Reducing the Complexity of International Claims

Nearly 80 million foreigners visited the US in 2018[1]. Around 10 million have long-term visas that allow them to stay anywhere from a few months to a few years.[2]Visiting an ER during a visit—short or long-term—is likely the last thing anyone wants, but it happens more often than you may expect. And when it does, it can be challenging for both staff and the patient, especially when considering language barriers, cultural nuances, and insurance differences. Unfortunately, the challenges don’t stop after discharge as international collections are extremely complex—one that, when not effective, can cause considerable damage to a hospital’s bottom line.

It’s about more than insurance

While half of foreign travelers who receive emergency care in the US do have some type of medical insurance, it may vary vastly in adjudication processes and regulatory requirements. The half without insurance further adds to the increasing pressure hospitals are already experiencing in collecting from self-pay patients. For this reason, international claims cannot fit neatly into a hospital’s traditional billing and collections workflows. Hospitals that try often cause more headaches with fewer results. The challenges include:

  • Requirements for medical coding for international medical claims vary from country to country
  • Foreign currency conversion can be difficult for billing staff and the patient
  • Language barriers can make communicating patient financial responsibility challenging
  • Collections agents need to be available around the clock to handle all time zones
  • Payment methods such as wire transfers and credit cards can have limits and regulations that cause roadblocks to collecting in full
  • International claim adjudication doesn’t seamlessly fit within a hospital’s RCM system and processes

The fact is, few hospitals have collections staff—or the RCM technology—to effectively navigate these many challenges. To mitigate these deficiencies, hospitals should consider outsourcing international claims and collections to industry experts. Considering the significant write-offs many hospitals experience, even just a few successful collections can return a positive return on the investment.

Finding the right partner

First of all, you need a partner whose culture and ideals align with those of your hospital. They need to understand the importance of the patient financial experience and the impact on your hospital’s reputation and patient satisfaction scores. They need to act as an extension of your own team. No matter how great the vendor’s technology or fees, without a commitment to the patient financial experience, the potential damage can outweigh the benefit.

Sunbelt Health Partners understands the unique challenges of international claims. They have the experience necessary to effectively navigate the nuances of language, cultural customs, and currency conversions. Their team of experts have acquired in-depth knowledge of international claims adjudication, including coding specifications and regulatory requirements.

Reporting is essential when choosing a partner. Sunbelt provides full transparency with qualitative and quantitative data on claims, ongoing account statuses, and patient satisfaction. They also have the highest level of security technology to comply with  HIPAA, HITECH, and ISO regulations, both internationally and at home.

By partnering with Sunbelt Health Partners, facilities can expect to speed time to payment and improve international payer and patient relationships. Our multi-lingual claims administration team is based in the US and provides onsite training, along with personalized provider and patient payment education and guidance.