Patient Access
Verify critical patient information and collect patient payments prior to service
No two healthcare organizations are the same. Each has varied workflows that optimize efficacy and overall care for patients. That’s why healthcare software solutions should never be considered one-size-fits-all approaches. It isn’t fair, or terribly productive, to force healthcare organizations to adapt to new software. Rather, the healthcare software should adapt to them. At Experian Health, we’ll never supply a software product and then expect you to adjust workflows to suit it. Instead, we embed ourselves into your company to ensure we deeply understand your productivity needs and the reasons behind them. Only then can we tailor the solution we provide around you. It’s never too early to get it right The conversation about customizing your healthcare organization\'s solution begins before you even sign up. As soon as a solution interests you, we’ll start looking at how to tailor it to your unique needs. We’ll hold a meeting that includes subject matter experts and implementation leadership groups to uncover your greatest usability needs. Then, we’ll document those needs to better prepare whoever runs your project and ensure he or she has all the necessary information upfront. Then, gears start moving during the sales process. After choosing a solution, our team of experts works with members from every department in your organization to iron out the appropriate design and functionality details. We believe the people who will be using and relying on the solution every day should have a significant say in these details. However, we’ll do all the legwork of actually building and implementing the solution itself. By the time we’re ready to run internal tests to make sure the software works, members of every department will already know what to expect. Consequently, when they run user acceptance tests to check whether the solution fits into their workflows, they can accurately measure the solution’s performance against their input into its design. Afterward, we can iron out any hiccups they run into before initiating the organizationwide training and “go live” steps of the process. It’s never too late to make adjustments Our deep involvement in customizing your solution also begins before you select it, and it continues long after it\'s successfully implemented. We don’t go away just because we marked you as “live.” Instead, we understand that the healthcare industry is in constant flux and you might experience operational changes that warrant additional tinkering and tailoring to our solutions. We’ll stick around for a couple of days after going live, and we’ll stay available forever after, just in case. For example, if you purchase a new physician group six months after going live, you’ll face quite an uphill battle onboarding them all into your software system and, in turn, getting them up to speed. Because the group is new, you might face opposition to bringing on any change in general. In this case, you could use help facilitating the training and the adoption of your system into this new group, and that\'s where we step in. Additionally, what if this implementation requires a work queue structure that’s vastly different from yours? If the new group operates in a different area of the state, they might also have unique rules for some of their payers. These rules have to be incorporated into their system to accommodate the patient population. None of this, though, should fall solely on your shoulders. We can worry about the system\'s features so you can focus on the operational change management aspect. For our clients, we’re always on call. This devoted availability could range from six months or even six years. Whatever the situation, we know that you’ll eventually face circumstances that your software wasn’t originally designed to address. Instead of feeling stuck and frustrated, clients can find comfort in knowing we are here for every step of the process. And beyond tailoring your solution before implementing it, we also offer continued customization to help you tackle new circumstances without compromising workflow. Overall, here at Experian Health, we understand the pressures facing healthcare organizations today, and we are eager to be partners with you in securing the best solution for you needs and guiding you through the challenges ahead.
