FAQs

Why should we outsource when we believe it can be done “cheaper” internally?

DECOnet™ Eligibility Application software, specifically designed for screening the patient and tracking the status throughout the process, is a critical tool for not letting anything ‘slip through the cracks’ and potentially not getting a patient coverage.

DECO’s field representatives can go to patient homes and pick up documents, transport patients to Social Services appointments, and hand deliver applications to Social Services. Facility liability typically prohibits these critical activities.

HFMA and the American Hospital Association published the Patient Friendly Billing® Project in February 2005, which encourages hospitals to utilize the expertise of an outside vendor for eligibility to avoid unintended consequences down the road.

DECO can pay bonuses to employees to encourage hard work. Most facilities do not have that latitude.

The price seems high, and makes my budget look out-of-balance. How can I justify bringing a vendor in when our current in-house team is very cheap?

DECO does not make a dime unless we generate revenue for the client. We convert potential zero-pay accounts into real dollars. A percentage of $0 collected is $0 on your budget, but a percentage of $1 million collected is worth the expense for basically ‘free money.’

Medical Assistance Eligibility Services should NOT be considered part of the normal budget. No payments would be due UNLESS a proportionate amount of revenue was received by the client. It is a no-lose situation for the facility.

Additionally, and more difficult to calculate except at the CFO level, is the Disproportionate Share benefit. These are very significant and real dollars that are paid to a facility for caring for a proportionately larger share of Medicaid and SSI patients than other payor classes. These funds are reconciled ultimately on a facility cost report or other settlement statement.

Other than good public relations, how can my facility benefit monetarily by helping my patient base get SSI and/or SSDI benefits?

Often a patient cannot qualify for traditional Medicaid due to income or assets slightly over the guidelines, but still cannot pay medical bills and may truly be disabled.

If a facility contracts with a vendor for disability services, this potential ‘gap’ in reimbursement can be filled with the patient initially getting Medicaid with a ‘look-back’ window from the date he or she first attempted to get benefits. This means that a facility caring for a patient who wins disability benefits could potentially be reimbursed for up to 24 months worth of visits from Medicaid and/or Medicare.

After 2 years, SSI recipients are eligible for Medicare, which reimburses faster and for more services.

Potential Disproportionate Share (DSH) benefit for facility.

Patient receives a monthly income.

Patient has resources to obtain treatment and medications.

Patient may be eligible to receive food and housing assistance.

We see great benefits in DECO’s services. How long will it take for DECO to be up and running and creating a revenue stream for our facility?

DECO produces a detailed customized Implementation Plan for each facility. Depending upon the specifics at a particular facility, DECO can begin servicing a new client typically within 60 to 90 days.

I think my current vendor is doing a good job. Why should I consider bringing DECO on board?

Be certain you have great reporting tools that are accurately and fairly measuring their results. You should track the total number of self-pay patients admitted to your facility and the total number of referrals converted to a paying account. This represents your gross referral percentage. Also, check the time frame from date of referral to approval date.

The revenue may seem good….but in reality you could be leaving just as much revenue on the table.

Does your current vendor have a Social Security Disability Advocacy Program with experienced representatives like DECO offers?