aag & misc test

As deductibles and premiums increase, more patients struggle to pay healthcare bills, and, in turn, the patient collections process becomes more and more daunting. Hospitals and clinics are now relying on debt collection agencies more than ever. At Experian Health, we estimate a 119 percent increase in this specific outsourcing over a four-year period, from 2014 to 2018. A third-party debt collection agency is attractive for many reasons. For one, it frees up your healthcare practice’s valuable resources. Also, patients with delinquent bills typically respond well to a debt collector’s call. However, using a debt collection agency does not relieve all concerns because you must consider vicarious liability. By law, your hospital or clinic can be held responsible for the debt collection agency’s actions when it acts on your behalf. To keep your healthcare practice out of legal trouble and clear of costly fines, ensure the debt collection agencies that you hire comply with relevant laws and regulations. Also, consider using tools to make sense of these complex requirements. Do You Know the Laws Controlling Debt Collection? The legal requirements governing debt collection are varied and frequently evolving. It can take a lot of work to keep up with them, but there’s a tool to help you. We’ll describe this tool in just a moment, but first, let’s review a sample of federal debt collection laws and regulations to make sure you’re up-to-date: The Fair Debt Collection Practices Act (FDCPA) limits the behavior and actions of collectors who attempt to collect debts on behalf of another person or entity. This federal law aims to eliminate “abusive, deceptive, and unfair debt collection practices.” The Telephone Consumer Protection Act (TCPA) governs interactions between businesses and their customers, including healthcare providers and their patients. In many cases, this federal law requires consent before a provider can communicate with a patient’s mobile device through automated dialing systems, such as auto-texting or “robocall” systems. The Fair Credit Reporting Act (FCRA) regulates the collection, dissemination, and use of consumer information, including credit information. The Gramm-Leach-Bliley Act (GLBA) requires institutions to explain their information-sharing practices to customers and any available opt-out provisions. IRS Code 501(r) is a federal regulation enacted by the Affordable Care Act. It mandates certain financial assistance practices in order for an organization to maintain a nonprofit 501(c)(3) status. A key provision holds many hospitals and healthcare systems accountable for the acts of their debt collection agencies. The Electronic Fund Transfer Act (EFTA) establishes the rights and liabilities of consumers in electronic fund transfer activities, as well as the responsibilities of all parties. The Truth in Lending Act (TILA) requires disclosures about lending terms and the costs associated with borrowing.  

Today’s healthcare consumers are at the center of healthcare transformation. They demand a personalized experience, use devices to monitor their health and are vocal when they are not satisfied with their service or care. Healthcare organizations are being challenged to think differently about healthcare engagement. To succeed, you must become consumer-facing and expand your reach. You need to attract and retain patients for service line growth. Connecting with consumers by tailoring their journey is expected, so you using data to predict health conditions and message effectively is critical. Do you know who your patients are? How to build a relationship with them? Can you improve their satisfaction and retention? Are you providing personalized communications? Superior data with actionable insights can help you remain competitive in this new healthcare landscape. This is a new approach to most healthcare organizations, but it provides an exciting opportunity. Leverage data the right way and gain deeper insights to improve patient and consumer engagement.  To learn more, visit Experian Health’s Marketing Services page, contact your account representative or email us at experianhealth@experian.com

Recent industry shifts, including the transition from volume- to value- based reimbursement, lower reimbursement and shrinking inpatient margins, increased bad debt due to high deductible health plans and other challenges, are causing undue stress for healthcare providers. It’s difficult for some organizations to manage complex reimbursement models or handle complex claims, so providers are often underpaid or write off revenue they are due. The cost to collect continues to rise when staff produces poor results or turnover is high. Additionally, hospital information system (HIS) conversions traditionally result in a backlog of accounts receivable (A/R), requiring incremental staff to support the conversion. 78% of CFOs are concerned about their revenue cycle platform capabilities for value-based payments and will outsource in lieu of investing in new technology.^ Experian Health's Revenue Cycle Services leverage Experian’s proprietary technologies and experienced staff to optimize revenue cycle management (RCM) performance to help you meet your financial goals, such as increasing A/R yield, lowering operating costs, and resolution of revenue leakage issues and denials. Contact us today to learn more about Experian Health’s Revenue Cycle Services.   ^2015 Black Book Survey

