Arm patients with a secure online self-service portal to settle bills, manage accounts, schedule appointments, pre-register and view lab results
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As Spotify and Amazon can attest, digital technology plus personalization is a winning formula. Consumers want anytime-anywhere access to the services and products they enjoy, without having to sift through irrelevant information. They want tailored recommendations that will make their life easier. More than eight in ten consumers say they’re more likely to choose businesses that treat them like a person instead of just a number. The pay-off for business—and health plans—is huge: by paving the way for better services, better relationships and a better consumer experience, personalization boosts profits, too. There’s one challenge: delivering personalization requires data. Health plans that want to offer a member-centric experience need the right insights to build a complete picture of what individual members need and want. Yet many health plans are forced to work from stale or incomplete data, notably when CMS hands over a new list of members or a new employer signs on to the plan. A system like that makes it nearly impossible to provide meaningful personalization, and consequently, the member experience suffers. With originally sourced data and consumer insights, health plans can fill in the missing links in member profiles and maximize opportunities to improve the consumer experience. Here, we look at how three specific data-driven strategies could help your health plan attract and retain satisfied members and demonstrate digital excellence by using personalization to drive improvements in communications and care. Personalize member communications for maximum engagement By looking beyond simple demographic data and clinical information, health plans can discover what really matters to members. Consumer data provides detailed insights about the kind of content that will resonate most with the member’s lifestyle, interests and health circumstances. Health plans can tailor their marketing messages accordingly, by highlighting articles about the treatment of relevant medical conditions or sending reminders ahead of annual check-ups.Health plans can also discover when and how to communicate with members so they’re most likely to respond. When member profiles reveal who prefers an email or a text and when, health plans can elicit higher levels of engagement, improve the consumer experience and see better results from targeted outreach campaigns. Make improvement decisions based on the most relevant data Consumer insights can also be used to develop improvement plans that zero in on exactly what members need for the best possible health outcomes. Combining insights on patient behavior patterns with an understanding of the challenges facing individual members means health plans can segment members, so the right support goes to the right place.For example, efforts to drive up medication adherence are going to be far more successful if based off accurate and current member profiles. Specific members can be sent automated, personalized reminders to fill out prescriptions in good time before they run out. Compare that to a “spray and pray” awareness campaign using generic messages that are likely to be ignored. Data-led improvement strategies are operationally efficient and create a better experience for members. Help members overcome social barriers to health Finally, when member profiles include a snapshot of how social and economic factors influence their ability to access healthcare, health plans can take action to offer support. Closing the gaps in care that arise when a patient fails to turn up to their appointment or ends up being readmitted to hospital, can often involve quite simple solutions. If data suggests the member has small children, but there’s no other adult in the household, it makes sense to cross-promote childcare services. Similarly, if the member isn’t known to own a car, a health plan could offer information on free transportation.Understanding these social determinants of health can help health plans offer proactive support so members enjoy better health outcomes in the long run. Experian Health’s rich datasets give health plans access to member-level insights on more than 330 million consumers, with data analysis and automation tools to help make business decisions based on the most relevant, current data. Contact us to find out how we can help provide the personalized experience members are looking for.
