Solutions important to medical debt recovery and compliance - Javier Alvarado Market Development, Collections June 18, 2021
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Solutions important to medical debt recovery and compliance Javier Alvarado Market Development, Collections June 18, 2021 © 2021 © 2021 TransUnion TransUnion LLC All LLC Rights All Rights Reserved Reserved | 1
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We achieve this with an accurate and comprehensive picture of each person, stewarded with care Unique data fusion methodology enables us to link, match and tap into the power of that data Foundation as a Knowledgeable credit reporting agency and passionate team lets us access both credit and stewards that information public record data with expertise and care
How we do it Identifiers Traditional identifiers of 650M+ consumers worldwide Credible baseline identity info, online and (Name, address, SSN, etc.) offline, personal and device, in compliance with local legislation around the world Digital identifiers from nearly 6 billion consumer devices; 97% of email addresses Phone numbers from 200+ countries, and can assess the risk associated with each
How we do it Information Device activity Events Public records • Location • Marriage • Licenses Added linked, proprietary and public data • Fraud patterns • Birth • Judgments sources—as fresh as possible—for a multi- • Social media • Death • Criminal histories layered understanding of that person • Purchases • Education • Violations Behaviors Financial liabilities Relationships • Driving • Debt • Household info • Location • Payment histories • Known associates • Online activity • Collections • Business ownership • Purchases • Payment lending • Rent-to-own • Utility bills • Rental payments Financial assets and capacity • Bank accounts • Insurance • Property • Autos • Income
How we do it Risk insights • Identify credit worthiness and predict delinquency with greater accuracy Insights • TU can identify 20M US consumers classified as prime or near-prime, who are worthy of super prime Leverage analytics to create a meaningful picture of each person and anticipate needs, • Specialized risk database of 100B+ records, derived from 10,000+ sources behaviors and potential risks Marketing insights • Help predict consumer behavior to extend relevant and timely offers • TU customers often achieve 3-4x boost in campaign performance Collections insights • Help customers monitor and manage collections with greater efficiency • Trended data expertise taps into 200+ predefined consumer traits/behaviors Fraud insights • Better identify and even anticipate fraud based on contextual red flags • Make confident decisions with TU’s access to 1B+ consumer records, 6.5B+ devices and 76M+ confirmed fraud reports
How we do it Implementation Delivery technologies seamlessly work together to help implement info and insights, so people can act quickly and easily Integrated capabilities for rapid, Apply Today seamless deployment Implement with TU end-to-end or Offer Available Pay Now plug into your system Provided with expertise—self-service, online or face-to-face
Market Overview – Q1 IPOV
Score shifts continue to provide more eligible consumers for lenders serving the prime and above market 35% VantageScore® 3.0 risk ranges Totals may not equal 100 due to rounding Subprime = 300–600; Near prime = 601–660; Prime = 661–720; Prime plus = 721–780; Super prime = 781-850 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 17
Consumer participation continued to increase in Q1, but at a declining rate as compared to previous years Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 18
Unsecured personal loans, card and HELOC balances declined in Q1, while auto and mortgage continued to climb Total Balances by Product (B) Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 19
Auto and mortgage saw origination growth at the start of Q1, while other products saw significant declines Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 20
Declines in delinquency totals have been driven by government programs, lender assistance and refinance savings *Serious delinquency considered as 90+DPD for card, Mortgage and HELOC, 60+ DPD for all other products Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 21
The number of consumers declaring bankruptcy has been trending downward, but declined sharply in 2020 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 22
