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This is the fourth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. In this post, we address the fourth step – prior authorizations, and helping your patients get the approved care they need. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. To read the full white paper, download it here. Ask ten physicians how to improve healthcare administration, and they are likely to share dozens of conflicting answers. But if there’s one thing almost all of them can agree on, it’s the need to dramatically overhaul the processes around prior authorizations (PAs) for patient care. Prior authorizations for specific procedures, tests, and medications are designed to reduce financial surprises for patients and providers – while encouraging evidence-based care. The challenge is that criteria for authorizations changes frequently and can be complicated. Unfortunately, due to the COVID-19 pandemic, frequent change and complexity are difficult to manage. After months of avoiding in-person interactions, patients are now flooding back to their providers to catch up on deferred care. In many ways, the increase in volume is to be celebrated: providers are recouping lost revenue and patients are once again receiving necessary services. But with the return of patients comes the return of onerous paperwork, and providers are not entirely prepared to play catch up. In 2021, two-thirds of providers told Experian that they are finding it difficult to keep track of complicated criteria that keep changing during the pandemic. The same number expect to see ongoing challenges with securing authorizations for scheduled elective procedures, a marked increase from just over half of those surveyed last year. As providers, payers, and patients adjust to the new normal of COVID-19, it’s time for providers to streamline operations, increase efficiency, and improve revenue cycle predictability with automated prior authorizations. Coping with the multiplying burdens of prior authorizations Faxes and phone calls dominate the pre-authorization process. Practice staff – or even patients themselves – might spend hours working with multiple payer organizations trying to fill out forms, get more information, or appeal decisions. Without going through this tedious procedure, practices risk claim denials that can significantly impact their revenue cycles and patients may end up with unexpectedly large out-of-pocket bills. Over 80 percent of providers have seen an uptick in prior authorizations since 2020, building on a multi-year trend of increasingly complex PA requirements. In a recent survey from the American Medical Association (AMA), 85 percent of physicians confirmed that the burdens from prior authorizations are “high” or “extremely high,” and are affecting their practice operations. With an average of 40 prior authorizations per week per physician, some practices are spending more than two full working days each week on paperwork, the AMA says. Practices that want to get ahead of PAs will need to take a new approach to preapprovals and health plan relations. Fortunately, innovative automation technologies are available to help. Leveraging automation tools to streamline prior authorizations Prior authorization software can significantly decrease the cognitive burdens and person-power involved in completing PAs. With key features, such as an always-up-to-date knowledge base of current requirements for multiple health plans, staff members don’t have to search for obscure rule changes or the right payer portal to make sure their submissions are accepted the first time around. Exception-based workflows with dynamic work queues can easily guide staff members through convoluted requirements. Advanced status tracking, flags for manual review requirements, and procedure reconciliation tools also ensure that staff are always informed and prepared to take action. As a result, providers and physician groups gain the ability to complete more PAs in less time with a lower risk of errors, resubmissions, or claims denials. Meanwhile, patients can get the timely, evidence-based care they need and are less likely to find unpleasant surprises in their next medical bill. Integrating proactive preapprovals into the patient journey Providers can even take these newfound capabilities one step further to create a fully coordinated, cost-effective administrative experience for their patients. For example, automated Notice of Care tools are the perfect complement to digital prior authorization solutions. With these solutions, providers can send timely and accurate patient admission, observation, and discharge notifications while simultaneously gaining visibility into pending encounters. Uniting Notice of Care tools with data-driven PA strategies will make it simpler to proactively and holistically manage patient flow, anticipate resource allocation, and provide patients with timely and accurate information. As consumers begin to return to their pre-pandemic healthcare habits, it will be more important than ever for providers to get a handle on their administrative requirements and ensure they have the bandwidth to focus on reestablishing strong relationships with patients. With a combination of prior authorization tools and Notice of Care solutions, practices can complete necessary administrative tasks quickly and easily to support efficient, effective, and engaging patient journeys through the continuum of care. Learn more about how Experian Health can help your organization streamline patient access and improve revenue cycle predictability with automated prior authorizations. Download the white paper to learn more about how the prior authorizations process is changing post-pandemic.   Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience COVID-19 highlights an acute need for digital patient intake solutions

