Patient Access
Verify critical patient information and collect patient payments prior to service
Yale New Haven Health (YNHH) established a goal to elevate the patient financial experience by compassionately educating patients about the finances surrounding their care, and educating staff on the tools and methods for delivering that message. YNHH embarked on a two-year patient financial advisory initiative, including patient and family advisors, to hear opinions and learn valuable information directly from consumers. According to Sharlene Seidman, Executive Director Corporate Business Services, with Yale New Haven Health: “We needed a consumer-focused price transparency strategy that would bring us on par with other industries, like retail. Our goal was that when patients discuss their overall YNHH experience, it is not just reflective of their clinical care, but their financial care as well.” Since going live with Eligibility and the Epic integration in May 2016, YNHH has made major strides toward meeting its pre-service excellence goals in four key areas 1) the right technology, 2) best practices, 3) patient interaction/engagement, and 4) employee culture and education. Read the full case study here
Multi-specialty, academic, non-profit healthcare delivery system increases productivity and improves resource efficiency The prior and pre-authorization inquiry and submission processes within patient access can be challenging for healthcare providers, as it’s often manual, cumbersome, and steps within the process can be missed or poorly integrated—frustrating both staff and patients. Experian Health’s Authorizations helped one of its healthcare delivery system clients increase efficiency and empower staff to spend more time with patients to discuss estimated liability and financial responsibility and provide them with payment plan options. “We needed an authorization solution that was integrated within our Epic workflow, easy-to-use and that our team could rally behind. We found that solution in Experian Health’s Authorizations tool.” —Director, Pre-service Center, multi-specialty, academic non-profit healthcare delivery system Inquiries are now automated and take place behind the scenes without user intervention. Submissions guide the user through the workflow, auto-filling all payer data and only prompting the user only when manual intervention is required. Hear more about this client’s success using Authorizations. Read the full case study.
During HIMSS17 in Orlando, Jason Wallis, Senior Vice President, Patient Access at Experian Health, sat down with IntrepidNOW to talk patient access and how Experian Health\'s solutions help providers across the revenue cycle. Excerpt below: \"We have the eCare NEXT platform that drives a lot of our integration and patient access products. So anywhere from orders, all the way back to collecting payment from the patients, so right identity, checking eligibility, authorizations, medical necessity, patient estimates and then a tool to collect payment from that patient for those estimates. ...we’ve really taken this eligibility rail that has been pretty standard in the industry, and we’ve added a lot of content and innovation on top of those rails. So I almost call our clearing house a content network. So we drive more value in that transaction by normalizing, cleaning the data and enriching it with other data assets, so that downstream our clients and our products are better because of that advanced content. ...our integrated platform takes this data and be able to start chaining products together, and deliver back to the provider an exception based workflow that really has their staff only looking and working when something’s gone wrong. And the more we can automate around products and even products chaining off of other products, so eligibility to notice of admission, we are able to remove some of those manual single point solutions because it’s integrated in a single workflow.\" Listen to the full podcast Learn more about Experian Health\'s patient access solutions and eCare NEXT platform
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
Earlier this year, Experian Health joined forces with hc1.com to empower companies to recapture lost revenue, control costs and better serve patients. At HIMSS17, Brad Bostic, CEO of HC1 sat down with IntrepidNOW\'s Joe Lavelle to discuss this and healthcare industry trends. Excerpt below: \"...our customers has really span medical laboratories, health systems and post-acute care providers. And the common challenge that these organizations face is that they’re so intensely focused on their internal clinical quality and processes and how do you code for things to make sure that they can get billed, that it’s difficult for them to rise up to the level of truly seeing the full picture of what they’re doing with their customers, and understanding holistically where do I have areas that I need to focus to be able to perform better financially? ...what we’ve done is we’ve really built this partnership to bring healthcare relationship management together with the best of Experian Health’s products in the eCare NEXT and payer alerts areas, and what eCare NEXT and payer alerts do in combination with our HIPAA compliant HC1 platform is that we’re able to bring this level of financial risk stratification to the picture, so that if I’m a lab I can see across all the different providers that are referring to me and all the different patients that are flowing through, where are the places where I might be exposed to where I might not get reimbursed? And it’s doing this on the front end of the process rather than having it be an unpleasant surprise later on in the process that you haven’t gotten paid.\" Listen to the full podcast Explore our revenue cycle management solutions
