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What do patients and providers really think about patient access services in 2024? Drawing insights from more than 1000 patients and 200 healthcare executives, Experian Health's fourth State of Patient Access survey pulls back the curtain. Previous surveys revealed a persistent gap between patient and provider perspectives on patient access, but could the gap finally be closing? The State of Patient Access 2024 report suggests that while discrepancies remain, the two groups appear closer than ever. This article provides a summary of the State of Patient Access 2024 report, and gives a run-down of patient and provider perspectives on patient access, what they see as top challenges, where opinions diverge and the steps providers can take to continue building a positive patient access experience in the year ahead. How do patients feel about patient access? 1. More patients think access has improved compared to last year 28% of patients believe patient access has improved over the last year, which is up from just 17% in 2023. As in previous years, patients' perception of whether access has improved hinges on how quickly they can see their doctor. Anything providers can do to accelerate scheduling and registration will be a winner. 2. Patients welcome the efficiency and accuracy of digital tools Patients have noticed improvements in scheduling and registration processes. They welcome the ability to book appointments anytime and avoid unnecessary paperwork using digital technology. That said, financial considerations trump convenience: the ability to look up insurance coverage and obtain accurate price estimates before care have risen to the top of the list of what patients consider the most important aspects to improve. 3. Cost of care remains a concern Unfortunately, patient sentiment around healthcare payments has remained relatively flat since 2022. Slightly more patients are receiving upfront cost estimates compared to previous years, but accuracy appears to have dropped, with 74% of patients reporting accurate estimates compared to 78% in 2023. Patients must have faith in their estimates if they are to plan for upcoming bills with confidence, and providers should be able to provide transparent and accurate payment estimates. What do providers think about patient access? 1. Providers are again more optimistic about improvements than patients Like patients, providers are generally positive about the state of patient access, though they may be a little too optimistic about the effect of improvement efforts. Around twice as many providers think access is better than the previous year compared to patients (55% compared to 28%). For providers, perceptions of improvements in patient access are closely tied to the impact of staffing levels. 2. Self-scheduling is back in favor Providers are aligned with patients on the need for digital scheduling and registration options. Interestingly, after the urgency to implement contactless scheduling during the pandemic began to wane in 2022, the latest survey suggests that self-scheduling is back in fashion, with 63% offering self-scheduling compared to 40% in 2022. 3. “Dirty data” remains a stubborn challenge Data collection at patient intake is a persistent headache for providers. Almost half (49%) say that inaccurate patient information contributes to claim denials. Improving the speed and accuracy of resolving patient information prior to claims submission were frequently listed in providers' top three challenges. See how healthcare organizations are using AI AdvantageTM to improve data accuracy and reduce claim denials. Digital technology bridges the gap between patient and provider perspectives on patient access When asked for their top three priorities for improvement, both groups ranked accurate price estimates and efficient insurance verification among their top two. While they diverge on the third – access to online health management tools for patients, and automated pre-authorizations for providers – it's interesting to note that these both reflect a desire to use digital solutions for greater efficiency and convenience. The survey highlights several opportunities to use digital technology to address upcoming challenges and continue to close the gap. Key challenges in patient access in the year ahead 1. Improving accuracy of upfront price estimates The survey showed 79% of providers plan to invest in patient access improvements soon. Given shared concerns about patients' ability to cover the cost of care, and worrying hints that some may postpone care due to cost concerns, prioritizing and providing accurate patient estimates would be a smart choice. While patients and providers are in closer agreement that estimates are accurate most or all of the time (74% and 85% respectively), there's clearly room for improvement. 2. Accelerating insurance verification and claims submission processes Several of the providers' top challenges speak to how difficult it can be to collate accurate information prior to claims submission. The need for better insurance reviews, more efficient management of prior authorizations, and more accurate patient information all contribute to the overarching goal of getting properly reimbursed. Almost a fifth say that managing multiple tools to determine eligibility, coordination of benefits (COB), and other pre-service checks is a top challenge. Could a single solution be the answer? Experian Health's new Patient Access Curator solution checks eligibility, COB, Medicare and commercial coverage, demographics and financial status in less than 30 seconds. Staff can check off several of these tedious tasks with just a single click. 3. Bolstering workforce capacity with technology A final challenge in the year ahead is the ongoing impact of staffing shortages. For the of providers who feel that staffing levels are disrupting delivery of scheduling and registration services, technology may offer a way through. Automation and artificial intelligence not only reduce the burden on staff by eliminating time-consuming manual tasks, but also allow staff to work smarter and faster on remaining tasks by improving data accuracy and insights. Most importantly, digital technology can improve scheduling, registration and payment processes for patients – and bring the patient experience in line with what both groups aspire to see. Download the full report: State of Patient Access 2024, or contact Experian Health to learn how technology can help streamline patient access.

