Hospital patients often find themselves navigating a labyrinth of insurance policies, billing procedures, and coverage options—all while dealing with the physical and emotional stress of injury or illness. This challenge becomes particularly acute for patients involved in motor vehicle accidents (MVAs) or other third-party liability (TPL) situations, where multiple potential payers and complex regulations create additional layers of confusion.
The Financial Burden on Patients
Consider this sobering statistic: aside from the very real human toll, motor vehicle crashes cost American society $340 billion, according to the National Highway Traffic Safety Administration. Even more alarming, according to the U.S. Centers for Disease Control and Prevention, on average each MVA-related visit to the emergency department costs more than $3,000, while hospitalization for these injuries averages more than $50,000. Even with insurance, patients may face substantial out-of-pocket expenses through deductibles, co-pays, and co-insurance requirements.
Many patients involved in collisions are reluctant to provide their insurance information, fearing premium increases—especially when they believe the accident wasn’t their fault. Without a clear understanding of their auto insurance or workers’ compensation coverage, patients may unnecessarily shoulder significant financial burdens during an already challenging time.
How Patient Advocacy Makes a Difference
Forward-thinking hospitals and healthcare systems have discovered that dedicated patient advocates can transform this experience. When implemented effectively, patient advocacy programs can:
- Reduce the patient financial burden: By helping identify all available coverage options, advocates can often reduce or even eliminate out-of-pocket expenses
- Improve the patient experience: Rather than facing a confusing entry process while worried about medical bills, patients interact with compassionate professionals dedicated to helping them navigate the system
- Uncover hidden coverage options: Well-trained advocates can identify coverage options patients might not know exist, including state-specific programs
- Streamline the administrative process: By collecting complete and accurate information upfront, advocates help prevent downstream billing complications
The Registration Moment: A Critical Opportunity
The patient registration process represents a pivotal moment for both patients and healthcare providers. For patients experiencing the trauma and stress of an accident, having a knowledgeable advocate can provide much-needed relief. These specialists can:
- Engage patients in a comforting and reassuring manner
- Uncover demographic and financial information that might qualify patients for additional coverage
- Verify benefits and eligibility with relevant programs
- Guide patients through application and enrollment processes
- Answer questions and reduce anxiety about financial responsibilities
The Revenue Cycle Impact
Patient advocacy isn’t just beneficial for patients—it’s also essential for hospitals and healthcare systems seeking to maintain financial health while providing compassionate care. Effective advocacy directly impacts the revenue cycle by:
- Preventing claims denials: By collecting complete information upfront, advocates help avoid costly coordination of benefits (COB) denials
- Accelerating reimbursement: Properly routed claims with complete information are paid faster
- Reducing accounts receivable (AR): When claims stay in AR beyond 30 days after submission, cash flow suffers—advocates help prevent these delays
- Minimizing costly rework: Overturning denied claims can require significant hospital resources; patient advocates can help spot issues upfront
- Improving recovery rates: Low revenue recovery rates for hospitals can be improved, especially when relying on experienced vendor partners
The TPL Challenge
Third-party liability claims present unique challenges. When patients leave the hospital without providing necessary information, connecting with them becomes increasingly difficult. This often results in balances being incorrectly classified as “patient responsibility” and moved to collections—frustrating patients who don’t understand why their insurance hasn’t covered the expense.
This process can put net patient revenue at risk while simultaneously damaging patient satisfaction scores. Patient advocates help address this by:
- Ensuring TPL information is correctly captured at registration
- Explaining the process to patients in clear, understandable terms
- Facilitating communication between patients and insurers
- Guiding patients through any additional steps needed during care and post-discharge
The Bottom Line
Patient advocacy represents a rare win-win opportunity in healthcare. Patients benefit from reduced financial stress and improved care experiences, while hospitals and healthcare systems enhance revenue recovery and operational efficiency.
For MVA and TPL claims in particular, dedicated patient advocacy is not just a nice-to-have—it’s an essential component of both compassionate patient care and sound financial management. By investing in advocacy resources or teaming up with an experienced vendor partner, healthcare providers demonstrate their commitment to patients while simultaneously protecting their financial health.
The results can be game-changing: an enhanced patient experience, a more efficient billing cycle, reduced costs, and maximized reimbursement. Patient advocacy isn’t just the right thing to do—it’s smart business.
Ready to transform your MVA claims recovery? Aspirion combines unique legal expertise, decades of industry-specific experience, and proprietary technology to help recover maximum reimbursement. We don’t just help you process MVA and TPL claims—we supercharge your approach to these often-overlooked revenue opportunities. Contact us today!