This is the third in a series of blog posts highlighting how the patient journey has evolved since the onset of COVID-19. Explore how digital patient intake solutions are transforming the registration process – presenting patients with self-service options and providers with an automated and more efficient process. To read the full white paper, download it here. Registration is a familiar pain point in the patient journey, but COVID-19 has pushed both patients and providers to embrace digital patient intake processes and solutions. These new solutions move registration out of the waiting room, reduce errors and inefficiencies, automate billing, payments and create an enterprise-wide approach to data. Digital patient registration, once considered a “nice to have,” is now a widespread priority. A reveals that 88% of providers plan to invest in patient intake capabilities as a result of the pandemic, up 15% over a year ago. Patients lead the way on post-pandemic digital experiences COVID-19 marked a tipping point in the digital patient experience. Contactless care in the form of telehealth, along with increased use of patient portals and self-service scheduling tools, helped patients access care from a distance. Now, even though 81% of patients say they believe their provider has made on-site facilities safe, many still prefer online and mobile registration options. The study also revealed that 64% of patients prefer an online or mobile-enabled registration experience. “There’s an ‘ick’ factor,” explains Spiro Kalapodis, Director of Product Management for Registration Accelerator and Patient Financial Advisor at Experian Health. Patients actively dislike filling out paper forms, using registration kiosks and handling iPads set out for public use. “I don’t blame them,” says Kalapodis. “Even though the initial wave of COVID-19 restrictions has passed, I would prefer completing the registration process from the comfort of my car, rather than fill out forms in a crowded waiting room.” Simplifying a difficult process with digital registration and digital patient intake solutions One reason automated registration can be such a relief is that manual processes are notoriously difficult for providers to manage. Manual patient registration has always been labor-intensive and subject to human error; COVID-19 magnified these limitations. Paper forms are inefficient – they require design, printing, paper, clipboards, pens, secure storage and disposal. So many things can go wrong: receiving illegible responses, inputting data incorrectly, misplacing forms, the list goes on—and each step consumes valuable staff hours, with questionable results. Meanwhile, patients moved, visited new providers, changed jobs and switched insurance companies which meant there was more information needing capture. At the same time, providers are struggling to recoup revenue that was lost when patients deferred care during the pandemic. Optimizing both human and digital resources is key to delivering on an improved patient experience and regaining consistent profitability. “Patient intake solutions automate everything so data can be used consistently across the patient journey,” says Kalapodis. “For example, when a patient scans their insurance card and submits it through Experian Health’s Registration Accelerator, we leverage technology behind the scenes that can automatically indicate the patient’s insurance provider, policy details, and correctly return the patient’s subscriber details —information that staff members otherwise have to figure out for themselves. By automating this process, we’re saving time and resources, reducing misunderstandings and preventing data entry errors, which can be costly for providers and confusing for patients.” With the right data, providers can also create accurate estimates and even invite patients to pay their bills as part of the registration process. The patient receives a text message with a link to their estimate, along with the opportunity to pay online or on their mobile device. “Not only does this streamline the billing and collection process for providers, it creates a frictionless experience and increases greater transparency for the patient,” says Kalapodis. Getting to a single view of the patient Maintaining accurate data records can help providers deliver smooth patient experiences, better care, simpler payment processes and allows for better communication. Unfortunately, COVID-19 created another challenge on this front. During the pandemic, many patients signed into patient portals to schedule vaccine appointments. In their hurry to secure a shot, many inadvertently created duplicate accounts—and now have duplicate records. Obviously, multiple vaccine logins are not the only source of duplicate, inaccurate and incomplete patient data. But thanks to COVID-19, providers have this additional problem to contend with. Automation can make fast work of data issues. A universal identity manager creates a single view of the patient using unique patient identifiers, which prevent duplicate data records. The result: fewer billing errors and reduced associated costs, better care and a more frictionless patient experience. Patient intake can be painless Digital patient registration was a good idea even before COVID-19. Paper forms, entry errors, fragmented data, duplicate records, slow billing, and a lack of transparency made the registration process costly and inefficient. But COVID-19 made the need for digital more acute. Providers that hope to re-engage patients and recover profitability in the post-COVID-19 era need the power of data and automation. Learn more about how Experian Health can help you deliver a patient registration experience that fits post-pandemic expectations while improving efficiency, reducing errors and leveraging patient data. Download the white paper to learn how digital patient intake solutions are revolutionizing healthcare.   Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience

