Formerly The Strout Company, industry leader in Medicare COB now offers pre-pay payment accuracy in real time
DALLAS, Feb. 28, 2024 /PRNewswire-PRWeb/ -- The Strout Company has rebranded as Strout and released a payment accuracy and eligibility solution that delivers the collective expertise of 30 years providing Medicare coordination of benefits (COB) in the form of real-time, pre-payment claim editing, the company announced today.
This announcement comes at a time when one in four Medicare beneficiaries are covered by another health plan, such as an employer or union-sponsored health plan, [1] and when the process of determining which plan should pay for a given healthcare service, commonly known as coordination of benefits (COB), results in frequent and expensive errors. These errors cost an estimated $17 billion each year as well as countless hours in appeals and corrections.
Until now, due to the complex data and regulatory expertise required, most COB solutions have been post-payment interventions, such as claim auditing. This approach avoids delaying claim processing, which is often required by law to occur in a timely manner, but it also means errors cannot be caught until after they happen. A large portion of incorrectly paid dollars are ultimately irrecoverable as a result of outdated approaches, delays in coordinating between multiple plans, and regulatory limitations on the timeframe in which recovery can take place.
Strout has transformed the Medicare COB process by providing a technology solution that ensures accuracy up front in real time. The solution combines rich, longitudinal data on member eligibility and plan enrollment with a sophisticated rules engine that incorporates AI trained on decades of Medicare COB decisions to predict, place, verify, and enforce primacy. Strout then delivers instructions to the customer's preferred claim system, preparation software, or editor.
"Today's announcement means we can ensure accuracy before coverage decisions and payments are made, preventing expensive errors and reducing the financial burden of care for some of America's most vulnerable patients," said Strout President Stacey Stabenow. "The fact is, when commercial plans incorrectly pay first, Medicare often pays nothing, resulting in unexpected out-of-pocket costs. When benefits are applied in the correct order, commercial and Medicare work in harmony and the patient often pays nothing."
This solution addresses another common challenge in COB, which is that too many cases require manual review to justify automation. Due to Strout's superior data and technology platform, fewer than 3% of claims require manual review, dramatically reducing delays and administrative burden.
"What previously took weeks now occurs in milliseconds," said Stabenow. "Correcting COB errors before they happen is a critical piece of stewarding our nation's healthcare dollars and ensuring Medicare beneficiaries receive benefits they deserve."
The Strout solution can be delivered through direct integration into healthcare payment processing workflows for health plans, third party administrators, and technology that supports claims and revenue cycle solutions. Data integration is supported through a partnership with DatumSure, a data technology company that has created a secure, entity-centric data fabric for innovation, collaboration, integrity, and efficiency.
For more information about working with Strout, contact [email protected].
About Strout
Strout, formerly The Strout Company, is the market leader in Medicare Coordination of Benefits (COB) payment accuracy solutions. For more than 30 years, the company has combined expertise in complex healthcare regulatory issues and pioneering technology solutions to regional and national health plans, third party administrators (TPA) and partner companies, collectively serving more than 100 million members. Based in Dallas, Strout is HITRUST CSF certified and a certified Women's Business Enterprise. Visit strout.ai to learn more.
[1] Kaiser Family Foundation. A Snapshot of Sources of Coverage Among Medicare Beneficiaries. Dec 13, 2023. https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries/
Media Contact
Stacey Stabenow, Strout, 1 469-258-7253, [email protected], https://strout.ai/
SOURCE Strout
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