Many thought the end of COVID-19 was in sight with the availability of a vaccine, and while that is somewhat true, an entirely new set of issues has arrived: how to properly administer and manage the vaccine. Now that a COVID-19 vaccine is approved and underway, providers need to execute a medical billing and coding strategy to sustain vaccination efforts. We interviewed J. Scott Milne, senior director of product management at Experian Health, about what’s changed and what providers can do to prepare. How can providers ensure that vaccine administration codes are billed correctly? The ICD-10 and CPT codes for the COVID-19 vaccine haven’t existed until now, which means providers have a new set of codes to learn and unfortunately, those codes seem to change or update almost daily. As more vaccines are introduced, more codes are also introduced, and not just for the vaccine as a whole, but for each specific dose of the vaccine. For example, dose one of the Pfizer vaccine will have a code that differs entirely from dose two of the Moderna vaccine. Keeping up with these changes isn’t only difficult for provider staff, who are likely already stretched thin, but they certainly don’t want to run the risk of submitting a claim with incorrect information. The errors are what result in denials or undercharges. A solution like Claim Scrubber ensures code sets are current on a daily basis – a necessity for times like these – but applies an extensive set of general and payer-specific edits before preparing the claim for processing. That means claims for vaccine administration are error-free before submission to the payer or clearinghouse. Providers can eliminate undercharges, boost first-time pass through rates and do away with costly, time-consuming rework. But proper coding is only the first piece of the billing puzzle. The second piece is to verify the accuracy of payment received from third-party payers. How can providers ensure that third party payers will reimburse at the contracted rates? Providers can certainly get reimbursed for administering the vaccine, but there are a lot of moving parts to keep up with. For example, both Medicaid and Medicare will reimburse providers for administering COVID-19 vaccines, but the percentage of what is covered will differ by carrier and the reimbursement rates can vary both by state and type of arrangement. Reimbursement rates will also vary amongst private payers. Then there is the variation in reimbursement based on vaccine type and dosage -- vaccines that require a single dose may be reimbursed at a rate different than those that require two doses. Even without the vaccine rollout underway it can be a headache for hospitals and health systems to manage multiple payer contracts and reimbursement methodologies. A solution like Contract Manager will pinpoint variance in reimbursement quickly and easily, accurately pricing claims and comparing actual allowed amounts to expected amounts. It is a tool built to adapt to changes within the industry, so providers can capitalize on emerging reimbursement schemes and changes in payer payment policies. It can also help identify sources and patterns of errors so recurring issues can be promptly resolved. The end result: the provider organization can the payer revenue that is due for vaccine administration. Interested in learning more about how providers can optimize vaccine-related reimbursements? Contact us. Other blog posts in this series: Segmenting your patient population for the COVID-19 vaccine Engaging patient segments with convenient, secure scheduling solutions Authenticating portal access with automation Optimizing reimbursements by capturing missing coverage
You may also like: Supercharge your COVID-19 vaccine management plan with digital solutions “Experian Health’s ability to move quickly and adapt their self-service platform to schedule vaccines for patients has been an invaluable improvement not only for our operations, but to the patient experience. The power to schedule the vaccine’s second dose after the first is administered helps us deliver on our commitment to providing reliable, quality care.” - Julie Frahm, director of consumer digital products at Sharp HealthCare The unpredictable nature of patient volume is a large part of what makes scheduling for the COVID-19 vaccine so difficult. Before now, providers haven’t had to manage mass appointment slots and registrations tied specifically to vaccinations. And even with those features streamlined, providers are still unsure of the best way to reach out to patients who are eligible for the vaccine to prompt them to schedule their appointment. Already a user of Experian Health’s Patient Schedule solution, Sharp HealthCare turned to online self-scheduling to improve patient access to the COVID-19 vaccine. With the solution in place, patients of Sharp HealthCare who are eligible for the vaccine can schedule their first dose online via computer or mobile phone. After answering a short set of questions, the scheduling solution will guide patients to a calendar of available day and time slots for receiving the first vaccination. After the first shot is administered, Sharp HealthCare staff can schedule patients for their second dose onsite, prior to leaving the office. Patients of Sharp HealthCare are consistently utilizing online self-scheduling to book appointments for their vaccinations. More than 1,000 vaccinations were scheduled in the first three weeks of online self-scheduling being available to patients. The ability for provider staff to help book the second dose of the vaccine for patients has also helped Sharp HealthCare deliver on their commitment to quality care, further ensuring the efficacy of the vaccine for each and every patient. Patients are also enjoying the expanded use of a self-service digital service, especially for a process that has been widely known to, at least thus far, be a detriment to the patient experience. Discover how Patient Schedule can improve vaccine management.
