nTelagent Sees Consumers Replacing Health Insurers as Primary Payers

Preferred Provider Organization insurance plans may account for the majority of insurance plans used by American consumers, but the rapid growth in nTelagent’s client base suggests health care providers have accepted that consumers have replaced insurers as their primary payers.

“Right now we’re growing 40 to 50 percent month over month, in terms of customer growth,” Earl Winter, president of nTelagent, Inc., told insideARM.

Winter said the health care information technology firm based in Nashville, Tenn., is posed to grow more than 400 percent in 2008 as more health care providers utilize the company’s self-pay management system to determine how much patients can afford to pay at the point of sale and help those patients who qualify for financial assistance apply for help (“Self Pay Patients Don’t Have to Become Bad Debt Write-offs,” May 1).

“The market is finally waking up to the fact that the market has already shifted. It’s a consumer model now,” Winter said. “The service provider has to start collecting on the front end. If they don’t start moving to that model, they will be in danger of being acquired or going out of business.”

Winter said nTelagent represents clients in more than 30 states and they include hospitals, physician practices and ambulatory surgical centers. He added that nTelagent’s self pay management system is starting to attract university hospital systems and chains representing more than 50 hospitals.

A recent study of nTelagent’s current and potential client base revealed 65 percent of their bad debt was attributable to insured patients not paying their out-of-pocket costs.  The average outstanding bill owed by insured patients ranged between $700 and $1,100, according to the survey.

“It the sheer volume of these instances that is causing a big problem because payments aren’t being collected at the point of service,” Winter said.