After seeing double-digit increases in prior years, charge- off compounded annual growth rate (CAGR) increased only 4% Composition of Charge-offs CAGR Composition of(Q1) Charge-offs (Q1) LINE 2019 2020 2021 (‘19-’21) $250 $180 Auto $55.5 $60.6 $60.4 4.3% Balance(B)(B) $160 Bankcard $200 $75.5 $84.9 $88.9 8.5% $140 Charge-off Balance Private label $13.4 $14.1 $14.1 2.8% $120 $150 Mortgage $6.8 $4.0 $2.6 -38.9% TotalCharge-off $100 HELOC $3.9 $2.8 $2.1 -27.1% $80 $100 Student loan $6.4 $5.8 $4.9 -12.3% $60 Personal loan (U) $12.0 $14.2 $15.8 14.9% Total $50 $40 Secured installment $8.1 $8.2 $9.0 5.4% $20 Other $7.4 $7.2 $6.5 -6.0% $0 $0 Q1 Q1 2019 2018 Q1 Q1 2020 2019 Q1 Q1 2021 2020 Total $189.0 $201.9 $204.2 4.0% Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 23
Charge-offs as a percentage of trades and balances saw significant year-over-year declines Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 24
Collections Overview – Q1 IPOV
Active collection trade line volumes and balances have declined year-over-year Active Collection Volume by Year $250 300 $216 $211 $204 $210 $206 $203 $203 $193 $195 250 $200 Outstanding Receivables ($B) Active Trades in Collections (M) $181 $182 $156 200 $150 150 $100 100 $50 50 $0 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 26
Active collection trade lines have been trending downward since Q1 2020 Active Third - Party Collections on File $240 280 Active Trades in collections (M) 260 260 Oustanding Receivables (B) $220 245 238 236 240 $200 218 220 $180 200 $160 180 160 $140 140 $120 120 $100 100 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2017 2018 2019 2020 2021 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 27
Medical / health care represents 60% of the active collection trade lines in Q1 2021 Composition of Trades in Collections (Q1 2021) 11% 12% 60% 8% 5% 4% Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 28
The average number of medical collections per consumer is more than double that of any other asset class Average Number of Collections by Asset Class per Consumer (Q1 2021) 3.5 3.0 3.0 2.5 2.0 1.5 1.5 1.3 1.2 1.1 1.0 0.5 0.0 Medical/Health Care Banking/Financial Retail Cable/Cellular Utilities Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 29
More than half of all active collection consumers have more than one collection trade line Number of Consumers with Multiple Collections (Q1 2021) 40 ~77 million 35 34.0 consumers with a Number of Consumers (M) 30 reported collection 25 19.8 20 14.5 15 10 8.7 5 0 1 COLLECTION 2 COLLECTIONS 3 COLLECTIONS 4+ COLLECTIONS Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 30
Active collection trade lines in banking/financial have increased slightly, while cable/cellular totals have declined Active Third-Party Collections Active Third-Party Collections Financial/Banking Cable/Cellular Financial/Banking Cable/Cellular Medical/Health Care Retail Retail Utilities Utilities Other Other 180 40 Trades in Collections (M) Trades in Collections (M) 160 35 140 30 120 25 100 20 80 60 15 40 10 20 5 0 0 10 11 12 13 14 15 16 17 18 19 20 21 10 11 12 13 14 15 16 17 18 19 20 21 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 31
From a balance perspective, collection trade lines in the financial/banking sector continue to trend higher Active Third-Party Collection Balances Active Third-Party Collection Balances Financial/Banking Cable/Cellular Financial/Banking Cable/Cellular Medical/Health Care Retail Retail Utilities Outstanding Receivables ($B) Outstanding Receivables ($B) Utilities Other Other $120 $45 $100 $40 $35 $80 $30 $60 $25 $20 $40 $15 $20 $10 $5 $0 $0 10 11 12 13 14 15 16 17 18 19 20 21 10 11 12 13 14 15 16 17 18 19 20 21 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 32
There is a slight uptick in Q1 2021 paid/settled collection trade line volumes Paid Collection Volume by Quarter $16 25 Collection Placement Amount ($B) $14 Trades in collections (M) 20 $12 $10 15 $8 $6 10 $4 5 $2 $0 0 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2018 2019 2020 2021 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 33
There is a decline in paid/settled collection volume in cable/cellular and utilities due to state restrictions Settled Collection Volume $700,000 $600,000 $500,000 $400,000 $300,000 $200,000 $100,000 $0 Cable/Cellular Medical/Health Care Retail Utilities Banking/Financial Q1 2020 Q4 2020 Q1 2021 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 34
The percentage of disputes increased even though there is a decline in collection trade lines Collection Dispute Rate v. Trade Line Volume Active Collections % of Collections Disputed 260 9.0% 7.6% 8.0% Trades in Collections (M) 240 7.0% 220 5.9% 6.0% 4.9% 200 5.0% 4.3% 4.0% 180 3.1% 3.0% 160 2.0% Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2017 2018 2019 2020 2021 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 35
