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Topics that matters most for revenue cycle management, data and analytics, patient experience and identity management.

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Published: February 26, 2025 by joseph.rodriguez

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Published: February 21, 2025 by QA MarketingTechnologists

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Published: February 20, 2025 by admin

Experian Health is very pleased to announce that we've ranked #1 in the 2025 Best in KLAS: Software & Services report, for our Contract Manager and Contract Analysis product, for the third consecutive year. Contract Manager, when paired with Contract Analysis, empowers healthcare providers by ensuring payers comply with contract terms, identifying and recovering underpayments, and arming them with real claims data to negotiate contracts. This enables providers to negotiate more favorable terms and maintain financial stability.  Clarissa Riggins, Chief Product Officer at Experian Health, says, “In the ever-evolving healthcare landscape, our Contract Manager solution has once again been recognized as the #1 Revenue Cycle Management tool by KLAS for the third consecutive year. This prestigious ranking underscores the significant value our solution delivers to our clients by identifying underpayments and facilitating revenue recovery. We are honored to continue supporting our clients with innovative solutions that drive financial success and operational efficiency.”  Learn more about how Contract Manager and Contract Analysis can help your healthcare organization validate reimbursement accuracy, recover underpayments and boost revenue.   Learn more Contact us

Published: February 5, 2025 by kelly.nguyen

Patient engagement still has a long way to go, and hinges on patient access. According to the 2024 Experian State of Patient Access survey, just 28% of patients feel access has improved since the previous years. However, more than half (51%) feel it has remained static. Today's patients are tech-savvy and have access to more health information than ever before. They want to be more active in their care, from scheduling appointments to messaging providers directly with their questions and concerns. Experian Health data also reports that 60% of patients are looking for more digital and mobile options to better engage with providers. Around the same percentage say they'd consider switching providers in order to get the access they crave. In 2025, healthcare organizations must empower patients with the control they want and an overall positive patient experience. Providers that successfully give patients a voice and opportunities to play an active role in their care are more likely to retain patients, see better health outcomes and keep revenue cycles in check. Here's a closer look at how providers can increase patient engagement, why it matters and key strategies that deliver improved end-to-end patient experiences. What is patient engagement? Patient engagement is a proven strategy healthcare providers have relied on for decades to improve patient care, boost outcomes, increase retention and keep revenue cycles churning. This patient-centric care approach encourages patients to take an active role in all aspects of their treatment – from decision-making to self-management. When successfully implemented, patient engagement gives patients autonomy over their personal wellness journey and forms a trusted and often lasting partnership between patients and providers. Why is patient engagement critical for healthcare providers? Engaged patients are informed patients who stay on top of their overall health and wellness. They're also more likely to identify symptoms sooner, attend appointments, follow aftercare instructions and have better health outcomes. When patients are actively involved in their care, they have a more positive patient experience, which increases patient satisfaction, preventative care, retention and repeat visits. The healthcare landscape continues to evolve rapidly. Today's patients have more choices and access to care than ever before. Thanks to an onslaught of emerging digital providers and big-name retailers now offering healthcare services, patients can see a provider without leaving their homes, or pop in for a care visit while shopping for groceries. Patients want to see their doctor quickly and crave the convenience of user-friendly digital tools to book appointments, complete intake paperwork and keep tabs on their care. To meet growing patient needs and keep pace with industry shifts, healthcare providers must adopt the latest strategies and technologies and increase patient engagement, or risk losing patients (and revenue) to providers that deliver more tech-savvy and personalized experiences. Challenges in patient engagement Improved patient engagement is a top priority for both patients and healthcare organizations. However, the industry faces several key hurdles to elevating the patient experience. Lack of patient access The patient-provider relationship starts with prompt access to an appointment. Patients prioritize being able to see their providers quickly and often measure their entire patient experience on the ability to get on the schedule. Experian Health's State of Patient Access survey data shows that opinions on appointment access hinge on wait times. In fact, both patients who think patient access has improved and those who think access has worsened cite wait times as their reason. However, patients don't just want to be seen sooner; they want more self-service options to be in control of their appointments. Nine out of ten patients want to schedule appointments online or with a mobile device—anytime, anywhere. Nearly 90% of today's patients prefer to avoid tedious intake paperwork and would welcome a digital or paperless pre-registration experience. Outdated systems and technology Healthcare providers have been increasingly adopting new technology solutions, like online patient portals