Improving the lives of the underserved disabled healthcare consumers and the financial wellbeing of their providers is improving.
Utilizing proven and innovative technology like mRNA vaccines and robotic laparoscopic surgery are saving patients’ lives and improving recovery times and patient comfort. While new artificial intelligent/machine learning (AI/ML) applications are improving the financial health of Healthcare Providers for these patients and increasing the positive impact in their communities.
The Social Security Administration (SSA) has been providing Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) to more than 8 million families monthly. A new application called Aubiqua is providing high accuracy to DI and SSI eligibility determinations. Designed and built by Global CI Health IT architects and technologists with over 20 years SSA disability experience within the government, Aubiqua now makes this capability available directly to Healthcare Providers.
What’s old, what’s new?
Until now Healthcare Revenue Cycle Eligibility Determination has been a largely inhouse or outsourced manual process of analyzing a patient’s financial and health records and cherry picking among potential DI/SSI candidates. Working with patients to gathering this information. Submitting. a disability claim to SSA. Initial disability claims processed by SSA take around 100 days to make a decision where 37% (2020 estimate) of claims are granted DI or SSI benefits. A Social Security disability benefit leads to a monthly cash benefits and public healthcare coverage through Medicare or Medicaid.
Aubiqua’s AI/ML analysis capabilities precisely mirror the SSA electronic medical determination analysis for all patients in the Healthcare Providers’ Electronic Health Record (EHR) System. No patient is left behind where they could receive these benefits. The accuracy is such that it also determines those patients who are close to eligibility and identifies missing supporting information.
Aubiqua can be used to support a Healthcare Providers’ existing eligibility process, or we can work directly with those patients as their advocates to take them through the Social Security disability process.
In 2019 Healthcare Providers are reporting unrealized revenue (bad debt, lost to collections, etc.) for services provided of $41.6 Billion ( AHA: Hospitals provided $41.6 billion in uncompensated care in 2019
| AHA News). This is annually. A Healthcare Provider who reports $100 million annually after all current efforts to collect/recover losses in unrealized revenue using Aubiqua, recovers 5% or $5 million annually*.
What is the Healthcare Provider effort to utilize Aubiqua?
Global CI, an award winning, 29+ year IT Services firm, designed and developed Aubiqua to have minimal impact to the Healthcare organization’s Revenue Cycle and Information Services processes. Aubiqua leverages national Health IT standards (FHIR) that are based on HHS/ONC policy which minimizes the implementation and enables quick access to key information. Revenue Cycle and administrative staff can easily identify patients that meet or close to meeting Social Security disability requirements.
Why does this matter?
Aubiqua was designed and built with three targets:
- Underserved Patients’ Medical Health
- Healthcare Provider Financial Health
- The Community at large
A Patient who is unable to work due to their medical condition and earn a living often loses their health insurance (if they had it) and must make financial decisions on paying the rent/mortgage, putting food on the table and taking of themselves and their family. Often seeking and paying for healthcare is low on the list. This creates a cycle of declining health and often puts a burden on family, friends and community for care and finances, and local Healthcare Providers and the emergency department. Once a Patient is approved and receives DI or SSI, they receive a monthly cash benefit from SSA to spend as they choose. For the DI or SSI recipient they will receive Medicare or MedicaidU upon SSA approval respectively. At this point they are no longer part of the underserved, but a paying patient who can readily seek medical care with fewer worries. Additionally, the Healthcare Provider has the capacity and funding to serve additional underserved patients. The Community has another person that is not using funds that can help others, has money to spend at local business establishments and can obtain the healthcare they need without concern. The Healthcare Provider/Patient/Community dynamic is incrementally improved with each successful Aubiqua find. Everyone benefits from Aubiqua! www.aubiqua.com
*This example is dependent on variables such as provider practice focus, charity care provisions, and other factors.
U Medicaid is provided automatically once Social Security Supplemental Security Income is approved in 33 states and the District of Columbia (DC). Other states have an additional step or two.
Mike Ziman is the founder and CEO (Chief Executive Officer) of Global CI. He has been supporting Information Technology and Health IT since 1978. https://www.linkedin.com/in/mikeziman