First Pst after migration to Cloud in Health care Blog

There's no question that portals increase patient engagement. According to the Office of the National Coordinator for Health IT, almost eight in 10 patients appreciate the improved access to healthcare information afforded to them by self-service systems. Unfortunately, portal systems also offer an obvious target for healthcare hackers. Within a patient portal, criminals can steal medical identity data, which is worth somewhere between 20 and 50 times as much as financial data, such as credit card numbers. They then use the stolen information to submit fraudulent claims, fill prescriptions, and resell medical equipment. What's more, because many healthcare organizations lack proper detection tools and some patients neglect to check their explanation of benefits (EOB) statements, health data breaches tend to go undetected longer than those in other sectors. No wonder healthcare data security incidents rose 211 percent in 2017, according to the 2018 "McAfee Labs Threats Report." Protecting patients' data with technology Patient portals engender patient engagement and loyalty, but if a data breach occurs, that loyalty is quickly lost. Besides losing patients’ trust, healthcare organizations that experience a data breach face potentially severe HIPAA penalties. Healthcare firms can learn a great deal from how other industries have met similar security challenges without overburdening consumers. Providers can use best-in-class technologies, data and analytics systems, and their deep understanding of patient needs to manage risks and protect patient identities. To arm providers against breaches, Experian Health offers Precise ID® with Digital Risk Score to protect portal users’ identities from their first sign-in to their last. By automating the portal signup process, it stops false enrollments at the source. Then, using multilayer verification, it provides access protection for future sessions. Because Precise ID takes less than a second to evaluate access risks, patients don't need to sit through loading screens. On the provider side, Precise ID satisfies the Centers of Medicare and Medicaid Services' Promoting Interoperability standards, minimizing compliance risks. At a time when one in five patients withhold information from physicians because of data breach concerns, Precise ID builds trust between patients and providers by protecting patients' data from unauthorized access. Giving patients the power to access their medical information through portal technology has been one of the past decade's biggest steps forward in improving patient-provider relationships. But with that reward comes responsibility: Providers must protect portals from unauthorized access and theft of medical records. With Precise ID with Digital Risk Score, providers get the security they need, and patients get the seamless access they've come to expect.

As a healthcare organization, if you're not already focused on decreasing claim denials, time is of the essence. According to one industry estimate, healthcare personnel spend a little more than 20 hours per week solely dealing with insurance claims. Altogether, that equates to about $83,000 worth of time per year per physician on claims-related administrative tasks. Most of those expenses come from needing to rework and resubmit denied claims. For example, the average U.S.-based health plan with 100 million patients processes about 1 billion medical claims annually. Up to 20 percent of these are denied due to poor claims management, and each denied claim costs approximately $25 to rework. It’s obvious, then, that cutting costs and improving productivity means learning to cut down on claim denials, too. This is exactly why Northwell Health turned to Experian Health's Claim Scrubber to accommodate its claims management needs. Cutting claim denials in half The Northwell Health network is intimately familiar with the high costs of dealing with claims denials. The nonprofit healthcare system consists of 22 hospitals and more than 550 outpatient facilities throughout New York state. In 2013, it partnered with Experian Health to cut down the rate of denied claims for all of its providers. With the help of Experian’s Claim Scrubber solution, Northwell Health cut that rate by 50 percent within just a few years. The network now also enjoys significantly shorter times between claim submissions and reimbursement, and staff can more easily stay up-to-date on regulatory and coding changes. By 2017, Northwell Health was a different, much more efficient healthcare network than it was four years before. The change was due mostly to the dramatically reduced time and costs related to denied medical claims, which Claim Scrubber made possible. The key to Northwell Health’s success Simple human error is the main reason why medical claims are denied so often. The smallest typo or discrepancy can lead to an immediate denial, and reworking a claim rarely increases its chances of being more accurate. Claim Scrubber eliminates that error by automatically quality-checking each claim line by line according to general, patient, and payer-specific information. The software solution streamlines claims management by checking that every claim is clean and error-free before the provider submits it, eliminating the costly, time-consuming need to redo them. Fewer denials (and, therefore, fewer reworked claims) mean a faster and more predictable revenue cycle, as well as lower administrative costs and more time for staff to focus on patient care. In turn, by 2017, Northwell Health providers' investment in patient care paid off. They were ranked the Best Children’s Hospitals across nine specialties by U.S. News and World Report. This is an amazing accomplishment, especially when Northwell Health's work with Claim Scrubber began as a small pilot program implemented for a single specialty. At first, the network chose 10 distinct edits to implement in claims related to a single specialty. Through direct communications with the Experian Health team, including weekly invoice audits to ensure the edits were working, Northwell Health providers quickly began seeing results. For that single specialty, claim denials in several categories started decreasing rapidly. After just one year, providers throughout the Northwell Health network saw the difference compared to their own claim denial rates. Before long, every provider wanted the edits enabled for their categories. Today, Claim Scrubber is activated for more than 25 specialties throughout the network, and leadership is confident that denial rates will continue to drop. Take your small step with Claim Scrubber The reason why the Northwell Health network is such a great example of Claim Scrubber’s potential is that it implemented the change in small steps. When it comes to claim submissions, every detail matters, and together with Experian Health’s experts, the solution allows you to examine every detail and the success of each edit before moving on. Change is challenging, especially in healthcare, but the exorbitant amount of time and money that providers lose every year to denied claims is becoming unsustainable. By following Northwell Health’s example and taking small steps toward better solutions, every healthcare provider can overcome that challenge and eliminate the burden of claim denials.