Seven years ago, Bill\'s healthcare group invested in a new health information system, and the dust still hasn’t quite settled. Like most health information system providers, Bill\'s vendor communicates mostly through the group’s IT leader. He has to pick and choose what updates and features are implemented, and the people who work with the system daily are expected to figure out how to make the most out of it. Fortunately, Bill and the head of IT are great pals. They eat lunch together, go out for after-work cocktails, and try to bridge the gap between their healthcare software vendor and the end users on the frontline. But Bill shouldn’t have to rely on that friendship for his healthcare team members to be able to do their jobs, and it shouldn\'t have taken seven years for the software to be properly integrated. Bill\'s not a real person, and his healthcare group is fictitious, but both are archetypes of the new healthcare landscape. Constant market changes and ongoing challenges have forced healthcare systems to partner more closely with medical software vendors. However, it’s challenging to find vendors that are willing to roll up their sleeves and work alongside the end users to design solutions that are tailored to their specific needs. At Experian Health, we want to make sure the first experience your team has with our health information system products is a positive one and that you all look forward to using them every day. Your group’s success is our top priority, and playing an active role in your onboarding process helps ensure that success. Providing health information systems and the knowledge to use them The problem with the archetype of Bill is that the end users in the group had to take on the tasks of learning and optimizing the system themselves. Trainers lacked the deep level of understanding needed to create enthusiasm about the system, and overall adoption lagged. By contrast, we know our solutions like the back of our hands, so it only makes sense for us to share that knowledge and collaborate to implement those solutions through medical software training. With years of experience under our belt working with healthcare organizations across the country, we’ve heard virtually every possible question end users ask. That experience gives us the flexibility to come up with on-the-fly solutions to challenges we haven’t thought of yet and suggest ways to optimize your group’s workflow with the system. We can offer shortcuts, tips, and tricks to make the system work more efficiently for your team. Collaborative onboarding lets our clients dive deeper into learning their new systems than they could by just reading predetermined lesson plans and FAQ lists. It helps us when we help you make the medical software training go smoother and ensure all end users actually want to use the product. In fact, for the first three to five months, Experian will be a physical presence at your organization, helping with change management and the onboarding process. Personalized, effective onboarding The process differs depending on how complex your organization is and what you’re installing, but typically, collaborative onboarding adheres to the following timeline: We start the process with a formal kickoff and demo to get executive leadership and everyone on the frontline up to speed. The demo lays out what the project will look like for the group and gives everyone the chance to start considering how to operationalize it for the organization. After the kickoff, our teams collaborate with specific subject matter experts and start digging into the nitty-gritty design and functionality detail work. We really stress the importance of operational input from people who will be champions for their specific areas, not just the IT teams. These champions need to communicate the details of the system’s design to their peers. When the design is complete, we do all of the heavy lifting to build the product, and then we conduct internal testing to make sure it works effectively. Next, we guide operational champions through user-acceptance testing to make sure the product meets their needs. User-acceptance testing occurs in a real-life, day-to-day setting so users can validate that it fits into their workflow. Once we iron out any changes warranted by the user-acceptance testing, we extend training into the larger workforce and officially go live. A month later, we come back and hold an optimization workshop to observe users in action. We can answer questions and provide suggestions on how to improve efficiency even further or make tweaks to improve user processes. With the rush to adopt faster and more efficient technology, many healthcare organizations have been left in the dust to figure out how to make new technology work best for them. At Experian Health, we stick around after software implementation to make sure your entire organization can hit the ground running. Our mission is to help the healthcare industry succeed in providing better, more comprehensive care to patients, and collaborative onboarding ensures our products do just that.
This is an exciting time for our industry, and agility and knowledge are critical for your organization to Lead the Way by meeting the growing expectations of patients and keeping pace with the ever-changing healthcare landscape. Since 2004, the Experian Health 2017 Financial Performance Summit has connected business leaders to discuss innovative ideas and solutions, allowing organizations to improve their overall financial performance and increase profits. Summit 2017 focused on collaboration, idea sharing and networking, with numerous sessions on how you can take control of your organization’s road map for growth and operational efficiency. The intimate setting of Summit 2017 allowed for unique networking opportunities, one-on-one conversations with subject matter experts and numerous breakout sessions that will provide valuable insights from industry thought leaders. The three-day Summit provided hands-on learning opportunities with product experts and the exchange of knowledge with peers in an engaging environment. The agenda featured industry-leading speakers, provider- and Experian Health-led educational sessions, a dedicated leadership track, one-on-one training, networking lunches and receptions, and evening events featuring live entertainment. Break-out sessions at the Summit covered: Claims Collections Contract Manager Patient Access Patient Engagement Price Transparency Thought Leadership If you attended the Financial Performance Summit about would like to download any of the presentations, they are available here. If you would like to attend one of our future events, please contact us.
