EOBs (explanation of benefits) are standard patient communication. They typically come after the patient has a health appointment. However, new legislation called the No Surprises Act is about to change this workflow. The law requires advance EOBs as a way to not “surprise” patients before a medical treatment or procedure.
For some health plans, that could dramatically increase your print and mail volume. With its effective date coming soon in 2022, how will you handle this new requirement?
How Do You Handle Current EOB Communications?
If you currently have a system in place for patient communications, will it hold up with additional volume? Health plans typically have two avenues to produce their EOBs, either internally or by outsourcing.
You may be able to have a rough estimate of your expected increase. Still, you likely won’t have a good handle on this until after the legislation becomes effective. Now is the time to plan for 2022 and reevaluate your entire operation.
Can Your In-Plant Handle Greater Volume and Not Increase Your Error Rate?
Does it make sense fiscally to continue running print and mail through your own in-plant? The advanced EOBs will need the same care as any others regarding data privacy and HIPAA compliance. As you’re aware, these aren’t simple requirements. You have to have a well-designed program in place to ensure that every letter makes it to the correct envelope.
It seems like a simple thing, but with thousands of letters every day, you’re likely to have an error rate. Odds would say that if your volume goes up, so will your error rate. The best way to minimize this is with technology that uses barcodes to scan every document, read by cameras to ensure individual folding. If you don’t have such a solution in place, are you willing to invest in it? It could be the difference between accuracy and noncompliance.
If You Outsource, Can Your Vendor Keep Up?
For those health plans that outsource, you should begin having conversations now about the expected increase due to advanced EOBs. Depending on their size and capabilities, they may not be able to support this influx.
Rethink Patient Communications
Regardless of what your current system is, there are big questions on the horizon because 2022 will look different. If you want to be confident in your ability or your vendor’s to meet the compliance requirements of the No Surprises Act, then consider a new partner like PCI Group.
We provide services to all types of healthcare entities and are HIPAA and HITRUST compliant. Our robust technology solutions enable us to drive efficiency and accuracy, including an industry-leading accuracy rate of 99.9999%. Additionally, we can likely reduce your overall cost due to our lean processes.