Credit Scoring Limitations: nTelagent’s New Predictive Modeling for Assessing
Patients’ Ability to Pay Can Help Healthcare Providers Manage Self-Pay Accounts,
Rising Bad Debt
December 18, 2007 (Nashville, TN) --- nTelagent, a company focused on helping healthcare
service providers increase collections and better manage the accounts of self-pay and
underinsured patients, has today announced that it is not following the latest trend in
determining a self-pay patient’s ability to pay for medical care. Instead of using an individual’s
credit score, nTelagent’s Self-Pay Management System incorporates in-depth demographic
information to help providers arrive at a more accurate picture of patient financial responsibilities
at the point of service. nTelagent’s system revolutionizes the way providers interact with patients
regarding financial responsibilities by integrating a provider’s business rules, such as discounts,
payment terms, and charity care options, with a patient’s demographic data to provide interactive
scripts and exact steps for registrars and financial counselors to follow. This integration insures
registrar compliance with the individual client policies and procedures.
Self-pay is the portion of the medical bill for which the patient is responsible. This includes copays
and deductibles for insured patients and the full medical bill for uninsured patients.
Historically, the vast majority of self-pay accounts were uninsured patients. But with the recent
shift to consumer-driven healthcare plans and health savings accounts (HSAs), which carry
significantly higher co-pays and deductibles than traditional insurance plans, a greater portion of
self-pay accounts, are derived from insured patients. Additionally, an increasing number of
individuals with the financial capacity to purchase health insurance are opting to “go bare” or
without insurance. All of these trends make it difficult for providers to determine the proper
patient payment plans at the time of service and more complex to accurately bill patients and
insurance companies.
"Our core value proposition is to increase upfront and overall collections, reducing bad debt for
the healthcare service provider. Our Self-Pay Management System is the vehicle that enables this
change," says Earl Winter, founder, president and CEO of nTelagent. "The tool moves beyond
obtaining a credit score to establishing an economic profile of the patient via the assimilation of
demographic data." The demographic data used for patient evaluation in nTelagent’s algorithm
includes a patient’s household income, real estate value, number of people in the household,
homeowner versus renter status, and other data.
“We do not use a credit score to determine an individual’s ability to pay simply because our
algorithm can be more accurate and does not hold the liability that goes along with obtaining
credit scores,” says Winter. “In particular, we have not gone the credit score route because of
the recent ‘security freeze’ laws and options now present in all states. These freezes allow
consumers to lock access to their credit file, and therefore a potential seller of services cannot
check that file. While these freezes can help to stop identity theft, they limit a hospital’s capacity
to determine someone’s ability to pay for medical services.”
In addition, healthcare providers can run into problems in obtaining someone’s credit score due
to rules set out in the Federal Credit Reporting Act. Section 604 of the Act states that a consumer
reporting agency can provide a report only when a patient or guarantor has initiated the request
(unless the requestor is offering credit or insurance), and for providers, the only way that can
happen is with a signed document. Without a signed document from a patient, healthcare
providers can receive only minimal information (e.g., consumers’ names and addresses) from a
reporting agency.
"For healthcare patients, nTelagent's system enables the financial accounting of their services to
be handled appropriately and in a non-discriminatory manner, from the initial point of service,"
states Winter. "Our system enables pricing transparency and medical banking or financing
options. For healthcare providers, nTelagent allows them to have a proactive connection and
dialogue with the patient before the patient even leaves the facility. This significantly enhances
the opportunity to increase upfront and overall cash collections."
nTelagent is a healthcare services company based in Nashville, TN. nTelagent is focused on
helping healthcare service providers make better decisions regarding patient responsibilities and
self-pay issues, which include co-pays, deductibles, underinsured patients and all categories of
patients where bad debt is an issue. nTelagent’s Self-Pay Management System properly identifies
patient demographic and insurance verification information and, based upon a healthcare
organization’s specific rules and policies, addresses all patients and charity applications in a
consistent and non-discriminatory manner. The nTelagent system also enables hospitals to
ensure better government compliance reporting and tracking. For more information, visit
www.ntelagent.com.
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Laura Campbell
CEO, Laura Campbell & Associates
laura@laura-campbell.com
615-579-6599