“Is this claim valid? How much is our financial responsibility?” These are the two big questions payers want to answer when adjudicating healthcare claims. Huge amounts of patient information, clinical data, diagnostic and billing codes, and policy specifications must be analyzed and cross-checked to verify that the right amount is paid to the right party. It's a complex process. Even the smallest error can result in a claim being rejected or denied, dragging out payment timelines and eating up provider profits. That's why healthcare providers should reevaluate their claims adjudication process. Experian Health is pleased to announce that we've ranked #1 in Claims Management and Clearinghouse, for our ClaimSource® claims management system, according to the 2024 Best in KLAS: Software and Professional Services report. Learn more The claim adjudication process is a pivotal step in the revenue cycle and determines a provider's reimbursement for services rendered. It's a complex process with many moving parts, which means errors or delays can occur at many points along the way. A smooth, streamlined system can reduce the amount of time and money spent on claims adjudication for both the payer and the provider. Here are six steps to improving claim adjudication processes for a better bottom line. What is claims adjudication? Claims adjudication is the process by which insurance companies thoroughly review healthcare claims before reimbursement or payout. During this process, they decide whether to pay the claim in full, pay a partial amount, or deny it altogether. If more information is needed, the claim will be rejected and marked as “pending.” Insurance companies employ this systematic procedure to determine the validity, accuracy, and eligibility of claims against the terms and conditions of their policy. During claims adjudication in healthcare, insurance payers assess the documentation provided by the service provider, examining factors such as the nature of the services, coverage details, and any applicable deductibles. The process can take weeks to resolve itself. This evaluative process ties up billions of dollars in an endless cycle of claims denials and resubmissions. Following this evaluation, the provider will reject or settle the claim. Additionally, claims adjudication may lead to partial settlements or modifications based on the assessment of the claim. By all accounts claims denials are exceedingly common; a recent Experian Health survey showed that these numbers have increased by up to 15% annually. Healthcare providers can implement several steps to mitigate the risk of denials, enhance the efficiency of claims adjudication and get paid faster. Steps to improving the claims adjudication process The healthcare reimbursement process is bogged down with manual tasks that create errors. Experian Health's State of Claims 2022 report revealed that the most common claims errors include: Missing or incomplete prior authorizations Failure to verify provider eligibility Mistakes in medical coding Yet providers have new technologies at their fingertips to improve how and when they get paid. McKinsey reports on data showing that applying the latest artificial intelligence (AI) and automation digital tools to the revenue cycle could save healthcare providers up to $360 billion annually. That makes these tools a kind of adjudication insurance to protect providers against costly claims denials. Here are six ways to apply technology to improve the claims adjudication process. Step 1: Invest in automation Some of the benefits of automating healthcare claims management include: Streamlined operations with fewer human errors. Less staff time tied up in claims adjudication. Better data with real-time insights into patient and payer trends. Faster claims processing—and faster payment. Better patient experiences. Happier staff. Applying AI and automation to claims management can eliminate errors by allowing the technology to validate and cleanse data at the point of entry. Tools like Experian Health's Claim Scrubber can thoroughly review each line of claim data in seconds. Alerts can flag a human attendant, allowing them to correct mistakes before claim submission. Automation technology like the Enhanced Claim Status streamlines the revenue cycle by tracking the claims adjudication process in real-time. Instead of submitting a claim and awaiting the payer's response, this technology provides claim statuses within 24 to 72 hours. Step 2: Prevent delays with front-end edits and save time spent in claims adjudication How much time could providers save by correcting front-end mistakes before the claims adjudication process begins? During claims adjudication, payers will compare claims data to payer edits, to make sure billed services are coded correctly. Therefore, providers must keep pace with current coding requirements and the universal, local and payer-specific edits that apply. If claims are not correct the first time, they'll fail the payer's initial automated review, and may be denied or pushed into a queue for manual review by a claims examiner, leading to inevitable delays. Front-end claims editing tools can find errors that might prevent reimbursement, such as missing prior authorization or coordination of benefits codes. Patient Access Curator, Experian Health's latest revenue cycle data curator package, helps healthcare providers eliminate errors quickly on the front-end. This solution uses AI to perform eligibility, COB, Medicare Beneficiary Identifier (MBI), demographics and discovery in a single solution, preventing denials at the front end with a single click, within seconds. Experian Health's ClaimSource® solution allows organizations to implement customized edits and rules tailored to specific payer requirements. These edits help catch errors related to coding, billing, or other aspects of the claim, preventing inaccuracies from progressing to claims adjudication. While the industry average for claims denials is 10% and higher, Experian Health clients who use ClaimSource have a typical denials rate of just 4%. That's one reason Experian Health's ClaimSource solution earned the top KLAS ranking for the second consecutive year. Step 3: Streamline record-keeping and data management Electronic record keeping plays a pivotal role in ensuring accuracy in healthcare claims. These platforms allow centralized storage of patient data, including medical history, treatment plans, and billing information. Electronic record systems can enforce standardized coding practices, ensuring that medical codes used for billing and claims adhere to industry standards. They also maintain detailed audit trails, documenting all changes and updates made to patient records. This level of accountability enhances accuracy by allowing organizations to trace any modifications and ensure data integrity throughout the claims adjudication process. Notably, electronic record-keeping systems seamlessly integrate with healthcare claims management systems. Integration ensures that the information entered into electronic health records (EHR) automatically populates relevant fields in the claim, minimizing the need for manual data entry and reducing the risk of transcription errors. Step 4: Automatically review coding for accuracy Coding errors can result in claim denials and delay reimbursements to providers. For example, manual coding introduces the risk of typos or misinterpretation of the medical record. Because of the complexities of payer requirements, an incorrect procedure or diagnosis code could trigger claim rejection. Some procedures require supporting documentation or pre-verification before treatment. At the same time, ICD-10 (codes for patient diagnosis) and CPT codes (that identify services rendered) undergo regular updates. Failing to stay on top of these coding systems increases the risk of a rejected claim. The solution is to apply AI and automation to improve the chance of claims adjudication success. Two solutions from Experian Health include: AI Advantage™ - Predictive Denials uses AI to spot documentation errors before the claim goes to adjudication. The solution automatically flags claims with a higher potential for denial, allowing the revenue cycle team to fix errors before claim submissions. For claims that have already been denied, AI-Advantage Denial Triage identifies and prioritizes high-value denials, so teams can focus on remits with the highest impact. Denial Workflow Manager allows providers to quickly identify denied claims early in the claims adjudication process. Remittance details show providers the steps necessary to amend the claim quickly for a higher chance of reimbursement. Intelligent data-driven denial analytics spot the root causes of denials, so remedial action can be taken. Step 5: Create clear patient communication channels Clear patient communication channels are essential for preventing errors in healthcare claims adjudication. Incorrect patient information can result in claim denials, causing delays in reimbursement and impacting both patients and healthcare providers. Automated patient outreach technology significantly enhances communication while reducing the likelihood of errors. Solutions like Patient Access Curator also work to capture accurate patient data at registration - all in a single click. Electronic patient portals, powered by automation software, can also solve this challenge. These portals empower patients to update their information directly, ensuring the accuracy of data submitted with claims. Patients can verify and input their demographic details, insurance information, and other relevant data through user-friendly interfaces. Electronic patient portals significantly reduce the risk of errors in patient information by minimizing manual data entry and streamlining the information-sharing process. These tools enhance the efficiency of the claims adjudication process, reduce the likelihood of denials, and promote a smoother experience for patients and healthcare providers. Step 6: Advocate for policy change Moving towards claims adjudication automation with uniform industry standards can save providers and payers time and money. Currently, each payer operates within their unique silo of ever-changing reimbursement requirements. A lack of standardization means providers spend hours checking claims against payer requirements. The first step toward industry standardization requires automation technology to eliminate these time-consuming manual processes. Digital solutions like Experian Health's online prior authorization software update requirements directly from payer websites, giving providers a better shot at submitting a clean claim. Advocating for healthcare policy change toward greater automation and more uniform industry standards is a strategic move that will save time and money and foster a more efficient, transparent, and technologically advanced healthcare ecosystem. This transformation will improve patient care and overall system sustainability. Experian Health was client-rated #1 by Black Book™ ’24 in Denial & Claims Management Outsourcing, Health Systems. Learn more Improving healthcare claims management with Experian Health Today, nearly 20% of all healthcare claims are denied, and 60% are never resubmitted. That ties up significant revenue in the claims adjudication process. However, better claims management processes can yield reduced denials and faster payments. Experian Health offers a complete ecosystem of tools to deliver cleaner claims and faster reimbursement. This suite of products creates an integrated technology ecosystem with a track record of increasing the speed at which healthcare providers get paid. Find out more about how Experian Health's Claims Management solutions can support a more streamlined claims adjudication process.