The delta variant is still surging – and flu season is about to begin. How can healthcare providers leverage innovative technologies to streamline care and prepare for a potential “twindemic?” The summer of 2021 has not been kind to healthcare professionals.  After a brief period of hope that the worst of the COVID-19 epidemic was over, the delta variant started its march across America, flooding hospitals and physician practices with a new wave of seriously ill patients. Autumn and winter look like they might be trouble, too, as delta joins forces with the seasonal flu to form a potential “twindemic.” After a mild season in 2020, many experts are predicting that the flu will reemerge with a vengeance this year as people return to in-person work and school. The combination of the two illnesses could easily overwhelm providers who aren’t prepared with technologies and workflows that allow them to serve patients efficiently and remain responsive to fluctuating demands. As providers look to navigate the coming months, they will need to make sure that they have self-service tools in place to keep patients safe and relieve strain on staff.  With a few key digital solutions, resources can be maximized, unpredictable patient volume can be managed effectively, and difficult circumstances won’t slow down operations. Online self-scheduling can improve experiences for patients and staff Online self-scheduling is in high demand because it provides flexibility. patients want to move on with their busy lives without having to sit on hold with a representative. In Experian Health’s recent survey, the State of Patient Access 2.0, more than seven out of ten patients wanted to take the appointment-making process into their own hands, citing the speed and convenience of choosing their own appointments. Providers and physician groups appear eager to oblige.  More than 70 percent of providers responding to the survey stated they are planning to offer online appointment tools to improve experiences and manage complex operations as the pandemic continues. The benefits for providers are significant.  Online self-scheduling can measurably reduce administrative burdens on staff, allowing practices to reallocate their people power to other high-priority tasks. Giving patients the tools to make appointments may also help to reduce patient no-show rates, which can drain billions of dollars each year from provider organizations. Using self-scheduling tools, patients with transportation issues or concerns about exposure risks may be able to opt for telehealth visits, as opposed to unplanned visits to urgent care centers or the emergency department. This can help protect other consumers and staff from illness while allowing them to manage their own calendars. Mobile patient registration keeps patients safe from exposure during a "twindemic" Shifting patient registration from the clinic to the home can also be beneficial for patients and providers.  When patients fill out new forms or update existing information in person, they increase their exposure risk by staying in the waiting room longer than necessary. In contrast, a digital registration accelerator solution offers a quick, touchless, and convenient intake experience on the patient’s own mobile phone.  Patients can complete the process in their homes (where they are more likely to have all their personal information at hand), or in the parking lot while waiting for clearance to enter the building. On the provider’s side, automating patient intake improves operational efficiency and avoids errors that come from illegible handwriting and verbal information communicated through masks and plexiglass.  Data integrity algorithms and real-time feedback for patients can correct mistakes quickly to ensure high accuracy of patient data – a crucial competency for treatment and reimbursement. Patient portals boost convenience, communication, and security As providers prepare to battle two illnesses instead of just one, practices shouldn’t forget to leverage one of the most important parts of the digital arsenal: the patient portal. Portals are instrumental for staying connected with patients, particularly with the 40% of patients who skipped medical care in the early months of the pandemic. As a complement to necessary in-person care, patient portals offer a convenient way to communicate with providers, complete administrative tasks, and access personal health information at their leisure. Providers must be certain, however, that their portals don’t become avenues for medical identity theft.  Healthcare organizations must maintain tight security policies that simultaneously deliver an optimized patient experience. A patient identify-proofing and authentication solution that automates patient portal enrollment while adhering to the high standards of HIPAA and other industry requirements is key.  Solid security can reassure patients that sharing digital health information with their trusted providers is safe – fostering more open relationships and leading to better care. Hopefully, fears of a “twindemic” will fizzle as communities continue to take sensible precautions against the spread of COVID-19.  However, if the flu does roar back into life, providers must be prepared. Self-service technologies and robust security measures can safeguard practices against the strain of higher-than-expected patient volumes and supporting the continued delivery of high-quality patient care. Learn more about how Experian can help your organization incorporate these new technologies and prepare for a potential "twindemic."