Credit-originated collection trade lines are disputed at a higher rate than non-credit collection trade lines Active Disputes in Collections Asset Class Volume 16% (Q1-2021) 14% Dispute Percentage (%) Medical/Health 12% 6,008,253 Care 10% 8% Financial/Banking 3,583,442 6% 4% Retail 2,051,062 2% 0% Cable/Cellular 1,381,161 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2016 2017 2018 2019 2020 2021 Utilities 616,638 Source: TransUnion consumer credit database © 2021 TransUnion LLC All Rights Reserved | 36
Workflow and Solutions
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© 2021 TransUnion LLC All Rights Reserved | 39
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About TransUnion Healthcare • Revenue Protection® Solutions • Serves more than 1,850 hospitals and health systems • Partners with more than 85 healthcare companies • Reaches over 550,000 physicians and other providers across the U.S. • Maintains connectivity to more than 880 payers, covering 98% of U.S. insured lives • Processes over 10 million transactions each day through its insurance clearinghouse © 2021 TransUnion LLC All Rights Reserved | 41
Improve patients' financial experience and optimize payment strategies by assessing their unique financial situations Patient financial responsibility continues to skyrocket. Almost a quarter of insured adults, or 31 million people, are now considered underinsured and lack the ability to fund their care 1 © 2021 TransUnion LLC All Rights Reserved | 42
© 2021 TransUnion LLC All Rights Reserved | 43
Patient Financial Clearance Solutions © 2021 TransUnion LLC All Rights Reserved | 44
Propensity to Pay Optimize collections strategy by segmenting patient accounts into the appropriate workflow § Increases collections through the accurate classification of accounts into the optimal payment workflow. § Increases patient satisfaction by helping providers set up payment plans based on the patient’s unique financial situation. § Reduces costs by improving billing staff efficiency through the use of more intelligent follow-up strategy recommendations on patient bills based on ability and willingness to pay. © 2021 TransUnion LLC All Rights Reserved | 45
Propensity to Pay INCLUDED DATA USE CASE DELIVERY § Available Credit § Provides scores and additional § Delivery options: § New Account Score credit report details to Real-time (FCH XML) and § Recovery Score determine patients’ ability and Batch § FICO Score (optional add-on) willingness to pay, enabling § Deceased Information more accurate account segmentation and payment § Bankruptcy Information (add-on) collection strategies. § Mortgage Indicator § Propensity to Pay Status § Can be used on Front and Back (Configurable) end § Employment Records (add-on) § Trade lines (add-on) § Public Records (add-on) § Collections Records (add-on) © 2021 TransUnion LLC All Rights Reserved | 46
CreditVision Propensity to Pay INCLUDED DATA USE CASE DELIVERY § Available Credit § Provides scores and additional § Delivery options: § CreditVision New Account Score credit report details to Real-time (FCH XML) and Batch § CreditVision Medical Recovery determine patients’ ability and Score willingness to pay, enabling § Vantage Score 4.0 more accurate account § Deceased Information segmentation and payment collection strategies. § Bankruptcy Information (add-on) § Mortgage Indicator § Can be used on Front and Back § Propensity to Pay Status end (Configurable) § Employment Records (add-on) § Trade lines (add-on) § Public Records (add-on) § Collections Records (add-on) © 2021 TransUnion LLC All Rights Reserved | 47
Why CreditVision? CreditVision New Account Score consistently beats traditional credit scores at assessing risk and future performance on new accounts. Traditional tradeline information Enriched tradeline information © 2021 TransUnion LLC All Rights Reserved | 48
Propensity to Pay Key Metrics Name Description Displays the amount of revolving credit available on credit cards that can be Available Credit used to pay for patient responsibility amounts. Identifies patients who are likely to become 90 or more days delinquent on a new account within a 24-month period. New Account Score *CreditVision Package utilizes trended credit data to take into account the trajectory of borrower behaviors Determines the likelihood of collecting $50 or more within 12 months. Recovery Score *CreditVision Package utilizes trended credit data to take into account the trajectory of borrower behaviors Assesses a patient’s risk of becoming 90 or more days delinquent within a 24- FICO Classic Score month period. Uses trended credit data to assess a patient’s risk of becoming 90 or more days Vantage Score 4.0 delinquent within a 24-month period. Compares Propensity to Pay metrics against end-user defined thresholds and Propensity to Pay Status returns a status message, such as Collect in Full. © 2021 TransUnion LLC All Rights Reserved | 49