Uncertainty over the future direction of the U.S. healthcare system has left a high percentage of patients uninsured or underinsured. These patients rely more heavily on price estimates for care and self-payment options, and this places a heavy burden on healthcare organizations to collect patients\' payments more quickly. In addition, healthcare reimbursements are increasingly based on value. Now, providers can be penalized for giving patients inaccurate cost estimates about medical care. These estimates are taken seriously because inefficient and unpredictable revenue cycle management (RCM) that stems from errors, late payments, and other factors can cost healthcare providers up to 65 percent of their revenue. This raises a pressing question: How do you make a historically unpredictable revenue cycle less chaotic and more efficient? There are many factors to that answer, but most of them point to and lean on innovative, data-driven IT solutions, such as Experian Health’s suite of RCM tools. How can healthcare providers better predict revenue cycles? When revenue cycles are accurately predicted across the care continuum, patients can more easily pay the costs of their care, and healthcare providers can increase their collection rates. Coverages can also be identified that patients are unaware that they qualify for, helping them lower their out-of-pocket expenses and decrease healthcare providers\' risks of failing to collect payment. For predictability to matter, however, a revenue cycle needs transparency in pricing, particularly in the cost estimates patients receive before treatment. Precise, trustworthy estimates make it easier for Experian Health’s technology to generate clean claims that won’t be denied due to inaccuracies. Reducing claims denials not only allows healthcare providers to be paid faster, but it also saves the time, costs, and lost revenue of having to resubmit them. All of these factors can be challenging to address individually — and exponentially more demanding to do so all together. However, Experian Health’s goal is to relieve that weight by providing solutions designed to make predicting and managing revenue cycles a more efficient and profitable practice. How Experian Health’s solutions increase revenue cycle predictability. Boosting the ability to forecast a revenue cycle requires a variety of data-driven solutions. At Experian Health, our Eligibility, Coverage Discovery, Patient Estimates, and Claim Scrubber technologies are just a few of the many tools we provide to help. 1. Passport Eligibility Eligibility is a verification tool that combines up-to-date eligibility and benefits data for individual patients to ensure the accuracy of their upfront estimates. In turn, patients can rest easier knowing their predicted healthcare costs are accurate and derived from recent data.Additionally, the eligibility tool matches patients with Medicaid coverage that they were previously unaware they qualified for. Reclassifying patients and submitting their claims with the appropriate information lightens their stress about payments and increases a healthcare provider\'s chances of reimbursement. As a result, future revenue cycles become clearer. 2. Coverage Discovery Even patients with existing insurance may be unclear about what their coverage entails or how their plans apply to specific medical treatments. With our automated Coverage Discovery solution, hidden coverages are uncovered and applied to claims to avoid costly, time-consuming claim denials. The tool analyzes data from Medicare, Medicaid, and commercial insurance policies to help ensure patients don\'t pay more unnecessary costs. For instance, in 2016, Coverage Discovery uncovered a total of $1.8 billion in hidden coverages for more than 275 Experian Health clients. With a stronger understanding of what coverage applies to patients, healthcare providers will gain better forecasting knowledge of the pain points in patient pay, which increases revenue cycle predictability. 3. Patient Estimates With the information collected by the Eligibility and Coverage Discovery tools, our Patient Estimates platform can provide highly accurate cost estimates upfront. The solution utilizes data from numerous sources and populates that data automatically for each estimate to avoid human error. Patients who know what to expect about the costs of their treatment can make better, more informed decisions about their healthcare. They’re also more likely to pay bills they’ve carefully budgeted for instead of ones that are notably higher than the estimates they expected. By understanding this cost information in advance, both patients and healthcare providers reap benefits, making the revenue cycle run smoothly. 4. Claim Scrubber Next to garnished healthcare reimbursements, denied claims are another expensive consequence of an inaccurate revenue cycle forecast. Up to 20 percent of claims are denied or require reprocessing because of inaccurate or erroneous information. Our Claim Scrubber solution eliminates such errors by autopopulating claims with data pooled from a variety of relevant sources. Claim Scrubber reviews each prebilled claim line by line for inaccuracies and then applies extensive edits based on general, patient-specific, and payer-specific data. The digital scrubbing drastically reduces the time, lost revenue, and possible penalties associated with denied claims by boosting first-time acceptance rates. Overall, with the elimination of troublesome errors, this tool allows revenue cycles to be predicted with ease. In addition to providing an enhanced patient experience, successfully predicting and managing revenue cycles are both vital for healthcare organizations to thrive. At Experian Health, we believe that strong RCM is fundamental to any lucrative healthcare organization that strives to provide the highest quality of care. With our comprehensive suite of healthcare IT solutions, the current stress of RCM can soon become your organization’s best asset.
