First Pst after migration to Cloud in Health care Blog

Healthcare providers are always balancing a million tasks at once. The most important of these tasks, obviously, is serving patients, which can sometimes crowd out the important but thankless business functions — like keeping tabs on the insurers you're processing. Payers are changing their policies and practices constantly, and those changes are easy to miss when you're focused on everything else you have to do to keep a healthcare organization running. But if a payer policy changes without you knowing, it’s going to cost you. If your denial rate ticks up because of an unknown change in payer policy, you could end up spending thousands of dollars per year to rework those extra claims. The good news, though, is that there’s a tool that can lighten the load. Experian Health’s Payer Alerts service keeps you in the loop about the payer policies and procedure changes you’re too busy to catch. That way, instead of poring over the mergers, acquisitions, and countless other details that affect the insurance industry, you can stay focused on what’s really important — without making sacrifices to your bottom line. How it works With Payer Alerts, every notification you receive is the result of extensive behind-the-scenes work by our software. The program monitors more than 50,000 web pages that payers visit and records any relevant policy changes before preparing an alert for you. The alert contains a detailed summary of those changes and a link to the affected policy. Once you receive the alert, you can just follow the link and make the necessary adjustments to your internal procedures. But given the variety of potential policy changes, those adjustments can be tough to pin down. That’s why every alert categorizes each change by healthcare specialty, allowing you to receive the alerts most related to your organization. And the customization goes further than that.Want an email that describes all relevant administrative changes? Done. Want a web-based portal where you can identify any reimbursement issues? Easy. Regardless of what you need, the alert will be waiting for you in the right platform. Finding ROI in new information Being privy to policy changes without having to sift through insurance jargon can mean a lot for a healthcare organization. “When things change and information is always current, that’s a huge benefit,” says the director of managed care at Rocky Mountain Cancer Centers, a longtime user of Experian Health’s services. When you’re in the loop about what’s covered and what's not, you’ll also be in better shape to increase your revenue and cash flow. RMCC, for instance, reduced its denial rate to 27 percent in its first year using the service and has reached a $1 million ROI on the investment year over year. Payer Alerts isn’t some app that bombards you with pointless notifications every five seconds. By giving you the necessary information to make timely, strategic decisions, the software can help you start running your practice more like a lucrative business. Building the perfect defense Payer Alerts helps healthcare organizations streamline their workflow and maximize revenue through more than just its immediate features; its compatibility with other Experian Health services can provide the perfect defense against the myriad payer issues that might arise. Combining Payer Alerts with our Contract Manager and Contract Analysis solutions not only keeps you up-to-date with policy and procedure changes, but it also helps you target those changes in ways that meet your unique needs. When RMCC realized that sending out individual forms for different information was wasting time, it used its Experian Health software package to aggregate all the data from those separate appeals into a single form. This helped the company reach its efficiency improvement objectives, satisfying both patients and staff. Ultimately, you can’t fix any issues with your insurance processing if you don’t know they exist, and you won’t even know there’s an issue if you aren’t aware of the constant policy changes in the industry. While you can’t stop these changes from occurring, you can invest in a system to adapt to them and avoid the agony of having to scrutinize it all yourself. If you're ready to learn more about Experian Health's Payer Alerts, get in touch with us today. To learn more about how RMCC used Payer Alerts to increase revenue and cash flow, download the case study.

