UnitedHealth pilot explores credit line/paycheck deduction

NATIONAL REPORTS-In order to better understand how to facilitate payments in the health system for the benefit of the patient, the employer and the provider, UnitedHealth Group will pilot a program that will enable patients to use a line of credit to pay for medical expenses and then pay off the balance with automatic deductions from their paycheck.

"The new payment option will enable UnitedHealth to pay providers in full after claim adjudication-including the patients' owed responsibility-while giving patients peace of mind with what was previously a complex billing process," according to Tom Policelli, senior vice president, healthcare financial solutions, Uniprise, a UnitedHealth Group company.

In 2004, hospitals nationwide incurred $26.9 billion in uncompensated care, according to the American Hospital Assn. While a chunk of this is the result of indigent care, another part of the problem is that bills go unpaid, or are slow to be paid, by the insured population, according to Policelli.

"I learned a major concern was consumer receivables, or money an insured patient owes the hospital system after the insurance company's payments," he continues. "In fact, consumers quite often don't pay what they owe a hospital or doctor's office, and when they do pay, it takes an average of seven months for them to reconcile their bills."

At the same time, Policelli adds, "Consumer-driven healthcare has reinforced just how much consumers value anything we can do to simplify healthcare."

PILOT PROGRAM

The pilot program, called OnePay, began operating in April in Texas. So far, the pilot includes 14 hospitals, several employers and the Texas-based employees of those employers.

"We plan to add more care providers and employers over the two-year life of the pilot," Policelli says. "What we learn in Texas will shape how this program develops in the future. This pilot is only available to employers who self-fund their benefit programs."

The program is completely voluntary. If an employer decides to offer OnePay, its employees then have the option to sign up. When enrollees receive care, instead of paying any money up front, they simply show their OnePay card.

"After we adjudicate the claim for approved charges, UnitedHealthcare then pays the provider the full allowed amount, including both the consumer's portion and the benefit plan's portion of the bill. In return, the care providers agree to a small additional discount, which is shared directly between the employers and consumers," Policelli explains.

"We consolidate and review all providers' bills for the consumer and automatically deduct from any FSA or HRA balances. The consumers then receive a single statement from us, showing the charges paid on their behalf and their total outstanding balance. After reviewing their statement to ensure they agree with the charges and how the claim was adjudicated, if a balance is owed, they can pay it off by writing a personal check or having the payment drawn from an HSA, if they have one," he says.