Many healthcare providers believe pairing “revenue cycle” with a qualifier like “predictable” is an oxymoron. From healthcare staffing shortages that slow down reimbursement tasks to increasing payer denials, financial regularity can seem like an unattainable goal for these organizations.  The American Hospital Association (AHA) reports over one-half of U.S. hospitals had financial losses in 2022. Another AHA survey shows that 84% of these organizations say the cost of complying with complicated payer policies is climbing. Providers throw an excessive amount of time and staff at chasing revenue, but reimbursement complexities make for anything but smooth financial sailing. How can healthcare providers even out the ebbs and flows of the revenue cycle? Experian Health's suite of revenue cycle management (RCM) solutions can help. Revenue cycle predictability during the life of a claim When it comes to finances, U.S. healthcare providers rarely have an easy go of it. Today, the average life of a claim is anything but average. From registration to collections, hospitals established a new normal over the past decade: Widening gaps between service delivery and reimbursement. How can providers tackle this untenable situation? The answer is two-fold: with technology and at each stage of the life of a claim. Here are three ways healthcare providers can use technology to create reimbursement predictability at each stage of a claim's life. 1. Establish payment accountability at patient registration with price transparency Reimbursement problems begin at patient registration. Healthcare price transparency demands patients understand the cost of care. According to Experian Health's State of Patient Access survey, 81% of patients agreed that an accurate estimate helps them better prepare to pay for their care costs. However, only 31% of patients received a cost estimate before care. There are three significant impacts of this troubling trend: Nearly 40% of patients say they put off needed care due to cost. The number rises to 61% if the patient is uninsured. Patients can't afford to pay for needed care. Currently, 41% of U.S. adults have medical debt. An Experian Health study showed four in 10 patients spend more than they can afford on healthcare treatment. Uncompensated care causes a significant drop in healthcare provider income, which has amounted to almost $745 billion, according to the AHA. Experian Health offers several data-driven solutions to improve price transparency. These tools make it easier for patients to handle their financial responsibilities while helping providers find solutions to help ease their burdens.Patient Financial Advisor creates more accurate service estimates for patients before their procedure. The mobile-first platform offers patients a detailed cost breakdown on their preferred digital device. Patient Estimates is a web-based platform offering real-time service estimates. Blessing Health System uses the tool to provide patient estimates that are up to 90% accurate. The provider increased collections by 58% and credits the software with a 1,200% return on their investment. Patient Access Curator automatically initiates communication with payers to improve coordination of benefits and maximize return. It also automatically identifies missing or incorrect Medicare Beneficiary Identifier (MBI) numbers or errors in patient contact details. This solution also helps providers understand the patient's ability and propensity to pay, allowing these organizations to predict revenue streams after service delivery. Behind the scenes, Experian Health also automates insurance eligibility verification to unlock hidden reimbursements. This software roadmaps the correct coverage, connects to more than 900 payers and verifies insurance coverage at the time of service to improve cash flow and ease patient payment burdens. 2. Reduce claim denials by decreasing manual paperwork errors Claim denials are one of the biggest impediments to revenue cycle predictability. Providers are stuck in an endless cycle of inaccurate payer submissions, rejected claims, and rebilling, creating a chaotic chase for payment long after the service. Today, 35% of healthcare organizations report $50 million or higher in lost revenue due to claims denials. Even worse, Experian Health's State of Claims 2022 report showed that 30% of providers say denials are increasing by up to 15%. According to that data, the top three reasons for claim denials are: Missing or incomplete prior authorizations. Failure to verify provider eligibility. Coding inaccuracies. Experian Health's Claim Scrubber software levels out provider cash flow, creating predictability amidst the chaos. The solution reviews complete claims for errors, generating actionable edits before submission. Claim Scrubber also reviews approved reimbursement rates to prevent undercharging. Transactions process within three seconds and providers reduce the need to rework claims. Experian Health's AI Advantage solution uses the power of artificial intelligence (AI) to evaluate every claim for its propensity to turn into a denial. Instead of submitting claims and hoping the payer will accept them, this solution takes the guesswork out of reimbursement for a more rational, predictable process. The software automatically scans for payer updates to reimbursement requirements that significantly contribute to claims denials. Hospitals like Schneck Medical Center use this tool to streamline the revenue cycle by preventing denials. After just six months, the provider’s denied claims reduced by an average of 4.6% each month. Claim corrections that took up to 15 minutes manually are now processed in less than five. 3. Increase collections efficiency with automation Patients trust their healthcare providers to take care of them. Providers also rely on patients to pay their bills. It's a mutually beneficial arrangement. However, it's also a problem forcing providers to walk a delicate tightrope between caring for a sick patient while still chasing payment for their services. Unfortunately, the increasing cost of healthcare leaves patients on the hook for more than $88 billion in debt. The volume of healthcare payments in arrears is staggering, causing a substantial drain on provider cash on hand. However, technology offers healthcare providers a way to improve the patient collections process. For example, Coverage Discovery impacts the revenue cycle at every stage of the claim: Before providing care, the software scans patient data to determine reimbursement coverage options from Medicaid, Medicare, and commercial insurance. It scans for active insurance 30, 60, and 90 days after care delivery. The tool scans patient data before determining whether the account moves to bad debt collections. A more robust understanding of patient payment options at every stage of claims management allows healthcare providers to forecast reimbursements more accurately, increasing the predictability of the revenue cycle. Collections Optimization Manager provides organizations with actionable insights, so that providers can segment and prioritize accounts by proprensity to pay. This solution increases patient collections by leveraging Experian's data driven segmentation models, and helps providers screen out bankruptcies, deceased accounts, Medicaid and other charity eligibility ahead of time. Experian Health's AI Advantage – Denial Triage prioritizes rejected claims based on their yield potential, automating workflows for claims managers so they focus first on the patients more likely to pay. This tool segments denials based on their potential value to help even out the revenue cycle with a faster rate of financial return. Denial Triage expedites A/R by increasing revenue collection per person per hour. Revenue cycles can be more predictable, but the complexities of reimbursement require technology to achieve this goal. Experian Health offers a comprehensive line of revenue cycle management solutions to help healthcare providers maximize collections and improve RCM. Find out why Experian Health ranks Best in KLAS for 2024 in the categories of Claims Management & Clearinghouse and Revenue Cycle: Contract Management, or contact us for a more predictable revenue cycle, better cash flow, and a healthier organization.

