Collections Optimization

Insights on this year’s HFMA ANI conference, peer to peer learning and exchanges, consumerism in healthcare and much more!

Agility and knowledge are critical for your health organization to meet the growing expectations of patients and keep pace with the ever-changing landscape.

To maximize reimbursement rates, healthcare providers must take control and optimize three particular areas: estimates, claims, and collections.

Better manage patient collections by finding the patients who can and will pay. Avoid wasting time and other resources on low-yield accounts.

To keep your healthcare practice out of legal trouble and clear of costly fines, ensure debt collection agencies comply with relevant laws and regulations.

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

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.  

Look forward to a better bottom line—and increased patient satisfaction Many providers face a of lack insight into agent performance and call durations, as well as the ability to route telephone calls to representatives based on experience or inquiry type. Others use manual vs. automated processes to call patients with outstanding balances. Having the ability to both contact patients and take inbound calls using a cloud-based dialing platform can significantly increase your collections and penetration rates. Some platforms can even provide the ability to monitor agent activity for performance and take payments after hours when no live agents are available, and provide access to actionable insight into call volumes and durations, giving you the ability to make more strategic decisions and adjust process flows. Increase the effectiveness of your collection and patient engagement strategies by pairing online and print communication channels using outbound and inbound dialing technology. Experian Health’s new cloud-based dialing solution, PatientDial, arms providers with the tools and data needed to make strategic decisions and increase calling campaign effectiveness and the collections bottom line—all without the need for costly hardware and software upgrades. PatientDial assists with patient outreach for patient collections and patient engagement processes and workflows. Services include inbound, outbound and blended call environments and can accommodate both live agent and blaster (unattended) messaging campaigns. IVR services are available to route calls to the proper type of agents and handle payments after hours. When combined with our PaymentSafe solution, PatientDial enables patients to make automated payments via telephone, and combining with our Collections Optimization Manager solution further increases ROI by leveraging screening results and segmentation to drive strategy solutions. Learn more about PatientDial Read the Sanford Health case study  

During HIMSS17, Experian Health's Nicole Rogas, Senior Vice President of Sales, sat down with IntrepidNOW to discuss the healthcare industry, challenges providers are facing and women in health IT. Excerpt below. "...it’s an industry that changes consistently, and Experian Health has the data and the history to be able to arm both our clients, which our providers, and the consumer, which is the patient, with information to help them make better healthcare decisions. We are hearing more about it in IT and as well as other areas of healthcare really nationally. Women do play a very important role in the future of healthcare, and I think the focus on it now brings to light some of the sort of special issues and challenges we face as women that are very different than what man may face as they grow their career. ...a lot of the challenges for our providers is to understand how to function as a business, and I know that that might sound crazy, but healthcare is always been a service, and most of our economies today, most of our people today believe that it’s really their right to (have) healthcare, and I think what’s happening is our healthcare providers are having to function more like a business organization to ensure that they are providing care at really great quality care, but in an efficient way. They are able to build and get reimbursed for that care, and then that they are able to arm their patients with the right information pre and post care to help keep them engaged in both their financial and their clinical journey. So I just think it’s a big time in our industry." Listen to the full podcast