BLOG

How Estimate Automation is Transforming Healthcare Billing

Providing accurate patient estimates in healthcare is crucial, but it can be difficult without the right tools and processes in place. That’s why the Almanac was developed, a computer program that can identify historical charging trends. This data can then be used to create better estimates and help healthcare systems meet the No Surprises Act standards. 

Learn more about how the tool was created and how it transforms estimate automation and improves healthcare billing.

Understanding the No Surprises Act

In 2021, the No Surprises Act was signed into law with the goal of improving transparency in healthcare pricing. It requires healthcare providers to give cost estimates to self-pay patients at least three days in advance of their visit, helping them avoid financial surprises after treatment.

Non-compliance with the act can result in serious consequences, including legal penalties and audits. Patients aware of their rights can refuse to pay if they don’t receive an estimate, or if their final bill exceeds the estimate they received by $400. 

This leaves healthcare providers with unpaid bills, overworked staff, and damaged relationships with patients. An automated solution was needed to meet these new requirements efficiently without sacrificing accuracy.

Introducing The Almanac

To address these challenges, Continuum Health IT management consultant Matt Stamerjohn developed a computer program called the Almanac. It identifies historical charging trends, which are used to automate estimate generation and ensure compliance with the No Surprises Act. 

Using historical data and analyzing various factors like location, department, specialty, and appointment details, the Almanac helps healthcare providers produce precise estimates efficiently. The tool enables automation, freeing up staff resources and improving trust between patients and providers.

The Power of Accurate Estimate Automation

Using the Almanac tool brings several key advantages to healthcare organizations by automating the estimate process and ensuring accurate, efficient billing practices. Here are some of the main benefits:

Increased Compliance

Organizations using the Almanac have seen a significant increase in compliance with providing estimates to self-pay patients. This ensures that healthcare providers meet their obligations under the No Surprises Act and fosters trust and transparency with patients. 

Higher Revenue and Pre-Pay Collections

The tool allows healthcare organizations to identify billing gaps and collect more payments upfront. According to Matt, one Epic client saw pre-pay collections increase by $125,000 year over year (January 2023 vs. January 2024) after implementing the Almanac — a potential increase of $1.5 million over the course of a year. 

Greater Staff Efficiency

By automating estimates, the Almanac frees up staff from manual estimate generation tasks. This improves productivity and gives healthcare professionals more time to focus on patient care.

Empowering Healthcare Organizations

By empowering healthcare organizations to assess compliance and streamline billing processes, the Almanac promises transformative benefits. Adopting automated solutions like the Almanac is crucial for healthcare organizations to best serve their self-pay patients and avoid losing money due to missed payments, billing errors, or legal loopholes.

Continuum: Your Partner in Estimate Automation

At Continuum, our team is here to discuss how we can help you implement the Almanac within your healthcare organization. We’ll work with you to extract and analyze your data, and then tailor an automation strategy that aligns with your needs. 

Contact us today to take the first step toward enhancing your billing processes and improving patient satisfaction.

Tell Us About Your Needs

Continuum Health’s IT experts can ensure that your organization has full access to deliver outstanding technology solutions and staffing assistance whenever and wherever you need it. Contact us to schedule a consultation.