Take a poll of any healthcare facility’s visitors, and the majority will tell you they’d like to book appointments online. When Experian Health surveyed more than 860 consumers in late 2020 for its patient access trends survey, 78% of those surveyed said they wanted to schedule their own appointments, at any time of day or night, from their home or mobile device. But with only four in ten providers offering self-scheduling as a service, there’s a big opportunity for providers who offer digital patient access to attract and retain more patients by giving them what they want. Online self-scheduling allows patients to choose when and where they make their appointment. It is easier for patients, reduces no-shows, improves health outcomes and minimizes the risk of errors that can result in denied claims. But while online self-scheduling is meant to foster a better patient experience, not every solution is up to scratch. Providers need to offer an online scheduling experience that is user-friendly, reliable and accessible in order to create the best possible digital experience for both new and existing consumers. Patient portals can be a great location for existing patients to schedule appointments online, but what about new patients? Without an existing relationship or log in, new patients will likely click away from online scheduling services that require them to set up a new account or request a call. Unnecessary friction makes it harder to attract new patients. Given that 80% of patients would switch providers for convenience factors alone, offering online scheduling to brand new patients without requiring the additional step of creating an account could be a powerful attraction strategy. With manual scheduling, call center agents have to sift through multiple spreadsheets and binders to check calendars and scheduling rules in order to match patients with the right provider and appointment type. With a system like that in place it can be impossible to place more than a few patients each day. Patients that don’t want to wait or participate in lengthy calls often end up looking for care elsewhere. But if the right questions are guiding the online scheduling process, patients can be matched quickly to the right provider and book an appointment that fits with the provider’s calendar and scheduling rules. Adding a web-based scheduling service with guided search allowed Heritage Medical Associates to increase the number of patients placed from as few as three per day to as many as fifty per day, creating a better experience for patients, call center staff and physicians. Consumers want to schedule medical appointments the way they might book dinner reservation or a grocery delivery slot: they want to see all the available options for their preferred day, book on the spot and receive confirmation right there and then. They want to complete the scheduling process in real time – not waiting for a call back to confirm. CareMount Medical implemented an online scheduling platform to give patients real-time access to book appointments across all of their providers, which has appealed to both new and existing patients. Chief Information Officer, Nicholas Korchinski, says: “Yes, we have been able to acquire new patients, but our strategy was really about retention… Month over month we see double digit growth in use of the application, so our patients are benefiting more and more.” The ideal online scheduling platform will be flexible, accessible, and easy to use for both patients and staff. With Patient Schedule, providers can improve the patient experience, attract new patients and guide patients to the right provider without delay
Providers know they need to improve their digital front door to withstand the financial impact of COVID-19, but change can feel risky, especially with so much uncertainty. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. But what do providers see for the future of patient access? And are those views aligned? Providers that offer the most accessible patient access solutions in a post-pandemic world will secure greater patient satisfaction and loyalty.
Read the previous blog post in this Q&A series on segmenting patient populations for the COVID-19 vaccine. There are a lot of unknowns in the COVID-19 vaccine management process, which makes the rollout and administration of this vaccine even more challenging. Many providers are in the dark about how many vaccines they will get, they don’t know which patients to include and in what order and they aren’t sure how to keep staff from being overwhelmed. We interviewed Sanju Pratap, vice president of product management for consumer products at Experian Health, about what specifically is so challenging for scheduling the vaccine and what providers can do to prepare. What about the vaccine scheduling solution function is challenging providers? The unpredictable nature of available vaccines is a large part of what makes the scheduling for these vaccinations so difficult. Before now, providers haven’t had to manage mass quantities of appointment slots and related registrations and billing. And even with those features streamlined, providers are still unsure of the best way to reach out to eligible patients, in an equitable manner, to prompt them to schedule their appointment. What have we seen as the most effective and efficient way to schedule those patients for a vaccine? The ability to target patients specifically, either by email, phone or text, who are eligible for the vaccine can make a big difference. It removes a lot of the anxiety on the patient’s end while also making the scheduling experience as simple as possible for patients and staff. But outreach is just the first step. To really streamline the process, healthcare organization’s need to leverage a scheduling solution that incorporates scheduling rules and protocols. This ensures that a set number of appointments every day are designated for vaccinations and patients can see and schedule directly into those slots. When a patient schedules their vaccination through a system like this, providers can better track and recognize who needs to come in for a second dose. They can automate that process, by pushing out a message to the patient to schedule their second dose or offer to schedule that second dose on behalf of the patient before they leave the office using those same scheduling rules & inventory. How can a provider best equip the call center to handle volume and schedule appropriately the individuals who prefer to set an appointment that way? Given the high patient volume, the preferred method is for patients to schedule their appointment online, and for providers to push as much as they can online via self-service tools. This will minimize the initial load on the call center freeing agents to focus on those who truly need to schedule via the phone or need additional help. Even if a patient schedules their vaccination online, the information is shared with the call center which equips agents to help patients schedule their second dose. If or when a patient calls to schedule that dose, all agents need to do is search by first and last name, pull up the information and schedule the next dose on the spot. Interested in learning more about how Experian Health can help supercharge the COVID-19 vaccine management process?
