Insurance coverage is only helpful if it stays active. One missed premium can result in a loss of coverage, delayed care, or even clawbacks from insurers. That’s why HealthFund Solutions created Premium Monitoring, a proactive service that alerts hospital partners if a patient falls behind on payments.
If patients enrolled in health insurance plans through the exchange marketplace fall behind on premium payments, there is a 30- to 90-day grace period for them to bring their premiums current before coverage ends. During that time, those patients still show up as covered in provider systems. In these cases, payments made by insurance carriers may be called back once the grace period is over, leaving providers on the hook for those charges.
This program protects patients from sudden loss of coverage while also protecting hospitals from financial setbacks. With real-time alerts and rapid intervention, we’re helping patients stay covered and hospitals maintain stability.
At the heart of premium monitoring is our belief that healthcare should be predictable, reliable, and uninterrupted. By catching issues early, we keep patients on track and ensure hospitals can focus on delivering care, not chasing down lost revenue.
Providing ongoing monitoring, HealthFund Solutions helps healthcare providers identify premium delinquencies even during grace periods. This allows for more accurate billing and processing and offers an opportunity to identify patients who may qualify for funding assistance programs to help with making premium payments.
Monitoring Services Include:
- Identify patients who are delinquent in premium payments
- Ensure payor records are accurate
- Offer temporary payment assistance through HealthFund Solutions funding programs
- Prevent denials in care or coverage
