, or even a doctor, there are a lot of areas for the information to be misentered. Not only that, but hospital staff members frequently edit or enter additional information following the patient's first visit. The constant editing and entering of data by a human results in more than just a tiny typo now and again.

Handling address data is such a routine occurrence for health insurance providers that it’s not the first thing that would come to mind as being a liability. However, the reality is that discrepancies and inaccuracies in address data can have far-reaching consequences, posing serious privacy and compliance risks. Healthcare fraud, reputational damage, and financial penalties are just a few examples of the potential hazards. In this article, we’ll delve into three common types of privacy and compliance risks resulting from incorrect or incomplete address data.

When it comes to physical health, sometimes the smallest things can have a big impact. A microscopic virus or a small injury can develop into a life-threatening infection before you even know it’s there — and conversely, a tiny pill or ointment can save a life. The little things matter when it comes to health data, too. In particular, address data is a small part of a patient profile that can have far-reaching effects if it is incorrect or incomplete. Address data is a key information point at the center of billing and communication with patients, and even a slight mistake in an address—a missing unit number or a misspelled street name—can make mail undeliverable.

Ever since the first Blue Cross health insurance plan was provided to Texas schoolteachers in 1929 for a monthly fee of $6, health insurance providers have formed the backbone of the American healthcare system. Today, as that system faces ongoing scrutiny, health insurance providers are still at the heart of the action, striving to connect patients to the highest possible quality of care while navigating significant changes including rising costs, digital transformation, medical advances, customer expectations, and ever-present regulations.