First Pst after migration to Cloud in Health care Blog

For healthcare providers, revenue cycle management has become more important than ever. Due to increasing complexity in the payer mix and patients encountering more out-of-pocket costs, revenue cycle directors are also finding management an uphill battle. To maximize their reimbursement rates, today’s healthcare providers must take control of revenue cycles, and that requires optimizing three particular areas: estimates, claims, and collections. However, this task is much bigger than one person or department to enforce. For success, revenue cycle directors require an array of reliable, automated solutions that allow leveraging a wide range of data and comprehensive analytics with minimal employee input. At Experian Health, we offer a variety of solutions that help optimize healthcare systems' revenue cycle management by simplifying the three key areas mentioned above. Unlock vital revenue cycle management capabilities With patients taking more responsibility for their medical costs, modern revenue cycles are most successful when tailored to patients. This includes providing accurate cost estimates upfront, making sure claims are clean before submitting, and prioritizing debt collection efforts where they are most successful. 1. Patient Estimates: providing accurate estimates early In our consumer-centric environment, patients expect a greater level of insight into the costs of medical procedures, preferably before receiving treatment. No one likes to be surprised months after treatment with medical bills that far exceed what they expected. In addition, state laws now require hospitals to provide more accurate patient estimates. For consistently accurate cost estimates, a healthcare provider must have a dependable price-generation process. For example, the estimates should incorporate a patient’s specific insurance information for accuracy. They should also be compared to the patient’s propensity to pay so a payment plan can immediately be set up, much like how financial institutions treat automobile loans. Patient Estimates, Experian’s price transparency tool, auto-populates much of the necessary data so healthcare providers can deliver accurate patient estimates as early as possible. In turn, consistently accurate cost estimates raise healthcare providers' chances of collecting revenue upfront and help avoid unnecessary headaches during the claims and collections processes. 2. Claim Scrubber: submitting clean claims The conflicts caused by denied claims are expensive to fix. Interactions with payers cost medical groups thousands of dollars per physician each year. Many of those interactions result directly from denied claims, which often stem from inaccurate data. Claims data can be edited in Experian Health's Claim Scrubber, which reviews each claim line by line and makes edits based on the platform's data. Claim Scrubber combines the data with general, payer, and patient-specific information to guarantee each claim is properly coded every time. 3. Collections Optimization Manager: collecting debt strategically and efficiently If a healthcare provider wants to redesign its collection processes to center around patients, it should rely less on random outbound calls and focus more on insight regarding each patient’s propensity to pay. The burden of collecting on past-due balances is a demanding task. It also reduces a healthcare provider's chances of successfully collecting bad debt. One of the most important reasons — among many — to consistently provide accurate estimates and claims is to make collecting debt more successful and less time-consuming. Granted, a healthcare provider can't expect to collect every single outstanding fee. However, by concentrating on patients who are able to pay, a much greater percentage can be collected. Furthermore, Experian Health's Collections Optimization Manager helps complete revenue cycle management by using in-depth collected data to identify patients who are most likely to pay their hospital bills. In turn, staff members can utilize their time and resources more efficiently by contacting these specific patients first. Like most companies, healthcare providers are beginning to realize that patient engagement is a top priority. With this elevated engagement comes the need for consistent price transparency for medical care. Luckily, Experian’s automated engagement solutions can help your healthcare system provide the increased transparency it needs while also optimizing its revenue cycle management.

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.