With the ability to research products, compare price information, and conduct transactions all from their mobile devices, today\'s consumers are more savvy than ever. They expect an unprecedented level of transparency from companies. In fact, they demand it and will easily take their money elsewhere if a company doesn\'t follow through. Consumers expect the same high-level transparency from healthcare providers, and the demand is growing as patients are forced to bear more out-of-pocket costs for medical care. They want to avoid surprises, such as higher-than-expected cost estimates for services or insurance that may cover only a small portion of the expense. Price transparency initiatives are becoming increasingly more important in healthcare systems, and providers must embrace new capabilities to meet patients\' expectations. The old model of billing patients weeks or months after they’ve received services is no longer viable. Billing needs to move to the front of the revenue cycle management process, and a number of Experian Health\'s solutions are designed to help do just that. 3 tools for greater price transparency in healthcare As patients are responsible for a higher percentage of their healthcare costs, healthcare providers\' financial performance depends on an optimal collections strategy that focuses on patient engagement. The advantage of patients knowing and having confidence in healthcare cost estimates makes the collections process much easier and helps drive the future revenue cycle. Here are three Experian Health solutions that can help healthcare providers improve price transparency: 1. Patient Estimates: Patient trust is built on meeting expectations. With this in mind, Experian Health\'s Patient Estimates tool brings accurate, upfront price transparency before or at the point of service so patients know what to expect and can confidently make decisions about their healthcare. Cost estimates are derived from numerous types of data, including a patient’s benefits information, a healthcare provider\'s reimbursement agreements, and payer contract rates, among others. Much of the information can be automatically populated into the system, eliminating the need to constantly update price information lists and reducing the risks of inaccurate cost estimates resulting from error. With Patient Estimates, healthcare providers can also more effectively comply with state and federal price transparency requirements. 2. Patient Statements:Accurate price information is one thing, but even if the patient’s billing statement matches the cost estimates, collections can be a challenge if the statement is hard to read or understand. Patient Statements is a communications tool that simplifies and customizes patient billing statements, complete with important, easy-to-understand updates and messages. Making billing statements straightforward for patients to manage helps healthcare providers build a stronger level of trust when it comes to payments. Personalizing the statements with marketing and educational information turns them into valuable resources that create a better overall patient engagement experience. 3. Patient Self-Service:With accurate, upfront price estimates and simple, useful bill-paying systems and statements, healthcare providers can more successfully integrate our online self-service portal. Experian Health\'s Patient Self-Service tool digitally delivers cost estimates and statements to patients. It also allows patients to securely make payments and conveniently schedule future appointments from their desktop or mobile devices. Patient Self-Service brings the high level of price transparency to healthcare providers that consumers now expect. This makes it more likely for patients to meet their self-pay responsibilities and return for future healthcare services. Patient Self-Service also helps healthcare providers more efficiently comply with \"meaningful use\" Stage 2 program requirements. The capabilities for price transparency that these solutions provide is just a small sampling of what we offer today, and we’re continuing to research and develop even more useful tools. In addition, we’ve recently launched an extensive consumer research project to better understand patients’ wants and needs. We’re excited to use these insights to continue developing solutions that help healthcare providers improve engagement with patients.