and telehealth, since COVID-19 kicked off major industry changes. However, the healthcare ecosystem is still heavily weighed down by complicated, outdated systems. For instance, nearly 60% of providers still use at least two different tools to gather the necessary patient information for claim submission. These manual (and often disjointed) processes can frustrate patients, burden staff, and affect all stages of the patient health journey and revenue cycle. Patients want easier access. Experian Health data reports that 60% of patients say they want more digital tools to manage their healthcare. Providers that want to improve the patient experience and stay relevant with patients must consider investing in user-friendly technology that meets the demands of today's tech-savvy patients. Staffing shortages expected to continue Unfortunately, one of the biggest challenges in the healthcare industry isn't showing signs of letting up any time soon. The American Hospital Association (AMA) reports that by 2028, the healthcare industry will experience a shortage of approximately 100,000 critical workers. With these expected shortages, already strained staff may struggle to keep up with administrative tasks that directly affect patient care. Without a solution to streamline tedious admin work, bottlenecks are likely to continue across scheduling, registration, insurance eligibility checks, claims processing, collections and follow-up communications. Strategies to increase patient engagement in healthcare The pandemic brought many advances to the healthcare industry, including virtual care and telehealth. However, today's patients want even more access. Digital tools that offer a seamless patient engagement experience, like patient portals, mobile registration and online scheduling, can help providers keep patients engaged and improve satisfaction. Healthcare organizations can benefit by adopting some of the following strategies to increase patient engagement and, ultimately, patient outcomes and revenue.  1. Implement patient self-service options Embracing user-friendly technology that opens the digital front door is critical to elevating the patient experience at every stage of the health journey. With the right technology solutions in place, healthcare providers can meet patients' growing demand for digital tools and improved access while easing administrative burdens on staff. It's no wonder nearly 80% of providers report planning to invest in patient access improvements soon. Automated patient intake solutions that kick off the registration process, like Experian Health's Registration Accelerator, engage patients early, right from their mobile devices. Patients have the flexibility to complete intake paperwork on their own time, while providers can verify patient details quickly, without tedious manual processes. Case study: How West Tennessee Healthcare simplified registration with Registration Accelerator. 2. Streamline patient and provider communication Communication is a key part of creating a positive patient experience. It starts with the first impression a provider makes during the initial contact – well before the patient even steps foot in the door. Online appointment booking options offer patients the 24/7 self-service scheduling they crave. Tools like Experian Health's patient scheduling software guides patients to the appropriate provider and appointment while keeping the provider in control of their calendar. Patients receive text reminders and can cancel or change their appointments as needed. Other self-service options, like online patient portals, make it easy for patients to have visibility into their care and communicate with providers directly. Patient outreach solutions can also close the gap between patient and provider communications, by enabling patients to conveniently self-schedule via SMS or IVR campaigns. Providers can also engage patients with automated, timely messages and meet patients where they are. On-demand webinar: See how IU Health increased one-call resolutions with Patient Schedule 3. Create personalized financial plans for patients With healthcare expenses on the rise, patients want to know how much care will cost before they receive treatment. More than 80% of patients say pre-service estimates help them prepare for medical expenses; however, more than half report needing their provider's help to understand what insurance covers. Providers can improve the patient experience by offering accurate, upfront estimates and clear paths for patients to meet financial responsibilities. Tools like Experian Health's Patient Payment Estimates generate estimates of what a patient will owe, incorporating real-time pricing information, benefits and discounts. Providers can further streamline the patient's financial experience by implementing tools that help patients check if they qualify for financial assistance, receive payment plans and securely pay bills. Patients can be further empowered when providers offer a way to quickly pay bills from a secure link over text or a web-based app. Read more: How to maximize patient collections with digital technology Improve patient engagement with technology Technology continues to transform all aspects of healthcare and patient engagement. From creating customized treatment plans to improving patient outcomes, these new technology innovations are rapidly changing the face of healthcare. Tools like artificial intelligence (AI) and automation now play a critical role in helping providers streamline all aspects of revenue cycle management, including insurance eligibility checks, claims processing and collections. When providers invest in a wide range of patient engagement solutions, they can deliver a strong patient experience, improve patient engagement, reduce administrative burdens on staff and improve the bottom line. Find out more about how Experian Health's patient engagement solutions help healthcare organizations improve the patient experience at every stage of the patient journey. Patient Engagement solutions Contact us

