Robert Wood Johnson University Hospital Hamilton

Robert Wood Johnson University Hospital Hamilton (RWJ Hamilton), an acute care hospital and integrated healthcare organisation in New Jersey, has selected US-based Provider Advantage NW’s Revenue360 pricing estimation module.

Provider Advantage’s Revenue360 pricing estimation module applies intelligent logic by calculating procedural charges, analysing historical data, evaluating contract pricing between the organisation and the payer, and applying patient insurance benefit information to establish an estimated patient financial obligation at the earliest point of patient contact.

RWJ Hamilton, which is a long-time user of Provider Advantage’s integrated Revenue360 eligibility verification module, recognised that the integration of a pricing estimation module with the existing eligibility verification solution could simplify the process of calculating, communicating and collecting on credible patient estimates.

According to RWJ Hamilton, one of the central issues of pricing transparency for healthcare providers is to provide a clear, concise estimate of a procedure’s pricing for the patient prior to service. Even more important is the ability to explain the patient’s out-of pocket portion of this cost.

This helps the hospital better communicate with patients while properly setting accurate payment expectations.

Creating this price estimate is difficult for the healthcare provider because they must combine actual experience with complex and transitory data into a single cost figure for the patient.

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According to Provider Advantage, integration of the Revenue360 pricing estimation with the eligibility verification module will allow RWJ Hamilton staff to deliver timely, credible estimates to any patient with the insurance plans they contract with.

In addition, the staff can provide estimates for uninsured patients by setting up a self-pay contract that calculates the out-of-pocket expected payment responsibility while taking into account any applicable discounts.

"It was natural that we would choose the Revenue360’s Pricing Estimator to integrate with our current processes, given the success of our eligibility experience with Provider Advantage."

Robert Wood Johnson University Hospital Hamilton patient access director Danielle Pieloch noted that Provider Advantage’s eligibility solution has helped the hospital to increase upfront collections by identifying co-pays and deductibles for over ten years.

"We are excited to add the Revenue360 pricing estimator solution to better communicate the patient’s total expected payment responsibility. This will help address pricing transparency by preparing our patients in advance, setting up payment plans where needed and ultimately improving our point-of-service collections process.

"It was natural that we would choose the Revenue360’s Pricing Estimator to integrate with our current processes, given the success of our eligibility experience with Provider Advantage," Pieloch added.

RWJ Hamilton is affiliated with Robert Wood Johnson Health System. The New Jersey hospital provides a network of comprehensive healthcare services that includes hospital care, prevention and wellness, primary and speciality medical services and diagnostic and treatment services in the community.

Image: Robert Wood Johnson University Hospital Hamilton in New Jersey. Photo courtesy of PRWEB.