Software

Patient Financial Clearance

Patient Financial Clearance uses healthcare technology to provide everything provider’s need to engage with patients and proactively educate them about their financial responsibility helping you to decrease denials, increase collections, reduce bad debt and increase patient satisfaction by providing the financial information patients need.

Our comprehensive financial clearance and patient engagement suite helps providers reduce denials with complete insurance eligibility verification, automated pre-authorization screening and verification, financial responsibility estimation, point-of-service collections, ID validation, and support for patient financial assistance programs.

Improves efficiency

Workflow-driven financial clearance dashboard that provides at-a-glance information for action across patients.

Reduces administrative costs

Automates everything and allows staff to work by exception, utilizing one of the largest payer networks with web technology and bi-directional HIS integration.

Reduces A/R and denials

Robust registration data quality assurance and pre-authorization/medical necessity management technology.

Included modules

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    AHI QA

    Registration data accuracy

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    AHI Lobby

    Patient flow monitoring

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    Clearance Verifier

    Eligibility verification

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    Clearance Authorization

    Pre-authorization and medical necessity management

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    Clearance Patient ID

    Patient data verification, identity validation and ID fraud detection tools

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    Clearance Propensity to Pay

    Determine patient’s ability and willingness to pay

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    Clearance Estimator

    Allows providers to estimate patient financial responsibility

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    Clearance Estimator Patient Direct

    Patient-facing financial responsibility estimation tool

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    Clearance Advocate

    Charity care/financial aid screening and enrollment

Related resources
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Transform patient access to drive engagement, loyalty and revenue

To achieve positive financial outcomes, health care providers need to reduce costs and speed up reimbursement. Optum helps you achieve greater patient satisfaction and healthier bottom line with a full suite of patient access solutions.

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Frequently Asked Questions

Q: Do I have to view eligibility responses in Patient Financial Clearance?

A: No, it has bi-directional functionality via ANSI x12 270/271 or HL7 interface.

Q: Can we use Patient Financial Clearance to identify undisclosed insurance coverage?

A: It can be configured to check for Medicaid coverage on self-pay patients. Coverage discovery for commercial plans is handled by Coverage Insight, which can be integrated.

Q: For Medicare and Medicaid patients, do you notify the user when the patient is enrolled in a replacement or HMO plan?

A: Yes, when the response notes the patient is enrolled in a replacement or HMO plan, Patient Financial Clearance will display a blue HMO icon.

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