The rising popularity of virtual care seems to be extending itself into other areas of patient experience, including a re-energized consumer preference for digital self-scheduling. In fact, McKinsey & Company reports that telehealth visits and utilization are 38x higher than pre-COVID-19 levels (July 2021). Meanwhile, Experian Health’s State of Patient Access 2.0 survey, released in June 2021, found that 73% of consumers now want to schedule their own doctor appointments online. Interest in self-scheduling is more than a lingering side effect of the pandemic. For providers, it’s a great way to build digital engagement with current and prospective patients – while accelerating internal efficiencies as patient volume increases. A clear preference for patient self-scheduling emerges “The preference for self-scheduling is not surprising when you look at the data,” says Sanju Pratap, Experian Health’s Vice President of Consumer Products, who sat down to talk about leveraging patient scheduling solutions to enhance digital engagement. “Patients are scheduling appointments online at all times of day – right before dinner, early in the morning or at lunchtime. During these uncertain times, self-scheduling is so much easier and safer." Expectations also changed when COVID-19 introduced consumers to self-scheduling for vaccine appointments. “At the same time, providers are cognizant of wanting to reduce patient waiting time when trying to schedule appointments or follow-ups – especially in care settings where they’re trying to minimize the time patients are in the office,” says Pratap. “Their resources are pretty slim these days. Any move toward efficiency is appreciated.” Self-scheduling creates a better digital patient experience—and a competitive advantage Now, providers are contending with a large number of consumers who moved during and after the pandemic and increased patient volume following a year or more of deferred care. Self-scheduling is often the first point of interaction. “I may Google a new provider to learn more about their practice,” says Pratap. “If I’m on their website and I see a “schedule now” button, I’m likely to try it, rather than waiting weeks or months to call the office to see whether they take my insurance or have an appointment for me.” That first point of contact can turn into a competitive advantage: “Does the orthopedic practice down the street offer online scheduling that makes it easy for other providers to refer to them—and easy for patients to schedule their own appointments? Providers that do are going to get new patient revenue and increase patient loyalty. They’re going to keep more of their existing patients if they meet consumers where they want to be.” Providers can create processes that exceed their own expectations Many providers still have their doubts about self-scheduling. “We often hear, ‘No system is going to understand the nuances of my scheduling template,’” says Pratap. These doubts aren’t totally unfounded. “Accurate appointments require a deep understanding of scheduling protocols. In the past, individually scripted schedulers had binders of questionnaires that they made notes on, relied on Post-It notes, and/or institutional knowledge. As you can imagine, this can be very inefficient, error-prone, and not the best experience for patients, providers or staff.” If humans have a hard time managing online healthcare appointment scheduling, what hope is there for automated systems? In fact, digital questionnaires and electronic medical records (EMRs) can streamline scheduling and provide a clean, seamless experience for all parties involved. The key: building a patient self-scheduling system without blind spots To make