Propensity to Pay Empowers providers with the data and decisioning tools to make objective propensity to pay decisions—and collect more Optional upgrades TransUnion New Account Score: § FICO score Returns a configurable Propensity to § Recovery Score Pay Message: § Identifies new patients who are § Parsed data from four sections of the likely to become 90 or more § Provides the user with data to credit report: Employer Name, Trade process the account days delinquent Lines, Collections, and Public Records § 150-950 score range § Messages display according to § High score = low risk end-user pre-set thresholds for available credit and the credit Displays total amount of scores revolving credit available © 2021 TransUnion LLC All Rights Reserved | 50
Propensity to Pay Metrics: Point-of-Service Determine the optimal payment workflow for accounts Account Recovery New Account Active Available Credit Propensity to Pay Status Number Score Score Mortgage D04010931 $14,954 800 840 NO Collect in full at time of service Configure Propensity to Pay status messages according to your customers’ collection D04001745 $39,817 policies. The following can be 632rules: factored into the 632 NO Collect in full at time of service - Available Credit D04009798 $20,507 - TU New Account Score 773 773 NO Collect in full at time of service - Mortgage Presence - TU Recovery Score D04004034 $30,207 674 674 NO Collect in full at time of service D04006259 $8,065 663 663 NO Offer discounts / payment plan D04022243 $8,100 605 662 NO Offer discounts / payment plan D04003681 $2,721 603 663 NO Offer discounts / payment plan D04005683 $3,091 600 606 NO Offer discounts / payment plan D04008974 $3,601 500 502 YES Offer discounts / payment plan D04019111 $12 378 478 NO Screen for Medicaid / Charity D04006047 $0 358 458 NO Screen for Medicaid / Charity D04006681 $47 392 492 YES Screen for Medicaid / Charity D04004359 $0 352 437 NO Screen for Medicaid / Charity © 2021 TransUnion LLC All Rights Reserved | 51
Financial Aid Use an objective, consistent method to identify patients who are eligible for financial assistance § Reduces bad debt by identifying charity care-eligible patients upfront § Streamlines financial counseling by screening your patients’ likelihood to qualify for financial assistance § Documentation support for IRS 501(r) reporting requirements © 2021 TransUnion LLC All Rights Reserved | 52
Financial Aid INCLUDED DATA CAPABILITIES DELIVERY § Estimated Federal Poverty Level § Scoring models: § Delivery options: (FPL) Leverages multiple decisioning Real-time (FCH XML) and Batch models to deliver income § Estimated Household Size estimates to support charity care § Estimated Minimum Household determination and compliance Income with 501(r) requirements § Financial Aid Status (Configurable) § Hybrid model: Includes both credit-based and community-based models § Community-based model: Uses non-credit data, including public records, to deliver household income estimates for patients with thin or no credit history © 2021 TransUnion LLC All Rights Reserved | 53
Financial Aid Key Metrics Metric What Does It Mean? Federal Poverty Helps to determine the patient’s financial situation relative to the federal government’s Level (FPL) % standard for indigence. Estimated The minimum monthly estimate is determined by analyzing individual level credit Minimum Monthly characteristics from the guarantor’s credit file OR by returning Community-based data Income Estimated The estimate is determined by analyzing individual level credit characteristics from the Family Size guarantor’s credit file OR by returning Community-based data Indicates the patient’s estimated monthly income that is not dedicated to debt Residual Income obligations. Financial Aid Compares Financial Aid metrics against end-user defined thresholds and returns a Status status message, such as Meets Charity Guidelines. © 2021 TransUnion LLC All Rights Reserved | 54
Financial Aid can leverage multiple decisioning models to produce the best results © 2021 TransUnion LLC All Rights Reserved | 55