Medical billing is the first line of defense against claims denials. However, medical billing errors cost U.S. healthcare systems approximately $935 million weekly. Not only do preventable errors wreak havoc on providers' revenue cycle, but patients say they're frustrated at the time spent correcting these errors—45% spend up to one month on the back and forth between payers and provider billing teams. Better medical billing software can automate claims management at the beginning of the reimbursement process and eliminate the traditionally labor-intensive processes plagued by human errors. Medical billing software can also make it easier for patients to pay and understand their coverage eligibility for fewer surprises after their care encounter. This article discusses how healthcare providers can implement these tools and set the stage for a better revenue cycle, happier patients, and more efficient care delivery. Common problems with medical billing Experian Health's State of Claims 2022 report showed healthcare denials increasing substantially each year. Some of the most common medical billing errors include: Medical coding transforms a healthcare service deliverable into reimbursable revenue. Yet Experian Health data shows that 42% of providers say inaccuracies in coding reporting lead to frequent claims denials. Coding errors delay reimbursement and, at worst, increase the risk of health system fraud, abuse fines, or even impact patient care with an incorrect diagnostic code. Patient information errors, including missing or incomplete prior authorizations, are among the top three reasons for claim denials. Even a misspelled name or date of birth can cause the claim to return to the provider for correction. Problems with outdated medical records and manual data entry exacerbate these issues. While each provider and payer has unique claims denial numbers to share, Medicare reports that the average volume of errors is just over 7%. Yet providers can't take all the blame for the volume of clerical errors given the complexities of ICD-10 requirements. Medical Economics explains, “The Centers for Medicare and Medicaid Services (CMS) announced 395 new diagnosis codes, 25 deletions and 13 revisions for the fiscal year (FY) 2024 ICD-10 CM code set.” Medical billing software is critical for preventing healthcare claims denials by keeping up with these complexities and avoiding human errors. What can the latest round of automated, artificial intelligence (AI) powered software do for the average healthcare provider? Prevent claims denials with better medical billing software Experian Health's Patient Access Curator solution heads off claims denials before they happen. The solution incorporates AI to improve the accuracy of claims management at patient registration and billing. The system leverages logic that returns multiple data points from a single inquiry in 30 seconds - streamlining benefits coordination, lessening patient identifier errors, and spotting “hidden” eligibility. Some of the benefits include: Faster and more accurate eligibility verification - Legacy medical billing software operates from a clearinghouse model. However, these tools often miss active, billable coverage and require extensive manual workflows to edit claims and appeals. AI eliminates the standard by-hand workarounds correlated with traditional billing software. Better coordination of benefits (COB) - COB denials are common in healthcare. Many patients do not understand the intricacies of government and commercial coverages and how they interact. Patient Access Curator can help. When integrated into the registration eligibility verification process, this AI-powered tool can lessen or eliminate COB denials by identifying hidden payer coverage requirements that outdated software cannot find. Additionally, the software can trigger automatic inquiries to third parties to verify active coverage quickly. Streamlines MBI conversions - How much time do providers spend tracking down Medicare Beneficiary Identifiers during patient registration? The complicating factor is that MBIs change without warning; many patients and providers find out after the payor rejects the claim. Providers can eliminate this frustration by adding software that automatically updates MBIs in real-time. No more searching websites, calling patients—or reworking the claim. Increases accuracy of patient demographic data - The quality of healthcare data can begin to erode at registration. Incorrect or obsolete patient data is a challenge for the entire industry. It makes sense that up-to-date, accurate patient demographic information improves their experience. Providers can eliminate obsolete or incorrect patient data with better medical billing software to lessen claims denials. Patient Access Curator automatically updates outdated information for cleaner claims and more accurate data. Automates coverage and financial verification for increased accuracy - Patients and providers benefit from AI automation that accurately identifies payment details. The solution is particularly beneficial for spotting missed revenue opportunities for self-pay, unbillable, or patients with unspecified payer status records. Patient Access Curator also identifies each customer's ability and propensity to pay, increasing the likelihood of successful revenue capture later while maintaining patient satisfaction and comfort. Reimbursement accuracy, staff efficiency, and patient satisfaction all stem from better medical billing software. Patient Access Curator offers healthcare providers a way to turn claims management into denials prevention. These tools apply a proactive, preventative automated process with artificial intelligence to increase downstream revenue by reducing claims denials. Experian Health, ranked Best in KLAS in Claims Management, Clearinghouse, and Revenue Cycle Contract Management for 2024, is the leading provider of technology solutions to improve healthcare reimbursement. Experian Health solutions have helped many healthcare providers obliterate claims denials. In 2023, the organization acquired Wave HDC, an AI-powered healthcare data curation solution leveraging the latest AI technology innovations for a better revenue cycle. To find out more, contact Experian Health today.