Last year, the National Academy of Medicine estimated that excessive and unnecessary medical tests waste at least $200 billion a year in the United States. The same report estimated that, in addition to the monetary costs, the mistakes resulting from unnecessary tests and treatments can lead to 30,000 deaths annually. No healthcare organization wants to write wasteful and unnecessary medical orders — they're bad for patients and for business. Unfortunately, given the fact that so many providers might be submitting and fulfilling orders for one patient, finding a way to organize a patient's treatment schedule in the most effective and efficient way can be difficult. For many healthcare organizations, however, Experian Health can provide a solution: Order Manager, a web-based platform for tracking treatment orders. Order Manager in action Experian Health’s Order Manager is a component of its comprehensive eCare NEXT® suite of healthcare workflow solutions. Order Manager facilitates communication between every player in a patient’s course of care — hospitals and health systems, standalone clinics, community physicians, and even testing facilities can all verify or update a patient’s testing and treatment schedules when necessary. Order Manager integrates data into a patient's electronic medical record so all supplementing data or documents he or she accumulates are captured and organized within a centralized interface that has actionable suggestions. The all-in-one platform gives providers a GPS-like ability to track an order until it's completed, and every provider in the patient’s circle of care can see what tests have been ordered, what medications have been prescribed, and what the results have been. With Order Manager, staffers don’t have to manually place orders or call the patient’s original hospital or doctor to verify prior authorizations — no more duplication, no more conflicting and dangerous treatment plans, and no more confusion. When ordering systems aren't automated, it doesn’t just affect patient care; the labs that fulfill the orders are getting squeezed by inefficiencies, too. For Aegis Sciences Corporation, a leader in healthcare and forensic laboratory sciences, Experian Health’s Order Manager helped optimize order processes as efficiently as it has for hospitals. Aegis Sciences wanted to provide staff members with the tools they need to consistently provide a positive experience to patients and the physicians they work with, and Order Manager has been an important tool in helping the company do so. The web-based platform improved efficiency and reduced costs by transforming operations into fully paperless processes. Healthcare staff at Aegis Sciences said Order Manager was key in supporting the quality of the organization’s work, particularly the processes that require certain authorizations to be completed before tests can be ordered. With the help of Order Manger, Aegis Sciences was able to reduce the time spent on tasks such as accessioning — the arduous process of logging and sorting a sample in a larger data collection — to less than a minute. In fact, according to Aegis Sciences: "Experian Health's Order Manager teams were key in helping us realize our vision of a fully paperless process that could improve our workflows and processes to keep pace with our exceptional growth. We're now able to offer a fully paperless process to our clients and require that certain fields, such as demographics and diagnosis codes, be completed on the front end." Client satisfaction at Aegis Sciences has risen thanks to a 27 percent reduction in errors and necessary follow-ups, as well as a 76 percent drop in attestation statements during the verification process. To learn how Experian Health's Order Manager can help your organization improve the quality of care for your patients and consumers, feel free to contact us today. Our team can assess the role that Order Manager could play in your organization's workflow and help you implement it in the most efficient way. To read more about Ageis Sciences' experience, download this case study.

The world of healthcare, as everyone knows, can be complex. And in such a complicated system, solutions that simplify, automate, and reduce busywork can make a real difference in both patient satisfaction and workplace efficiency. Although healthcare is, by its nature, a high-touch field, there are several opportunities to allow automated software solutions to handle the basic processing tasks associated with patient management. When routine interactions with patients are automated, medical and administrative staff members can devote more of their time to the cases that need the most attention. Automated workflow solutions also simplify and reduce busywork to make a noticeable difference in patient satisfaction and workplace efficiency. Obviously, that outcome is desirable for all parties involved. It reduces costs, improves morale, and results in satisfied patients. In an ideal workflow environment, employees can personally attend to problem cases and resolve certain issues manually while an automated system handles the run-of-the-mill cases that cause administrative backlogs. Experian Health has worked hard to develop just such a system. We call it eCare NEXT®. Introducing eCare NEXT The eCare NEXT platform, using an approach called Touchless Processing™, is able to offload a number of key patient processes, including scheduling, preregistration, registration, and admissions. Touchless Processing is an exception-based system, meaning that it automatically flags patients who require manual follow-up with staffers. The system updates data in real time, and users can interact with it through either a work queue system or by responding to triggered alerts. Healthcare organizations using the system can automate up to 80 percent of human intervention in the patient management process — allowing healthcare staff to focus on larger, more important initiatives to improve the patient experience. And Touchless Processing doesn't just free up staff time; patients see immediate benefits as well. One of the biggest frustrations in a patient's experience is the inability to get a reliable estimate for how much a service will cost. The eCare NEXT system sorts through all the complex factors that affect healthcare pricing — which are often too complex for hospital billing departments to accurately estimate on their own — and quickly determines accurate cost estimates for both the patient and insurance. Efficiency results in lowered costs — and happier patients The eCare NEXT system cuts costs in other ways, too: by reducing staff training needs, by ensuring compliance, by enforcing transparency, and so on. The benefits of an automated patient management system can manifest themselves in all sorts of ways. Blessing Health System, based in Quincy, Illinois, implemented eCare NEXT and found that it reliably increased efficiency and accuracy in patient management: "Experian Health provided our staff with a reliable, real-time registration error-alerting process. Our overall registration accuracy rate has improved significantly since implementing eCare NEXT. We now have the tools we need to be successful in one user-friendly application." Blessing's employees found that eCare NEXT improved dashboard capabilities and made it easier to view critical data, including missed estimates and copays. It was a clear upgrade over Blessing's previous system, in which employees manually calculated patient estimates. After adopting eCare NEXT, Blessing's point of sale collections increased by over 80 percent, its clean claim rate increased from 63 percent to 90 percent, and denials went down by 27 percent. And because the process had become so much more accurate and efficient, the average number of days an account spent in accounts receivable decreased by 28 percent. There’s no need to labor under an outdated administrative system that's certain to cause backlogs, errors, and intense frustration for patients and staffers. By offloading patient management work to the eCare NEXT system, healthcare providers can do what they do best: help people. For more information, contact Experian Health or check out our Touchless Processing whitepaper.