Ontash

Disability Workbench

Software that uses Artificial Intelligence (AI) to identify hospital patients who may qualify for disability benefits. Resulting Medicare and/or Medicaid insurance coverage helps to mitigate hospital uncompensated care.

Overview

Uninsured, or self-pay patients represent a huge problem for most hospitals. Most hospitals have teams of professionals tasked with enrolling as many self-pay patients as possible into Medicaid - so the hospital may receive some payment for services. If the patient cannot be enrolled in Medicaid, he or she may qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). These awards will provide Medicaid and/or Medicare coverage respectively for the patient, and guaranteed payments for the hospital. The problem with Disability, is that it is often difficult to identify candidates, and further, the time and resources needed to qualify the individual for disability are beyond the scope of many hospital eligibility programs. Consequently, many, if not the vast majority of disability candidates are never processed, and hospitals must continue to write off their charges to Charity Care.

Hospitals can’t possibly process every self-pay patient for disability. It’s too labor intensive. But thanks to Ontash, hospitals now have software that identifies and prioritizes disability candidates. Ontash Disability Software has evolved from a rules-based set of algorithms, to the level of Artificial Intelligence (AI). The software creates a multi-dimensional model of the ideal disability candidate. Then, it takes daily data feeds from the hospital and analyzes patient medical data including diagnoses, medications, procedures and lab results. Patient outcomes are automatically fed back to the model, which consistently updates and refines the characteristics relevant to identifying disability candidates. Once the hospital’s eligibility team (or vendor) has a handle on “high value” disability candidates, they can appropriate the time necessary to shepherd the patient through the disability award process.

Disability Workbench is 100% HIPAA compliant, and is deployed in the cloud as Software as a Service over a secure encrypted connection. Detailed reports tracking patient encounters, protected filings, awards, denials, as well as Medicaid and Medicare billing are generated on a regular basis as required by the hospital.