Improving the patient pre-registration process continues to present a challenge on both sides of the front desk. For patients, dealing with paperwork, struggling to provide the right information, and worrying about payment and insurance coverage make in-person registration feel fraught. Meanwhile, providers are searching for digital solutions to make the patient registration process simpler, more accurate, and more efficient. How are providers tackling these patient registration challenges? Barb Terry, Product Manager at Experian Health, who oversees Registration Accelerator, a digital pre-registration solution, shares her perspective on the state of the industry and insights from Experian Health's State of Patient Access 2024, a survey of 200 healthcare executives and more than 1,000 consumers conducted in February, 2024. Q1: Why is patient registration still so challenging for providers? “It continues to present challenges for both providers and patients,” says Terry. Despite the growing availability of patient registration software, many providers and their patients still contend with outmoded manual processes and confusion over insurance and the cost of care. For providers still coping with staffing shortages, manual registration can be time-consuming and error prone. According to the State of Patient Access 2024 survey, 82% of providers who say access is a challenge cite staffing as a reason. Meanwhile, Terry estimates a typical registration process consumes 15 minutes of staff time and 10 minutes for patients: “It's time that neither the provider nor the patient has,” she points out. “The manual registration process for most offices requires printing, scanning, faxing, calling the patient a few times, and then manual data entry into the office systems,” Terry explains. “The provider is also under pressure to obtain financial clearance before the appointment. In many cases the provider team is working with reduced or new staff, managing repetitive and manual tasks for registration, all while striving to maintain a positive patient experience.” Q2: Why is creating a positive registration experience important for patients? “Patients are evolving into consumers of healthcare, meaning they're more active in their healthcare decisions,” says Terry. “They have growing expectations of their healthcare experience and expect the same convenience and modernization they find with other industries like retail and financial services.” To keep up, healthcare providers need to meet patients where they're used to completing tasks and communicating---namely, on their smartphones. “Patients use their smartphones to complete many everyday tasks at their convenience. Many prefer to be contacted via text rather than with a phone call, since text allows them to answer when they have time.” Terry says. Helping patients complete registration on their time increasingly means providing mobile solutions. As an example, Registration Accelerator sends patients a pre-registration link they can use to scan in their identity and insurance cards. Patients can locate their cards and scan them in wherever and whenever they prefer. Data is captured accurately and sent automatically to the eCare NEXT platform, where it can be verified and used for billing. “Compare this process to time-consuming phone calls that must be made and re-made until contact happens,” Terry says, “or trying to collect information at the time of the appointment. Simply put, patients do not want to spend time in a waiting room completing paper forms that could have been completed digitally.” Q3: How is patient pre-registration important to the revenue cycle? “The traditional registration process isn't very efficient,” says Terry. “Manual processes can easily lead to inaccurate patient information. If the registration process does not include real-time insurance verification, there will likely be more denials and a slower revenue cycle process." “Waiting until the patient's appointment to collect insurance information doesn't give providers much time to verify insurance, or to determine the patient's financial responsibility for copays, deductibles, and out-of-pocket expenses,” Terry continues. “At the same time, patients don't have time to prepare for their out-of-pocket costs. In the 2024 survey, 94% of providers said they felt a sense of urgency to implement a faster, more comprehensive review of insurance coverage." “We know from past surveys that 40% of providers say registration errors are a primary cause of denied claims,” Terry concludes. “When the provider has patient information early, they can start facilitating an estimate and confirm insurance coverage before the appointment. Obtaining patient registration data before the appointment helps to ensure revenue cycle processes flow efficiently to reduce denials and financial risks.” Q4: Greater efficiency is better for providers, but how does it help patients? “The State of Patient Access 2024 survey found that patients expect efficiency as well as convenience,” Terry says. “Here's an example: 85% of the patients surveyed think they shouldn't have to fill out paperwork if their information hasn't changed.” Digital pre-registration solutions that allow providers to re-use valid patient information on file simplify registration all around. “For the patient, spending less time filling out paperwork in the waiting room contributes to a positive experience and improves their overall satisfaction with their provider, in turn leading to increased consumer loyalty,” says Terry. “Instead of managing forms at the appointment, the staff can focus on addressing any questions or discrepancies, and getting the patient settled in for their appointment. For many reasons, going to the doctor can be stressful for patients. Minimizing the forms they need to complete in the waiting room can alleviate some of that pressure.” Q5: How are providers improving the patient pre-registration process? “Providers are presenting additional registration options to their patients, including a modernized and digital process,” says Terry. “In the 2024 survey, 65% of providers agreed that patients prefer digital and self-service pre-registration,” so patient-facing mobile solutions like Registration Accelerator are a clear option for providers to explore. “Patients expect an easy digital experience,” Terry continues, “and, in response, providers should make registration as simple and straightforward as possible.” Yet, the same tools that make pre-registration better for patients can improve the process for providers as well. “Optical character recognition (OCR) is a great example of a feature that creates mutual benefits,” says Terry. “OCR can be leveraged to read insurance cards and pull out relevant and correct information. Staff members are under less pressure to avoid manual errors, and so are patients, who are relieved of the pressure of having to decipher their own insurance cards. “A registration solution should streamline the workflow, reuse patient information, keep data private and secure, and reduce manual entry,” Terry concludes. “By putting the registration process in the patient's hands, the provider is gathering information directly from the source while reducing their operational costs. Once registration data is obtained, it should flow into the front-end revenue cycle processes, so that eligibility is validated and errors are highlighted. This helps the provider ensure they have up-to-date insurance information for billing, leading to faster claims processing and reimbursement.” Q6: What does the future of pre-registration look like? “As patient expectations and provider demands grow, providers will increasingly turn to digital solutions,” says Terry. “Our survey found that 42% of providers have already expanded digital/mobile patient communications to reduce intake friction, and that trend is likely to continue.” “Digital solutions like Registration Accelerator give patients the ability to complete the registration process at their convenience and give providers more consistency in gathering information, less manual data entry errors, and opportunities to integrate with other patient access processes. All these benefits provide much-appreciated efficiencies for providers, and can lead to a better healthcare experience for the patient, so they can focus on their appointment and time with their provider.” Learn more about Registration Accelerator, a patient-facing mobile solution that lets patients scan in their own insurance and identity cards, captures data accurately, and uploads it automatically into Experian Health's eCare NEXT® platform, simplifying registration for patients and providers.

