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How to Knock a Digit out of ER Claims

Updated: Nov 11, 2021


This is the second part of the Quizzify Prevent Consent series. The first part focused on the health equity issue of minimizing that large chunk of ER claims that employees are responsible for. This part focuses on making sure employees use the Consent, to knock at least one digit out of allowed ER claims.

 

By way of review, the Quizzify ER Sticker Shock Prevent Consent reads:


"Superseding other consents, I consent to responsibility (including insurance) for up to 2 times Medicare, following receipt of an itemized bill for appropriate treatment coded at the correct Level."


The key to saving money with the Quizzify Prevent Consent is for employees to use it. Along with simply waiving copays or providing a bonus out of the savings, there are five ways to facilitate that. Generally these are cumulative. The more of these you do, the higher the utilization.


1. Encourage employees to download the Quizzify2Go app


Quizzify2Go is very easy to access. Go to http://2go.quizzify.com. It It will ask you if you’d like to save it to your home screen, and when you do it'll appear as follows:



But how many apps do you have on your screen right now whose purpose you’ve totally forgotten? And how many benefits do your employees have that they never use?


2. Use the Quizzify Healthcare Trivia Question-of-the-Week option to remind employees


Every week, one question can go out, either to all employees or else to the ones who have downloaded the app, who can “opt in” to participating in the question-of-the-week. People who get it right may be entered into a drawing, hosted by you or Quizzify. (We host a master drawing for all users. You could cost an employees-only drawing.)


This question is accompanied by reminders that this app exists. Also, that Quizzify2Go has another, very useful attribute, which is…


3. Teaching employees that most questions to ask a doctor are right on Quizzify2Go


Good doctors like good patients, and good patients ask good questions. Quizzify2Go provides a unique “crib sheet” of questions covering the 90+ topics comprising around 80% of all doctor and dentist visits. This is the first and only compilation of its kind.


If you type in a keyword, at least one topic with a list of questions will pop up. You should find a match. You can then calendar those questions right into the day of your visit.



Because who amongst us always remembers what questions to ask when the time comes?


The average person visits or calls the doctor or dentist six times a year. Quizzify2Go on average would support five of those interactions, creating more useful visits or conversations. And in some cases, the topics are accompanied by self-quizzes, for employees to hone their knowledge before the visit.


For any other vendor, this unique compilation would be the lead story – with value for employee relations and employee health. But if you have a laser-focus on health equity, it’s the “Prevent Consent” that generates the immediate savings to the employer and avoids or mitigates employee financial hardship.


As a sidebar, we would note that Quizzify2Go could be “free.” As one option, you can use our Pay-As-You-Save model, where you don’t write us checks until you realize the savings.


4. Add the language to the insurance cards


Here is an example of my own card with the (original) Prevent Consent taped on:

This older version reminds employees what to write. The newer version has the preamble "Superseding other consents," that could possibly “trump” the provider’s financial consent if indeed the employee also signs theirs by mistake. Absent a specific objection, processing the insurance card should mean the hospital presumably de facto accepts what’s written on it, even if it contradicts what’s on the provider’s financial consent.


This “presumed” legal theory from this new three-word preamble has never been tested, though. We can't guarantee that it will work. Here's what we can guarantee: it works if you don't sign the provider consent. Hence the repeated entreaties to employees not to sign the provider’s financial consent. (A little repetition should help.)


5. Teach Employees How to Use the Prevent Consent


It’s not enough to have the Quizzify Prevent Consent available. You must also include step-by-step instructions on how to use it, accessible exactly at the point where it is needed. And that’s what the Prevent Consent does:



Each step is laid out.


Then we have expert backup. The backup will be 24/7 by January, but now is generally available most of the time. (No promises, except to customers.) Our experts know the federal law which requires hospitals to treat your employees, the Emergency Medical Treatment and Active Labor Act (EMTALA) backwards and forwards. We can explain to the hospital’s intake coordinator or supervisor exactly why they need to treat your employee and why it’s in their best interest to accept it.


We are 100% certain your employee will get treatment if the conversation takes place.* We suspect that the conversation with the intake coordinator will achieve favorable resolution after the first sentence: “This call is being recorded and is admissible in Court.”

 

*As mentioned in Part One, freestanding ERs lacking a hospital license are not covered by EMTALA, but those are the small minority of all ERs. And a patient who is admitted from the ER is not guaranteed to be able to get the 2x Medicare for their entire stay, only up to the point of stabilization.