Cincinnati Children’s Hospital Medical Center (CCHMC) is a distinguished nonprofit academic medical center and one of the oldest pediatric hospitals in the United States. A few years ago, the center set out to make a much-needed change: upgrade its online bill pay system, as the current system was not popular with patients. The center kept two important objectives in mind while implementing the reboot: offering patients an attractive online experience and making it easier for patients to understand what payments they owe. Attracting patients with an intuitive bill pay system In 2012, CCHMC launched Patient Self-Service to deliver a more intuitive, comprehensive online portal. Before the launch, 900 families used the medical center’s basic online bill pay system. But after a small marketing push to promote the new option — a simple note on the center’s paper statements describing Patient Self-Service — enrollment jumped from 900 to more than 45,000 families in a single year. Plus, CCHMC saw immediate cost savings and increased revenue: The cost of distributing general notices dropped to $0. This was a significant change because mailing a notice about a new customer service phone number in the past could cost $1,400. Online payments increased from $200,000 to $800,000 per month. The medical center’s patients now use the portal to ask questions of their healthcare providers, change on-file insurance information, and schedule or revise appointments. These features reduce customer service phone calls and other related costs. In addition, the new bill pay system makes it easier for patients to clearly see and complete payments. Patients can request a cost estimate before treatment, submit payments, and set up payment plans — all online and whenever it is most convenient for them. Helping patients understand the bills they pay When CCHMC released its new self-service portal, the center also used Patient Statements to simplify and customize hard-copy bills. In the first year after the launch, the medical center saved $70,000 in invoicing costs for three reasons. First, the medical center reduced printing and mailing costs by utilizing a more attractive, interactive online bill pay system. Second, it minimized material costs by trimming invoices to a one-page statement. Lastly, the center saved on postage rates by earning the five-digit ZIP code discount. Institutions can earn a discount by bundling statements directed to the same ZIP code, thus reducing time in a postal processing center. CCHMC also combines hospital and doctor bills in a single statement that explains all treatment costs. The medical center can also add personalized messages related to each patient’s interests to foster engagement through educational opportunities, videos, microsites, and social media. Two of the most important ways a company communicates with its customers are through billing and customer service. For example, a bill pay system can give many impressions: that a company cares about its customers, doesn’t care, or, worst of all, attempts to trick its customers. It’s common to read stories about the hidden fees lurking in airline or cellphone bills. In fact, entire marketing campaigns are built around the idea — think of those “no hidden fees” commercials. Unfortunately, such instances also occur in the medical industry, which is why it is crucial to be upfront and transparent with patients. For a medical center like CCHMC, billing and customer service may rarely be in the same important spotlight as patient interactions with doctors and nurses. Still, no medical center wants to detract from its reputation by providing any kind of faulty service. CCHMC proves it cares about its patients every day by giving them an intuitive, comprehensive self-service portal and improved statements that just make sense. In the end, the hospital saved money and boosted revenue with its improvements, but it ultimately achieved much more in the overall care for its patients. To learn more about CCHMC use of Patient Self-Service to improve its bill pay system, read this case study. To see how Experian Health helps improve ROI in healthcare, view the full list of our client videos and case studies.
Today’s healthcare consumers are at the center of healthcare transformation. They demand a personalized experience, use devices to monitor their health and are vocal when they are not satisfied with their service or care. Healthcare organizations are being challenged to think differently about healthcare engagement. To succeed, you must become consumer-facing and expand your reach. You need to attract and retain patients for service line growth. Connecting with consumers by tailoring their journey is expected, so you using data to predict health conditions and message effectively is critical. Do you know who your patients are? How to build a relationship with them? Can you improve their satisfaction and retention? Are you providing personalized communications? Superior data with actionable insights can help you remain competitive in this new healthcare landscape. This is a new approach to most healthcare organizations, but it provides an exciting opportunity. Leverage data the right way and gain deeper insights to improve patient and consumer engagement. To learn more, visit Experian Health’s Marketing Services page, contact your account representative or email us at experianhealth@experian.com
Recent industry shifts, including the transition from volume- to value- based reimbursement, lower reimbursement and shrinking inpatient margins, increased bad debt due to high deductible health plans and other challenges, are causing undue stress for healthcare providers. It’s difficult for some organizations to manage complex reimbursement models or handle complex claims, so providers are often underpaid or write off revenue they are due. The cost to collect continues to rise when staff produces poor results or turnover is high. Additionally, hospital information system (HIS) conversions traditionally result in a backlog of accounts receivable (A/R), requiring incremental staff to support the conversion. 78% of CFOs are concerned about their revenue cycle platform capabilities for value-based payments and will outsource in lieu of investing in new technology.^ Experian Health\'s Revenue Cycle Services leverage Experian’s proprietary technologies and experienced staff to optimize revenue cycle management (RCM) performance to help you meet your financial goals, such as increasing A/R yield, lowering operating costs, and resolution of revenue leakage issues and denials. Contact us today to learn more about Experian Health’s Revenue Cycle Services. ^2015 Black Book Survey
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.