The State of Patient Access 2024 is the fourth in a series of patient and provider surveys that began in 2020. This year's report compares how patients experience access to care and providers' perceptions of those experiences. This blog post highlights findings from the survey, which was conducted in February 2024 and is based on 200 healthcare revenue cycle decision-makers and more than 1,000 patients. The study finds that perceptions of access to care are improving. It's a positive sign that providers are moving in the right direction—but there are still have mountains to climb. What remains the same from prior surveys is that providers believe access to care is much better than what their patients are truly experiencing. The survey showed 55% of healthcare providers believe patient access has improved. It's a big jump from 2022, when just 27% of doctors felt access increased. What's striking, however, is that patients don't completely agree. Only 28% say patient access improved in 2023, an 11% increase from the prior year. Over half (51%) of patients and 26% of providers say patient access has remained fairly static. While the findings show access is improving, there is still a gap between patient experience and provider perception. How can providers improve care access and make their perceptions a reality for their patients? Download The State of Patient Access 2024 report to get the perspectives from patients and providers on their perceptions of access to healthcare. Myths vs. realities of patient access The good news from the survey is that most providers and patients agree access to care isn't worsening. Despite increasing patient volumes and chronic staff shortages, patient access is better than before the pandemic. The findings are a sharp reversal from last year's report, where almost one-half of providers and one-fifth of patients reported care access had grown more challenging. Patient access is: Better Patients: 28% Providers: 55% The same Patients: 51% Providers: 26% Worse Patients: 22% Providers: 20% Consistently, across these annual surveys, providers believe access to care delivery is better than what their patients experience. The survey highlights opportunities to bridge this gap by using digital technologies to align the patient experience and provider assumptions. Opportunity 1: Provide accurate upfront financial estimates 96% of patients want an accurate upfront estimate of treatment costs. 88% of providers agree an accurate upfront estimate contributes to successful patient payments. The survey showed upfront cost estimates are central to a better patient experience. A high percentage of patients (96%) said an accurate estimate of treatment costs is essential before service—so crucial that 43% said they would cancel their procedure without it. Yet 64% of patients did not receive a cost estimate before care, despite increasing state and federal regulations that require this transparency. Perhaps even more troubling, the accuracy for those estimates is questionable. Of the 31% of patients who received a pre-procedure cost estimate, 14% reported the final cost was much higher than anticipated. At the same time, 85% of providers say their estimates are accurate most or all the time. The gap in provider perception and patient reality come together at the point of understanding the need for accurate cost estimates. Understanding what is covered by insurance helps patients manage their healthcare costs. Providers are invested in getting estimates correct because they are a key part of getting paid on time, in full. Patient payment estimates software can automatically create a more accurate picture of costs, reducing the burden on healthcare staff and eliminating unwelcome patient surprises. Consolidating service pricing estimate data from multiple sources empowers patient accountability and decision-making. One health system used these digital tools to increase point-of-service patient collections by nearly 60%, producing estimates that were 80 to 90% accurate. Opportunity 2: Improve data collection at patient intake 85% of patients dislike repetitive paperwork during the intake process. Almost half (49%) of providers say patient information errors are a primary cause of denied claims. The survey showed patients and providers are frustrated with the data collections process during registration. More than eight of 10 providers say automation could improve this process. Yet, in practice, intake remains primarily manual. Patients complain they shouldn't have to complete the same paperwork at each visit. Providers know these manual tasks lead to errors that cause big headaches for claims departments later. However, only 31% consider improving the speed and accuracy of collecting patient information a priority. The top reasons for claim denials are paperwork inaccuracies and missing or incomplete claim information. Human errors cause challenges when it's time for providers to get paid. Up to 50% of claims denials stem from a paperwork processing error at patient intake. As a result, in 2022 alone, healthcare providers spent nearly $20 billion pursuing reimbursement denials. Everyone agrees that providers must do all they can to prevent errors. Providers understand claims denials are a significant roadblock to cash flow. Patients grow frustrated when account balances remain in limbo long after their procedure is complete. Digital technology can streamline patient access and transform the healthcare revenue cycle. Experian Health's Patient Access Curator solution can check eligibility, COB, MBI, demographics, insurance coverage, and financial status in less than 30 seconds, in one click, speeding up the laborious human intake process that creates anxiety—and errors—for patients and providers. Opportunity 3: Give patients online self-service options 89% of patients said the ability to schedule appointments anytime via online or mobile tools is important. 63% of providers have or plan to implement self-scheduling options. According to this year's survey, self-scheduling is hot; waiting on hold with a call center is not. Digital and paperless pre-registration is increasingly important to patients and there is evidence that providers are finally starting to listen. For example, 84% of the providers strongly agreed that digital and mobile access is important to patients. However, self-scheduling did not make the list of the top three provider priorities for improving patient access to care. But the data tells us patients hold out hope for a mobile-first online scheduling process that puts them in the driver's seat to control their access to care. Convenient online scheduling software gives patients control over booking, canceling, and rescheduling appointments. It's a digital front door that's easy to use across any device. Automated notifications can remind patients of annual health exams, replacing the need for staff calls and closing any gaps in preventative care. These tools can reduce time spent scheduling patients by 50% and significantly decrease appointment no-shows. More importantly, they give patients the digital experience they demand. Digital technology brings together patient experience and provider perceptions The State of Patient Access 2024 survey illustrates a narrowing gap between what providers perceive and patients experience. That's good news because a lack of access to healthcare is a contributing factor to a sicker population, which costs much more in the long run. According to Deloitte, barriers to accessing healthcare in this country will grow to a $1 trillion problem by 2040. Patients will continue to experience care access issues in the coming years, from staffing shortages and a lack of rural providers, higher co-pays and more. Can we bridge these future gaps? The answer is a resounding yes. While there's still work to do, the survey showed that 79% of providers plan to invest in patient access improvements soon. Download The State of Patient Access 2024 to get the full survey results, or contact us to see how Experian Health can help your organization improve patient access. 

