It’s getting harder and harder for consumers to get the healthcare they need. Even when a person has insurance, and even when their policy covers a medically necessary procedure, most are forced to pay a high deductible. A $5,000 deductible might keep down costs for employers who offer health coverage, but it can be a real obstacle for consumers without financial means to get the care they need.
“They don’t have that type of money sitting in a bank someplace,” said Tom Burnside, CEO of LendingPoint, a balance sheet lender that gives consumers better access to affordable credit. “If they don’t have the money for the deductible, then they have to make a hard choice, and what we’re trying to do is make that choice easy.”
LendingPoint has joined forces with ezVerify, a tech company powering real-time health insurance verification and benefits info, to build a solution to healthcare’s last-mile conundrum: ezCarePoint. Burnside talked details with PYMNTS’ CEO Karen Webster just days before ezCarePoint went live in its first pilot location.
Burnside explained to Webster that ezCarePoint predicts patients’ out-of-pocket costs and gives them the option to apply for flexible payment plans, including short-term loans, right at the point of sale, before they receive a procedure. It also provides financing options after costly and emergency events, helping consumers avoid large, unexpected bills for procedures that have already been performed.
EzVerify integrates between the hospital and insurance provider so that all patients have to do at the point of sale is swipe their license and medical card and answer a few questions. Then, ezVerify reaches out to the insurer to find out what remains of the deductible before offering payment options — all within seconds.
Burnside clarified that ezCarePoint isn’t financing the procedure itself — only the deductible. If the procedure costs more than the deductible, the remainder of the cost burden falls on the patient. Loans will range from $3,500 to $4,500 on average, he said.
EzCarePoint will not offer loans to patients seeking elective surgeries, which are more risky and more expensive, Burnside said. They are for medically necessary procedures only. The whole point is to make sure average people don’t have to make a choice to get treated based on their financial circumstances.
More than 30 million people forego necessary medical attention due to the financial burden it could impose, according to a report by The Commonwealth Fund. Others go ahead and get the care and simply don’t pay their bills. In one instance, the consumer suffers; in the other, the provider. EzCarePoint makes it possible for both parties to get what they need.
“Informed patients are happier patients,” said Dr. Gerald Glass, co-founder and chairman of Automated HealthCare Solutions, ezVerify’s parent company. “In the current environment, it’s very difficult for patients to know what they’re required to pay. And for hospitals and practitioners, this leads to administrative headaches, frustrating calls and unpaid bills.”
Not everyone gets an ezCarePoint loan. Not everyone even gets the option. Burnside explained that the solution isn’t designed to help people who are uninsured or have subprime credit. Rather, it focuses on people who have insurance but simply can’t afford to meet their deductible, such as retirees or average employees whose healthcare plan has a high deductible. Most beneficiaries will have a FICO credit score of 600 or higher, he said.
LendingPoint and ezVerify announced their exclusive partnership June 26 at the Healthcare Financial Management Association’s Annual National Institute event. EzCarePoint will be available on iOS and Android devices as well as via web portal. After the 30-day pilot, it will begin rolling out at select hospitals and healthcare providers by Q3.