Published: January 30, 2025 by Experian Health

As margins tighten, traditional revenue cycle management strategies are on shaky ground. Many healthcare providers are turning to automation and AI to simplify payments, prevent revenue loss and protect profits. This article breaks down some of the most common revenue cycle management (RCM) challenges facing healthcare leaders and offers a practical checklist to optimize patient access, collections and claims management, while building a resilient and patient-centered revenue cycle. Common challenges in revenue cycle management Revenue cycle management is how healthcare organizations handle the financial side of patient care, from patient billing to claims management. Healthcare providers rely on RCM to ensure they are properly paid, so they can keep the lights on, pay their staff and deliver quality patient care. Are traditional RCM strategies still fit for purpose? Consider some of the current challenges: Patients are responsible for a larger share of costs due to high-deductible health plans. How can providers help them understand their financial obligations and make it easier to pay without hurting their experience? Minimizing claim denials is a daily focus, thanks to constantly changing policies and regulatory updates. How do revenue cycle teams keep up with payers? Staffing shortages remain on the agenda. How can providers ease pressure on staff to maintain productivity and morale? There's also the question of how to turn mountains of data into actionable insights. How do teams interpret it correctly to identify bottlenecks and opportunities for improvement? Automation and AI offer a way through. When implemented thoughtfully, these tools can speed up processes, reduce errors and clear operational roadblocks for a more resilient revenue cycle. The following revenue cycle management checklist includes some of the key questions to consider along the way. Checklist for improving revenue cycle management Automating patient access Can patients book appointments online? Does the online scheduler automate business rules to guide patients to the right provider? Are patient identities verified at registration and point of service? A healthy revenue cycle starts with efficient patient access. According to the State of Patient Access 2024, 60% of patients want more digital options for scheduling appointments, managing bills and communicating with providers. Providers who see improvements in patient access also credit automation, which speeds up intake and improves accuracy. A good first step is to replace paper-based processes with online self-scheduling and self-service registration. These tools make life easier for patients, boosting satisfaction, retention and engagement. Behind the scenes, Experian Health's new AI-powered tool, Patient Access Curator, helps providers get paid faster by verifying and updating patient information with a single click – accelerating registration and paving the way for faster reimbursement. Register now: Exact Sciences and Trinity Health will share how Patient Access Curator is redefining patient access in this upcoming webinar. Optimize patient collections with data and analytics Are patient estimates provided upfront? Are notice of care requirements being addressed? Are patients offered appropriate financial plans and easy ways to pay? With more financial responsibility resting on patients' shoulders, patient collections are under the spotlight. The State of Patient Access report shows that upfront estimates and clarity about coverage are top priorities for patients, because when they know what they owe, they're more likely to pay on time. Implementing tools to promote price transparency and easy payment methods should feature in any RCM checklist. With Coverage Discovery, healthcare organizations can run checks across the entire revenue cycle to find billable commercial and government coverage that may have been forgotten, to maximize the chance of reimbursement. Meanwhile, Patient Payment Estimates offers patients clear, accessible estimates of their financial responsibility before treatment, so that hose who need financial assistance can be directed automatically to payment plans and charity options. Case study: How UCHealth secured $62M+ in insurance payments with Coverage Discovery® Improve claims management to reduce denials Are high-impact accounts prioritized? Are remittances reconciled with payments received? Does claims management software generate real-time insights and reports? With 73% of healthcare leaders agreeing that denial increased in 2024, and 67% saying it takes longer to get reimbursed, claims management is a great use case for automation. ClaimSource®, ranked Best in KLAS in 2024 for claims management, automates the entire claims cycle in a single application. It integrates national and local payer edits with custom provider edits to verify that each claim is properly coded before submission. By focusing on high-priority accounts, providers can target resources in the most effective way to ensure a higher first-pass payment rate. A major advantage for ClaimSource users is access to AI Advantage™. This tool utilizes AI to “learn” from an organization's historical claims data and trends in payer behavior to predict the probability of denial. It also segments denials so staff can prioritize those that are most likely to be reimbursed, reducing the time and cost of manual appeals and rework. Case study: After using AI Advantage for just six months, Schneck Medical Center reduced denials by an average of 4.6% each month, and cut rework time from 12 to 15 minutes per correction to under 5 minutes. Benefits of implementing a revenue cycle management checklist The key to choosing the right RCM tools and technologies is to build the strategy around what patients need most. A clear, transparent and compassionate billing experience is more manageable for patients and helps providers get paid faster. An RCM checklist helps teams stay focused on the tasks that matter. Providers can build on the suggestions above by choosing the key performance indicators (KPIs) that align with their specific goals. Metrics like financial performance, billing efficiency and collections rates can be combined to guide resource allocation, drive improvements and speed up reimbursement. With a well-designed checklist informed by clear KPIs, revenue cycle leaders can keep their teams on track and take their organizations from “surviving” to “thriving.” Learn more about how Experian Health's revenue cycle management tools can help healthcare providers meet current challenges, improve the patient experience and increase cash flow. Learn more Contact us

Published: January 28, 2025 by Experian Health

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