While the various waves of vaccine priority may be largely defined, the ability for many providers to segment their patient populations based on those designations isn\'t always simple. Without accurate data, there’s a risk that some vulnerable patients will be missed out. We interviewed Mindy Pankoke, senior product manager at Experian Health, about the challenges in segmenting patient populations for the COVID vaccine and how providers can best overcome those challenges. How does addressing patients’ barriers to care increase vaccination rates? The early versions of this vaccination have two doses which comes with its own set of challenges. Getting a vaccination is one thing but getting people to follow up for a second dose in a certain time frame is another. It’s the non-clinical factors that will prevent patients from getting the vaccine. So, things like inflexible work schedules, lack of transportation or even the access or comfort levels with technology required to schedule an appointment online can prevent patients from receiving or prioritizing the first and/or second dose. It can be an uneven playing field with those patients that do not have more flexible schedules, a vehicle or even access to the proper technology to schedule and register for both doses. It’s much easier for patients to prioritize getting the vaccine when those non-clinical factors are a non-issue. What challenges may providers face when trying to segment patient populations for vaccine administration? There are a lot of gaps in patient demographics which can make it difficult for providers to accurately identify and segment patients. Think information like date of birth or occupation. If providers want to segment by age, which many will likely do for the first wave of vaccinations, that would require a complete record of every patient with an accurate birth date. Providers may also want to segment by occupation, knowing essential workers are also eligible for the vaccine. But how can you understand who is an essential worker? Especially when that definition may vary by state or local government? Including non-clinical insights and enhancing demographic data as part of the patient record can help providers fill in the gaps and better segment patient populations for vaccine administration. By combining the power of Experian’s consumer demographic information with more than 40 years of experience compiling consumer data from self-reported and state license boards, Experian Health is able to drill down into occupation data to view different types of employment (construction, utility, etc.) for you to use to outreach, verify and streamline the scheduling (and automated scheduling) or the COVID vaccination. What are some best practices to move from identifying at risk or priority populations and operationalizing that information into actually administering the vaccine to those groups? This is really where it all comes together, and really where providers need to act fast. Once a group is identified, providers can automate the process as much as possible. First, it is imperative that providers clean up their data. Recent processing of Experian’s Universal Identity Manager solution has identified 1,800 duplicate records in COVID vaccination registrations, for individual facilities. Providers can remove the duplicates, enhance the demographics where they may be out of date or missing, and put in place a proactive system to call out and prevent duplicates moving forward. And the vaccine has a shelf life, correct? So even after segmenting the right patients, how can providers act fast to ensure it is administered? So another best practice is to automate the scheduling for as many vaccination appointments possible. With a tool like Patient Schedule, providers can leverage the demographic data to programmatically push out a notification to a patient’s cell phone via IVR or text message, have them verify their eligibility based on the age or occupation data from Experian, and then allow the patient to book their appointment on the spot for a time that works best with their schedule. On the back end, the Patient Schedule solution syncs with the clinic or mobile vaccination site’s calendar to confirm the appointment, allowing staff the opportunity to tackle other pieces of the COVID vaccination strategy. Anything else you\'d like to add? Providers will also want to risk stratify using social determinants of health insight on the individual level. Patients in every wave of vaccine priority present an opportunity for better patient engagement (68% of the US is impacted by at least one social determinant of health hindering them from accessing or prioritizing their care). Many patients will need help adhering to that second dose and knowing that information and those circumstances on the individual level can help providers engage in the best way possible to ensure the vaccine is administered correctly. Interested in learning more about how Experian Health can help supercharge the COVID-19 vaccine management process?
How has the pandemic affected consumer attitudes around patient access? What do consumers want when it comes to accessing care? These are the questions providers must answer if they are to survive the pandemic and lay the groundwork for future financial success. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. Wherever you are in the digital patient access journey, there\'s an opportunity to improve the experience for patients to one that will not only survive the tumult of the pandemic, but also thrive in the years ahead.