Financial Aid Facilitates an objective, consistent method for identifying patients who are eligible for financial assistance Estimated Household Monthly Income and Size § Calculated using individual level credit characteristics from a consumer’s credit file OR the Community-Based Model Residual Income § Estimated monthly income that is not dedicated to debt obligations % of Federal Poverty Level (FPL) § Determines the patient’s financial situation relative to the federal government’s standard for indigence Returns a configurable Financial Aid Message: § Provides the user with data to help qualify patients for financial aid § Messages display according to end-user’s financial aid thresholds. Optional upgrades § Community-based decisioning model that uses public records data sources (may be cascaded from thin or no-hit credit-based model) © 2021 TransUnion LLC All Rights Reserved | 56
Financial Aid Metrics Segment accounts for presumptive charity care using credit and community-based models Min. Debt to Percent of Hospital Account Family Residual Monthly HH Income Federal Poverty Financial Aid Status Hit FPL Model Charges Number Size Income Income Ratio Level (FPL) $525.00 D04007296 $1,100 2 85.11% Complete FA App / PE Charity Y comm-based $188.65 D04004380 $800 1 83.55% Complete FA App / PE Charity Y comm-based Determine presumptive charity $400.00 D04008992 $1,246 care based 2 on30.00 FPL% $436.33 96.45% Complete FA App / PE Charity Y credit-based $597.00 D04000053 $1,700 4 17.88 $349.00 86.62% Complete FA App / PE Charity Y credit-based $440.91 D04003583 $2,333 2 30.00 $816.67 180.53% Needs-Based Discounting Y credit-based $3,403.10 D04006259 $1,710 1 178.59% Needs-Based Discounting Y comm-based Configure FPL ranges and $277.27 D04021577 status message $1,823 1 according to your 30.00 $1,276.33 190.43% Needs-Based Discounting Y credit-based customers’ financial assistance policy. The following can be factored $1,300.00 D04013397 into the rules: $4,790 4 30.00 $838.25 244.08% Discount to Sliding Scale Y credit-based $76.71 - FPL% D04009547 - Mortgage $4,353 3 Presence 30.00 $1,015.78 267.49% Discount to Sliding Scale Y credit-based $35.80 D04008210 $2,943 2 30.00 $1,030.17 227.72% Discount to Sliding Scale Y credit-based $122.61 D04011388 $8,373 4 30.00 $1,465.33 426.67% Pursue Payment Arrangement Y credit-based $175.50 Use D04001745 credit-based $14,483 and/or community-based 4 to help30.00 models $2,534.58 financially assess patients 738% Pursue Payment Arrangement Y credit-based $75.00 D04007387 $5,803 2 30.00 $2,031.17 449% Pursue Payment Arrangement Y credit-based © 2017 TransUnion Healthcare, Inc. All Rights Reserved | 57
Blended Collection Status For clients who use FA + P2P, we offer a blended status message Blended Collection Rules: • FPL % • Mortgage Presence Single configurable status • New Account Score message with FA and P2P • Recovery Score elements combined • Available Credit © 2021 TransUnion LLC All Rights Reserved | 58
Soft vs. Hard Inquiry Credit inquiries are records created when your credit information is reviewed. Credit inquiries are classified as either "hard inquiries" or “soft inquiries” • Hard inquiry • When a business views your credit report in connection with an application for credit or a loan, a hard inquiry appears on your credit report and may have an effect on your credit score • Soft inquiry • When a business views your credit report for most other reasons, such as to make a pre- approved credit offer, a soft inquiry appears on your credit report that is not seen by others. Soft inquiries may occur without your permission, but they do not have an impact on your credit score TransUnion’s revenue cycle solutions use soft inquiries for the purpose of determining a consumer’s ability to pay or likelihood to qualify for financial assistance © 2021 TransUnion LLC All Rights Reserved | 59
Community-Based Financial Aid A charity screening solution that uses non-credit, public records data sources to identify patients who may be eligible for charity care or payment assistance § Delivers patient financial estimates Block Group: Zip + 4 based on demographic data from public records Block Group is § Uses block groups, which are found by linking geographical units used by the U.S. zip+4 with latitude / Census Bureau that contain: longitude coordinates – Average Household Income – Average Household Size § Calculates FPL% using block group data Region by Zip (WITHIN A STATE) § Block groups typically have a population of 600 to 3,000 people © 2021 TransUnion LLC All Rights Reserved | 60
Scoring Model Attributes ATTRIBUTE COMMUNITY MODEL CREDIT MODEL Data Source Non-credit data Credit data FINANCIAL AID Estimated Household Income X X Residual Income X Estimated Family Size X X Debt to Income Ratio X FPL percentage X X Configurable Financial Aid Status Message X X © 2021 TransUnion LLC All Rights Reserved | 61
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