The MongoDB Innovation Awards celebrate organizations building the world's most innovative applications, recognizing those with a transformative impact on their respective sectors. Recently, Experian Health was recognized for our innovation in healthcare. Our Universal Identity Manager (UIM), which integrates with MongoDB to accurately sequence patient data, can accurately match, manage and protect patient identity. Drawing on more than 40 years of experience managing identities across various industries, Experian Health’s interoperable patient identification solution leverages consumer credit data to improve record quality. Our UIM creates a unique, universal patient identifier to identify patients and link their records to allow entities (pharmacy, lab, payer, and provider) with disparate databases, systems, and data formats to share a single view of the same patient. Accurate and complete information is securely exchanged, minimizing medical and billing errors, and fraud. “We leverage MongoDB to deliver UIM information in real-time – and that makes performance critical,” said Michael Ochs, chief technology officer of Experian Health. “If patient data is delivered out of sequence, it can create multiple issues in the delivery and accuracy of patient information. This technology makes the interoperability and exchange of information across the healthcare ecosystem is an achievable goal. With UIM, it is possible to successfully address problems caused by data integration challenges and fluid patient data.” Our consumer demographic information combined with reference data and referential matching methodologies allow the UIM to achieve higher matching rates and mitigate matching challenges associated with data quality. “We encourage health organizations to adopt universal patient identifiers because there is a well-documented need for it – the absence of which poses both business and safety issues,” said Jennifer Schulz, group president of Experian Health. “Our UIM batch product is being offered to organizations at no charge* to provide a universal patient identifier that will help address the complexities of managing patient identification by identifying consumers in the healthcare ecosystem more accurately.” Michael accepted the award on behalf of Experian Health at the annual MongoDB World event in Chicago on June 21, where he joined 13 other innovative companies being awarded in different categories. This award for Experian Health comes shortly after being recognized in the healthcare industry by Healthcare Informatics as no. 45 on the list of “Top 100 Companies by Revenue.” *Offer is limited to Experian Health’s UIM Batch Process product and shall remain open for such time as Experian Health may decide.

Reimbursement pressures and the real potential of changing regulations require that revenue cycle leaders leverage data and technology to be as efficient and nimble as possible to maximize net revenue, reduce denials, and lower operating costs. Shifting reimbursement models, complex benefit designs and limitations, increased patient responsibility, and growing regulatory pressures are driving near-constant change in the healthcare revenue cycle. Healthcare organizations that used to be paid by the encounter are adapting to emerging trends of also being selected, measured, and paid for how they perform and collaborate with other providers to improve outcomes. This value versus volume movement has forced hospitals, physicians, and other providers to focus on delivering high-quality, collaborative care at a lower cost while enhancing the patient experience, including efficiency and patient sensitivity in the revenue cycle. Experian Health’s Revenue Cycle Analytics provides visibility across the revenue cycle continuum, transforming operational and financial information into actionable insights. By tapping into Experian Health’s vast product workflow data and revenue cycle transactions, you can hone in to optimize specific workflows and compare your facility’s operations and processes against industry peers to make more informed business outcomes. Relevant data is presented for users based on responsibilities. With your internal data, we can Improve your workflows, operational performance, and financial results by leveraging your data across the revenue cycle, matching it, and analyzing the account across the various revenue cycle workflows and transactions Ensure accurate reimbursement by analyzing workflows and optimizing activities Create and monitor revenue cycle KPIs around pre-service, point-of-service, post service, denials, etc. to provide data points needed for process and financial optimization Provide comparative analysis and benchmarking that scores payer performance based on claim, rejections, denials, and exceptions Identify trends by drilling down to the staff, department, and service levels to uncover insightful details Maximize return on investment in Experian Health revenue cycle management products Enable the calculations of HFMA Map Keys and NAHAM Access keys for true peer-to-peer benchmarking With decades of Big Data experience, and as experts in gathering and securely managing huge quantities of data, Experian Health’s Revenue Cycle Analytics manages an unrivalled breadth and depth of data to help clients gain a deep understanding of people, businesses, places, economics, and health.  

Yale New Haven Health (YNHH) established a goal to elevate the patient financial experience by compassionately educating patients about the finances surrounding their care, and educating staff on the tools and methods for delivering that message. YNHH embarked on a two-year patient financial advisory initiative, including patient and family advisors, to hear opinions and learn valuable information directly from consumers. According to Sharlene Seidman, Executive Director Corporate Business Services, with Yale New Haven Health: “We needed a consumer-focused price transparency strategy that would bring us on par with other industries, like retail. Our goal was that when patients discuss their overall YNHH experience, it is not just reflective of their clinical care, but their financial care as well.” Since going live with Eligibility and the Epic integration in May 2016, YNHH has made major strides toward meeting its pre-service excellence goals in four key areas 1) the right technology, 2) best practices, 3) patient interaction/engagement, and 4) employee culture and education. Read the full case study here