scheduling more efficient, questionnaires must be consistent, but also flexible enough to accommodate a variety of providers, locations and specialties. Patients and access coordinators should be able to look for appointments across providers within a single view. If one provider is not available within a patient’s requested timeframe, a system could suggest another qualified provider. In doing so, systems can avoid scheduling imbalances that overload some providers, while under-scheduling others. Pratap shared additional ideas for avoiding blind spots: Remove friction from the patient journey end to end. For example, if you require a sign-in to your patient portal to view appointments, you may discourage consumers who don’t want to create new sign-ins just to view availability. Create a system that works for many users. “It’s not just patient self-scheduling you have to consider, but also the call center, the patient portal and anyone that’s leveraging an API to book into a provider’s schedule,” says Pratap. “Scheduling tools should make it easy to see availability across multiple providers and locations, and allow patients to see accurate availability and easily book, no matter who you are or how you accessed the system.” Revaluate pre-visit messages sent after appointments are made. Capture all the information you need to ensure the patient’s registration process and visit goes smoothly. Build in accommodations for unique needs. While automation can help streamline scheduling, it’s important to understand every patient’s individual needs. If necessary, staff can step in and take the reins on scheduling. For example, staff can manually accommodate appointments for an older patient who suffers from chronic issues and needs more time with their doctor. Don’t rely solely on out-of-the-box solutions. Using the scheduling functions that come with different types of EMRs may be tempting. However, making the additional effort to create a process that is accurate, efficient and flexible—and encourages digital patient engagement—increases the value of a patient scheduling solution exponentially. Measure progress and mine data to continue optimizing Scheduling isn’t just your digital front door. It also has the potential to make—or lose—revenue. “Some providers worry about patients booking the wrong appointments and taking time away from other patients,” says Pratap. “Their concerns are valid; these time slots are valuable.” “One of the metrics we use to gauge how successful our scheduling systems are is by looking at the rescheduling rate,” Pratap explains. “We look at how many appointments need to be re-booked because the wrong provider or appointment type was chosen and filter out appointments that were re-booked for other reasons. By using this information, we can create systems where re-booking is rare.” Monitoring data also helps providers stay ahead of fluctuating needs and preferences.  “When you’re choosing a scheduling solution, ask what reporting and analytics are built-in,” says Pratap. “You want to be able to find out, for instance, what availability looks like across your practice—and whether it’s the reason patients aren’t scheduling with you. Analytics and insights can be layered on top of data to help you optimize the patient experience and keep your practice running efficiently.” Watch Greg Young, Senior Director Marketing, and Sanju Pratap, VP of Product Management for Consumer Products, discuss how you can enhance digital patient engagement and accelerate call center operations with patient scheduling solutions in the latest Interview with the Expert.   Contact us to see how Experian Health can help streamline patient scheduling for your organization.