Last year, a Kaiser Family Foundation study revealed that employer-based health insurance deductibles in the U.S. were at an average of $1,505. In 2006, the average was only $303. During this span of 11 years, the majority of responsibility for healthcare costs shifted from insurance companies to patients themselves, and many are still reeling from the sticker shock. Before consumerism and routinely high deductibles, healthcare providers focused most of their collection efforts on health insurance companies. Now, patients are a main source of providers' revenue, and some organizations are struggling to fit their old revenue cycles into the new payment landscape. However, many patients aren’t prepared for the increasingly high costs of healthcare, so they may opt to delay their care until they’ve met their deductibles at the end of the year. This creates a volatile and unpredictable revenue cycle in which organizations are slow in quarter one and quarter two and then slammed in quarter three and quarter four. Other patients could forgo medical care altogether, cutting down revenue for providers. Both scenarios contribute to a less healthy general populace and a vicious cycle in which more patients need increased care but most of them continue to hesitate or refuse it. At Experian Health, we recognize and want to bring change to this unstable healthcare climate. Our healthcare price transparency tools take sticker shock completely out of the equation by stabilizing the revenue cycle and putting transparent pricing in healthcare and payment options at the forefront. Applying consumerism to transparent pricing in healthcare Healthcare might have been a bit slow to catch up, but modern consumerism has already changed virtually every other industry. Today, consumers demand to know what they’re paying for and exactly how much before any transactions are complete. They need payment options that make their lives simpler and the ability to manage their accounts conveniently online without jumping through hoops. All of this is possible for healthcare organizations to provide, but they must be proactive in helping patients overcome the burden associated with modern healthcare costs. From financial education to flexible financing programs, any organization can improve patient satisfaction by providing transparent price information and affordable solutions upfront. With that goal in mind, Experian Health offers a variety of healthcare price transparency tools that can set your organization on the path to financial clarity, education, and advocacy: Patient Estimates A high medical bill is stressful alone, but it’s infinitely more so when the amount of the bill far exceeds what a patient expected. Price transparency is paramount to overcoming that stress. It’s also mandated in several states and will soon be in all others. With Patient Estimates, you can deliver transparent pricing in healthcare to every patient before or at the point of service. Our Patient Estimates tool automatically generates estimates based on treatment costs, payer rates, and a patient’s eligibility for benefits. The platform takes the guesswork out of the process by automatically storing and populating this information so you can provide patients with highly accurate estimates as early as possible.   Patient Statements When patients know what price to expect on their medical bills, they’re more prepared to pay them. Yet if they can’t read or understand the bill, they might still delay paying it until they have time to thoroughly address any concerns. To simplify the final bill, we offer Patient Statements software that combines separate billings into one simple, easy-to-understand statement. Patient Statements not only simplifies a patient’s bill, but it also helps you turn it into a valuable engagement tool. Every statement can be personalized with educational information about the patient’s condition, links to relevant videos and websites, and marketing messages for products that can improve the patient’s quality of life. Patient Self-Service Consumers are used to going online and managing their finances from a smartphone or computer. They often choose retailers based on this availability, and soon, most will choose healthcare providers on the same basis. Giving them convenient, 24/7 access to their healthcare accounts through Patient Self-Service portals will become increasingly more important for organizations to stay competitive. An online, self-service portal allows patients to view their estimates, manage their integrated fundraising accounts, pay their bills, and stay up-to-date with changes to their healthcare. Our self-service healthcare price transparency tools are also protected by highly secure payment processing technology, so patients can be confident that their information is closely guarded every time they interact with the platform. PaymentSafe® Collecting healthcare payments requires the combined security of protected health information and a patient’s personal and financial data. Our comprehensive PaymentSafe solution makes it possible to safely and conveniently collect payments at any point in the care cycle and from any department within the organization. Every payment is automatically settled throughout the system, as well, so patients are never double-billed. PaymentSafe also applies to every type of remittance — from electronic checking and debit cards to cash, checks, and money orders. In addition to satisfying information safety compliance standards, the technology gives patients peace of mind and encourages them to be more proactive in settling their healthcare bills. Transforming your revenue cycle to make it more consumer-centric and price transparent can seem like a daunting task, especially in an industry in which every small change has resounding consequences. At Experian Health, we’ve made it our mission to make that transformation easier by helping organizations provide the healthcare price transparency tools and payment options that their patients demand.