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Automated Estimates Take the Surprise out of Medical Bills

UCHealth, based in Colorado, automatically generates price estimates for patients before they receive care, increasing transparency and understanding of what they will owe. The organization automatically sends over 35,000 patient estimates each month, supporting a lean and nimble billing office.

UCHealth, which provides care in Colorado, Wyoming, and Nebraska, had a small team that manually created estimates for patients who asked for them. UCHealth knew that this manual process couldn’t handle the volume, speed, and accuracy required under the No Surprises Act. In response, they looked to automation to streamline estimate creation and delivery for both uninsured and insured patients. As a result of its project, in January 2023, UCHealth delivered over 35,500 estimates to patients without any manual work from its estimates staff, and these estimates had a high level of accuracy—72% had a patient portion that was within $50 or 5% of the final billed amount.

How They Did It

  • Implemented Epic’s estimates feature to pull together clinical, financial, and insurance data
  • Automatically delivered estimates where the patient is expected to owe up to $400
  • Educated clinical and scheduling staff about how to address patients’ questions about estimates
  • Provided estimates to both insured and uninsured patients

Read the full article on EpicShare.