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How Dollar For automated hospital charity care applications

Learn how a national nonprofit was able to advocate for more patients seeking access to medical debt cancellation by automating the complicated application process.

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The Company

Nonprofit hospitals are required to offer financial assistance to patients under a certain income limit, but these programs are often little known and hard to access. Dollar For is a national nonprofit that works to eliminate medical debt by empowering patients to discover and participate in hospital “charity care” programs.

Dollar For increases awareness of and access to these programs by helping  patients check if they are eligible for financial assistance at their hospital, prepare and submit applications, and eliminate medical bills, all at no cost to the patient. Since 2019, Dollar For has worked with patients to complete and submit over 4,300 financial assistance applications, which has led to nearly $24  million in debt cancellation.

As the only organization directly serving patients who need charity care nationwide at scale, Dollar For has  a uniquely broad view of charity care practices and how they impact (or fail to impact) patients in every community. The data Dollar For collects on individual charity care cases enables them to advocate at the local, state, and national level for better charity care practices.

The Problem

While charity care is mandated by law, each hospital sets its own criteria for eligibility and designs its own financial assistance application forms and processes. For example, Kaiser Permanente has a one-page form with just a few questions, while MD Anderson Cancer Center has a 10-page form. Some hospital forms have unusual layouts (Children’s Hospital Colorado) while others don’t provide enough space for a human to write in their answers.

After a patient provides information through Dollar For’s website form, the company fills out and submits applications on their behalf. The process of filling out an application is the most time-consuming step, taking 15 to 30 minutes per patient. To serve patients quickly and scale up their operations to meet growing demand, Dollar For needed to reduce or eliminate entirely the time it took their team to complete charity care applications before submitting them to hospitals.

At first, the Dollar For team tried creating a standard application form, but none of the hospitals would accept it. The team then used a free PDF-filling tool called Sejda, but this still required a human being to manually find and type in the necessary data.

The Solution

A scalable solution would need to automate the process of placing pieces of data from Dollar For’s database in the appropriate places on any of the hundreds of hospital application forms a patient might need completed.

Using Anvil’s no-code document templates editor, the Dollar For team created PDF templates for each of the hospital systems’ application forms in Anvil and mapped the form fields to the corresponding database fields using field alias tags.

When a patient provides their information via the Dollar For website, the data is sent to Make, a no-code integration platform.  Make then sends the JSON data to Anvil to fill in a standard Release of Information form and any additional PDFs for the individual hospital applications. Anvil sends the completed PDFs back to Make, which then pushes the forms and  the associated data to Dollar For’s CRM.  Within the CRM, a Patient Advocate reviews the PDFs along with the other patient data, which they then send to the hospital.

With Anvil and Make, Dollar For is able to complete application PDFs the moment a patient provides their information and quickly get those forms to the hospital for processing.

The Result

By automating data filling via Anvil, Dollar completes application forms significantly faster. Their Patient Advocates are able to shift their focus away from manual data entry to the highly specialized work of reviewing applications and submitting them to hospital charity care programs. With this improved process, they will be able to serve between 55 and 80%  more patients without increasing staffing.

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