Technology has a long track record of improving patient care. But humans are now entering uncharted waters as the latest wave of digital tools impact healthcare clinical and administrative workflows. Technology advancements in artificial intelligence (AI) have spawned a fourth industrial revolution. According to the World Economic Forum, it's a time in history “that will fundamentally alter the way we live, work, and relate to one another. In its scale, scope, and complexity, the transformation will be unlike anything humankind has experienced before.” New developments in AI and automation in healthcare will offer numerous benefits to providers. The impact of recent technology advancements in healthcare is staggering. New AI and automation tools can detect human illnesses faster, monitor patients in the privacy of their homes, and streamline laborious administrative healthcare workflows to save providers up to $360 billion annually. The impact of AI and automation in healthcare is just beginning. Here are three ways these tools can help prevent and reduce claim denials, alleviate staff workloads and improve the patient experience. 1. AI and automation helps lessen claims errors Experian Health's State of Claims Survey 2022 reported that 61% of providers rely too heavily on manual processes and lack the automation necessary to streamline reimbursement. Billions of dollars are tied up in rejected claims; healthcare professionals say up to 15% of their claims are denied. However, many denials are preventable simply by eliminating human error stemming from manual workflows. When paperwork is still done by hand, mistakes in eligibility verification or incorrect insurance information are all too common. Some of the typical reasons for claims denials include data entry errors. Claims are complex, and providers handle most revenue cycle tasks manually, so it's common for incorrect insurance details, eligibility verification problems, or other inaccurate or missing information to make it through to claims submission. Far from being science fiction, the newest AI-powered administrative tools can scan patient claims data to detect errors that lead to denials. Given that diagnostic errors alone cost more than $100 billion and affect 12 million Americans annually, this new breed of AI tools offers providers a way to improve care delivery while lessening the endless hassle of claims denials. AI and automation tools can help eliminate up to errors that lead to denied claims. For example: Patient Access Curator automates insurance eligibility and coverage, scanning patient documentation for inaccurate information. The software uses AI and robotic process automation (RPA) to reduce manual errors. AI Advantage™ works to prevent denials before they happen: AI Advantage -Predictive Denials spots claim errors before submission to the payer. It's an early warning system designed to reduce denials by red flagging claims errors. But it also flags claims that fail to meet payer requirements—even if those requirements have recently changed. 2. AI and automation reduces manual processes and staff burnout Manual processes in healthcare contribute significantly to burnout, which affects nearly 50% of staff. The cost of staff burnout and preventable turnover runs around $4.6 billion annually. However, overworked staff leads to mistakes in manual processes and ultimately claim denials, so the cost of burnout directly affects the revenue cycle.Experian Health's 2023 staffing survey shows 100% of healthcare providers say staffing shortages have impacted their revenue cycle. But staff burnout and turnover affect more than reimbursement—more than 80% say it also negatively impacts the patient experience. AI and automation in healthcare can help alleviate the overwork that many staffers feel. Experian Health offers solutions to automate manual tasks, free up staff time, and reduce the volume of claims denials. ClaimSource® reduces the industry's average claims denial rate of 10% or higher to 4% or less. This software automatically scans claims, payer compliance, insurance eligibility, and patient demographics to spot the errors that lead to denials. Automating claims submission lessens the administrative burden and improves the work/life balance for overburdened staff. AI Advantage - Denial Triage covers any claims that end up rejected, prioritizing claims with the highest rate of ROI for providers. The solution uses artificial intelligence to help staff organize their efforts toward the highest revenue generating opportunities to increase revenue collection. It can lessen workloads and help teams work smarter for a higher return and better bottom line. 3. AI and automation in healthcare improves patient experiences Automation improves the patient journey. Experian Health and PYMNTS research show positive patient experience starts with self-service scheduling and registration. This kind of digital front door puts control back in the hands of patients, who are frustrated by time-consuming administrative processes. Patients have high expectations for better tech experiences throughout their healthcare encounters. Experian Health offers solutions that give customers exactly what they demand. For example: Patient Scheduling software allows 24/7 online access to appointment setting tools. In addition to making a more convenient and accessible scheduling process, this tool reduces the time it takes to set an appointment by 50%. The benefits for healthcare providers include a higher patient show rate (89% on average) and higher patient volumes (32% more patients per month). Patient Financial Advisor offers seamless, automated service estimates that go straight to the patient's favorite digital device. The tool creates a transparent payment process to help patients understand their treatment's cost and payment options. Patient Financial Advisor integrates with a secure online payment portal. These tools establish financial accountability up front while eliminating unnecessary surprises that affect the provider/patient relationship. Benefits of AI and automation in healthcare AI and automation in healthcare are changing how patients experience care delivery, how providers interact with their customers, and how clinicians manage getting paid. The benefits of using these tools include: Faster and more accurate patient diagnoses. Fewer patient readmissions and more proactive care management. Streamlined administrative tasks to reduce claims denials and improve the revenue cycle. Experian Health offers a suite of technology solutions, including a revenue cycle data curator package, to help providers get paid faster, free up staff time, and improve the patient experience. These solutions can help healthcare organizations achieve their goals by harnessing the latest AI and automation technologies to work smarter. Connect with an Experian Health expert today.

“With our paper-based systems, we were stuck in the 1990s.” For Anthony Myers, Director of Admitting and Registration at West Tennessee Healthcare (WTH), outdated registration processes were at odds with the non-profit health system’s mission to provide exceptional and compassionate care to its patients. He says, “We knew our patients expected a more modern experience. We wanted to meet them where they are, rather than forcing them to come to the registration desk. Our goal was to make preservice registration easier and smoother for patients and staff.” With staffing shortages and revenue pressures contributing to the push for change, WTH turned to Registration Accelerator to modernize patient intake and replace clipboards with clicks. Here’s a run-down of their results. Registration Accelerator: A single tool for easy, efficient, error-free patient intake WTH is a multi-specialty health system serving 19 counties in West Tennessee and Southeast Missouri. With over 700 employees working across 90 hospitals, workflows must be tight. Myers and his team wanted to update the patient intake experience and increase reimbursements – but without placing an undue burden on staff. It was clear that a digital registration tool would be the only way to check the boxes. Having has successful outcomes using Experian Health’s products in the past, WTH selected Registration Accelerator. This digital intake solution allows staff to send a text to patients to register online, without having to come into the office, download an app or create a profile. Patients simply access the link to answer questions, sign forms, upload documents and scan their insurance cards. The data goes straight to Experian’s eCare NEXT® platform to be validated against information already held. The process is intuitive and convenient for WTH patients, while significantly reducing the workload for busy staff, who now have fewer calls to deal with. Below are some of the specific results. Digital registration's impact on patients: “Everything was quick and easy” The response from WTH patients in all age groups was overwhelmingly positive. In survey feedback, patients noted that the new online registration process had led to much shorter waiting times, which improved their overall experience of accessing care: “the wait was short, which made the appointment so much easier.” Registration completion rates corroborate the reported impact on wait times. Between July 2022 and June 2023, WTH saw an average registration completion rate of 38%, with 50% registration completion rate in June 2023 alone. Other clients using Registration Accelerator achieve similar results for this key performance indicator. “I love the new process. All you have to do is register online and all info is ready for your appointment. There’s less hassle and faster in-and-out times.” - Patient, West Tennessee Health Registration Accelerator's impact on staff: “Staff have more time for patients” By simplifying patient intake, Registration Accelerator has given staff their time back. They no longer need to spend so much time filling out forms and calling up patients to check (and re-check) their information. Reducing the admin burden means staff can spend more time focusing patients instead of paperwork. This is not only much less stressful for staff, but contributes to a frictionless experience for patients. Implementing new processes and tools can often be a daunting prospect for large health systems. But because Registration Accelerator was designed to be intuitive and integrate seamlessly with the existing eCare NEXT platform that staff already used, WTH staff were able master the new approach quickly with very minimal training. Myers says, “Training was very simple – it was clear that for staff, this solution was just another chevron in the workflow.” Watch the video: Anthony Myers discusses how Registration Accelerator helped WTH create a faster, more efficient approach to patient registration. The impact on claims rates: “Automation means registration is more accurate” Registration Accelerator automatically uploads patients’ documents and extracts data from insurance cards instead of relying on staff to transcribe information. The risk of incorrect data making its way into the system and derailing the claims process further down the line is significantly reduced. More accurate data means more claims are clean first time, giving WTH fewer denials to rework. And because staff no longer need to spend so much time on upfront data entry, they have more time to focus on other aspects of patient access that can have negative downstream effects in the revenue cycle, such as authorizations. According to Myers, “with automated data intake, self-services registrations are also more accurate, so staff can take more time on authorizations. This has a positive effect on our clean claims rate.” Registration Accelerator’s compounding positive effect on claims management is helping WTH achieve their goal to increase reimbursements. Find out more about Registration Accelerator or contact us to see how this solution can help your healthcare organization improve the patient experience and increase payments.