There has been a lot of uncertainty with regards to what the future holds for healthcare in the U.S., but the reality is that the move away from transaction-based services where providers are paid by transaction or by interaction with their patients, into a world where some of those services will be paid as bundles, is a reality. At Experian Health, our perspective is that there isn’t going to be one single form of payment. There isn’t going to be only fee for transaction or only fee for value type payments. There is going to be a variety. And our solutions can help providers handle that. When we talk to our largest providers, they want to make sure that they are prepared for the future of healthcare, and that their payment and revenue cycle is robust enough that they can handle whether it is a fee for transaction interaction with the provider or with the patient as well as fee for value. In order to do that, they have to optimize their operations. There is a lot of belt tightening happening in the industry and people are trying to see and understand how best to organize, how best to analyze and facilitate that payment cycle. We believe that data and analytics are two of the key ways to do that. Our software tools as well as the data that we embed into that software helps optimize the revenue cycle. Listen to the complete podcast
On April 27, millions of workplaces, employees, parents and children will celebrate the 24th year anniversary of the Take Our Daughters And Sons To Work® Day program, which encourages girls and boys across the country to dream without gender limitations and to think imaginatively about their family, work and community lives. This national, public education program connects what children learn at school with the actual working world. Experian Health\'s offices will be participating in this program as part of its Women in Leadership initiative. Learn more about it and how your organization can participate.
In case you missed them, below are links to recently created videos of our clients and staff, as well as links to recorded webinars. New Videos Our healthcare provider clients share their experiences and best practices using Experian Health’s solutions. Watch Now Chris Lah from Cincinnati Children’s Hospital shares his insight around healthcare reimbursement challenges. Watch Now Rachel Papka from Steinberg Diagnostic Medical Imaging Centers outlines her orders management challenges and how her organization has overcome them. Watch Now Karly Rowe from Experian Health highlights the importance of matching, managing and protecting patient identities to safeguard medical information and reduce risk. Watch Now Tony Murdoch from Experian Data Quality explains how Experian\'s Data Quality Solutions can add value to our clients. Watch Now On Demand Webinars Patient Identification – The Challenges Healthcare Leaders and the Industry are Facing Today (HealthLeaders-hosted event). View Now (registration required) The Importance of Managing and Protecting Patient Identities (NAHAM-hosted event). View Now (registration required)
Why is missing coverage so detrimental? When patients are unable to pay, providers see an increase in self-pay receivables - 97% of hospitals reported an increase in self-pay receivables compared with the prior fiscal year. When providers can’t collect, the result is uncompensated care $35.7 billion – The amount of uncompensated care hospitals provided in 2015 (AHA, Dec 2016, http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf) Registration errors and frequently changing insurance coverage contribute to an increase in self-pay receivables and bad debt: 20% error rate: Wastes an estimated $15.5B in claims that are never corrected and re-processed. Find previously unidentified coverage to reduce bad debt Experian Health’s Coverage Discovery® solution provides an efficient and trusted means for healthcare providers to reduce misclassified self-pay accounts. Our advanced self-pay engine maximizes the actionable coverage found for our customers across government and commercial payers, previously missed due to frequently changing insurances, data entry mistakes or patient misrepresentation to avoid high deductible health plans. The benefits to you: Make coverage identification more efficient Reduce number of accounts sent to collections & charity Maximize insurance reimbursement revenue Identify primary, secondary, & tertiary coverage Automate the self-pay scrubbing process What are our clients are saying about Coverage Discovery: [Video] Murry Ford, Grady Health System: “Coverage Discovery has brought in quite a bit of revenue for us—revenue that we would not have identified otherwise.” [Video] Mike Simms, Cone Health: “Since we’ve been using Coverage Discovery, we’ve received over $3 million in payments—more than a 300% ROI. It’s well worth every dollar spent.” Here’s why Coverage Discovery is different: Flexibility: Multiple delivery options easily fit Coverage Discovery into your revenue cycle Time matters: Find coverage on-demand Powered by Experian: Billions of data assets improve account specific intelligence and maximize found coverage Relevant: Confidence Scoring reduces data noise and removes potential false-positives to ensure staff time is focused on actionable accounts Uncover previously unidentified coverage with Coverage Discovery.