This is the second in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. In this post, we explore how 24/7 self-scheduling can help healthcare providers adapt to the post-pandemic digital landscape.  To read the full white paper, download it here. If there’s one digital tool that punches above its weight in the healthcare industry, it’s online self-scheduling. This simple concept – allowing patients to book their own appointments online – resolves many sticky issues throughout the entire patient journey. It drives patient satisfaction, acquisition, and retention. It boosts staff efficiency and smooths out bumps in the revenue cycle. No-shows and delayed care can be minimized, leading to reduced costs and far better health outcomes. All of that was true before the pandemic. However, when COVID-19 hit, self-scheduling was a gamechanger. When more patients wanted to manage their healthcare online, and staff were forced to work remotely, online medical scheduling was convenient and safe. Now, the return on investment is even higher. As patients struggle to overcome growing barriers to care, and providers wrangle with soaring volumes of returning patients, the digital front door must remain open. How can providers leverage the benefits of 24/7 digital self-scheduling seen over the last year or so, and create a digital patient experience that’s fit for the future? Consumers schedule appointments differently now – and they don’t want to go back Healthcare has been playing digital catch-up to other industries for much of the last decade. Consumers have long grumbled about archaic registration processes and the absence of digital tools seen frequently in other sectors. The urgent reconfiguration of the healthcare consumer experience over the last year means many of those missing digital options are now available. Instead of calling to make an appointment during office hours, patients can use 24/7 online scheduling platforms – accessible any time, from any device. Having had a taste of convenience and control, consumers expect online scheduling to continue beyond the pandemic. According to a new Experian Health study, nearly three-quarters of consumers want to continue to schedule their own appointments online. More than eight in 10 prefer an online or mobile-related registration experience. Rather than wait in a long customer service queue, patients can make, cancel, or reschedule appointments with the push of a button. Patients of all ages like having a flexible and frictionless way to manage their care, so why would they choose a provider that doesn’t offer online self-scheduling as part of the mix? 24/7 self-scheduling reduces barriers to care In addition to meeting consumer expectations, 24/7 self-scheduling also helps providers overcome many new and existing consumer challenges in the wake of the pandemic. Patients can be blocked from accessing the care they need for all sorts of reasons – financial worries, lack of transportation, lack of time to phone and book appointments, and/or cultural barriers to seeking support. As with many public health challenges, those who experience the greatest social and economic challenges have also been hardest hit by the pandemic. While many of these issues aren’t easily resolved by any one organization, self-scheduling does offer a route around several barriers to care. By simply offering a more flexible way to book and cancel appointments and interact with their provider, self-scheduling platforms allow patients to make plans in a way that fits their circumstances. Inconvenient business hours and long waits for available appointments become less of a concern. And with automated patient outreach, providers can make the process even easier, by sending text or email reminders to specific groups of patients to make sure they get the care they need. Digital self-scheduling eases call center bottlenecks Giving patients the ability to book their own appointments online also eases the burden on call center staff. Setting up staff to work remotely, while managing an influx of patients scrambling to book COVID-19 tests and vaccinations, created many pain points throughout the pandemic. First come, first serve scheduling options create bottlenecks in call volume, and when patients can’t get through to cancel appointments they can no longer attend, those slots sit unused – wasting physician time. As patients look to reschedule deferred care, 24/7 self-scheduling can minimize these bottlenecks by relieving pressure on call center staff and spread the load across multiple channels. Call center agents can reallocate their time to higher-priority inquiries. Call times can be cut because agents will have integrated access to disparate electronic health records and project management systems. Training time can also be reduced through simplified online systems. It’s no wonder that 71% of providers offer (or plan to offer) online self-scheduling options. Building a self-scheduling ecosystem that’s fit for the future Digital self-scheduling systems implemented during the pandemic should become a permanent feature in patient access. Providers that want to create an attractive patient experience should expand their digital self-scheduling offering beyond simply booking appointments. Multiple specialty services can be integrated into the scheduling system to streamline referrals. Telehealth services that gained so much ground over the last 18 months can be connected to online scheduling tools so they’re fully embedded going forward. Digital payment options and coverage functions can also be linked to scheduling platforms, for a seamless end-to-end digital patient experience. Find out how Experian Health’s 24/7 online patient scheduling software can help your organization deliver an optimal patient experience, improve call center productivity, and reduce revenue loss as the healthcare industry adapts to the new digital landscape. Download our white paper to get patient-provider perspectives on self-scheduling and other digital trends.

In November 2020, Experian Health conducted a survey to capture consumer and provider attitudes regarding patient access. At the height of the pandemic, patients welcomed telehealth services and maintained their distance from hospital waiting rooms. Providers scrambled to implement and provide digital services that would help them maintain quality care for their patients. In June 2021, we revisited these questions to see if healthcare providers and patients changed their views on the state of patient access: The pandemic has forced rethinking how to “do” healthcare in the digital age. Patients want flexible, convenient, and contactless care; providers need to continue providing these services. Download the white paper for the full survey results and get strategies to plan for the future of healthcare.