A recent Peterson-KFF brief found that around 20 million adults have unpaid medical bills, with 14 million owing at least $1,000. Data from the Survey of Income and Program Participation puts the total figure at more than $220 billion. Healthcare providers must find ways to streamline patient financial assistance screening, to help patients and prevent unpaid bills piling up from uncompensated care. Many patients who would be eligible for financial assistance miss out on much-needed discounts due to outdated screening processes, leaving their unpaid bills to linger in accounts receivable. Automated presumptive charity screening offers a cost-effective solution for healthcare providers to modernize the process and reduce avoidable write-offs. Patient financial assistance software can also aid providers in fostering compassionate patient experiences, by identifying individuals in need of help and efficiently guiding them towards appropriate financial assistance pathways. The hidden consequences of medical debt Rising costs, unexpected medical emergencies and lack of insurance are the main culprits in the growing problem of medical debt. Though uninsured rates have dropped, millions of insured Americans remain without adequate coverage: high deductibles and co-payments leave many individuals “underinsured” with out-of-pocket costs they cannot afford. Providers end up shouldering the costs, leading to revenue loss, operational strain, and impaired capacity to deliver high-quality care. In some cases, the burden of an individual's medical debt may be initially concealed from the health system, papered over with credit card bills and loans. But it does not remain hidden for long: medical debt becomes simply “debt,” as families cut back on food and clothing, fall behind on other household bills, or even declare bankruptcy. The repercussions can escalate for patients and providers as patients opt out of further care, which eventually causes their medical needs – and costs – to spiral. Creating a more compassionate financial experience for patients will help avoid these ripple effects, with benefits for providers, too. Who is eligible for patient financial assistance programs? Patients who cannot afford to pay may be eligible for support via a patient financial assistance program. These programs, offered by providers, charities and government agencies, alleviate the financial pressures on patients by covering some or all of the cost of care in the form of partial or full discounts. Providers can offer patients information and support early in their healthcare journey to help them access such programs. The challenge is figuring out who is eligible. Eligibility criteria for financial assistance is often complex, covering the individual's income, household income and size, savings and medical need. Gathering and analyzing this data using manual processes can be time-consuming and often lead to gaps and inaccuracies. These inadequate screening processes result in missed opportunities to connect patients with the financial assistance they need, and risk falling foul of charity care regulations and policies. On-demand webinar: Hear how Eskenazi Health boosted Medicaid charity approvals by 111% with financial aid automation. How to use data to identify patients eligible for financial assistance Instead of asking the patient to fill out a stack of forms and manually checking data against the Federal Poverty Level to determine eligibility for charity care, providers can get the answers they need using data analytics and automation. Patient Financial Clearance automates eligibility checks prior to service to see if patients qualify for financial assistance programs. It uses Experian data and analytics to predict the patient's ability to pay and calculate the best-fit payment plan based on individual needs and circumstances. It also generates scripts for staff to use when running the tool and helping patients find assistance, which makes for a more compassionate experience. Alex Liao, Product Manager for Patient Financial Clearance at Experian Health, says, “Many patients are unaware that they're even eligible for financial assistance and need help to navigate the process. Discussing personal finances can also be uncomfortable, so it's not uncommon for patients to avoid sharing information that could actually lead to them getting support. Automating presumptive charity screening is more efficient and reliable. It's also a lot more compassionate than the old way of collecting forms and documents. Patient Financial Clearance pulls together credit information and demographic data to determine whether the patient qualifies without long, drawn-out discussions. Patients get the help they need and providers can reduce bad debt without delay.” Case study: Discover How UCHealth wrote off $26 million in charity care with Patient Financial Clearance. Using patient financial assistance technology to create compassionate patient experiences As Liao notes, many patients feel awkward or hesitant when discussing their financial situation with a stranger. Additionally, patients are increasingly looking for digital channels to handle their administrative tasks. Experian Health's Self-Service Patient Financial Clearance option offers patients a simple and more private way to complete eligibility checks, whenever and wherever it suits them. Using a mobile and web-based platform, patients can fill out screening forms and upload supporting documents, then get real-time status updates without having to call up their providers. Information is stored securely so staff can check application status as needed. How Self-Service Patient Financial Clearance works Self-Service Patient Financial Clearance puts patients in control, so more individuals complete their applications and find out if they’re eligible for financial assistance. This frees up staff to focus on other revenue-generating tasks that require their attention. With a cost-effective, compassionate and convenient option on the table, is it time to say goodbye to paper-based presumptive charity checks? Find out more about how Patient Financial Clearance helps providers reduce bad debt and improve the patient experience by quickly and correctly checking eligibility for charity care.