First Pst after migration to Cloud in Health care Blog

Surprise tends to magnify human emotion. If the surprise is positive, a person's reaction to it will be intensely positive. If it's negative, it will be extremely negative. Such is the case with unexpected medical bills, and that's one reason why the No Surprises Act was passed in 2021. It aims to protect consumers from unexpected bills for out-of-network care in both emergency and non-emergency settings. Thanks to the Act, U.S. healthcare organizations must now provide transparent details of the estimated costs of their services – otherwise known as patient estimates. And, so far, it's working. One 2023 survey by Blue Cross Blue Shield and AHIP shows that "The No Surprises Act (NSA) prevented more than 10 million surprise bills in the first nine months of 2023 — continuing to protect millions of Americans from crippling medical bills each year." And as insurance deductibles and out-of-pocket expenses continue to rise, patient estimates are becoming even more critical. Experian Health's State of Patient Access Survey 2024 shows that both patients and providers would like to see improvement in the accuracy of patient estimates. Surveys show that 4 in 10 patients say they spent more on their healthcare than anticipated, and nearly one-quarter received surprise bills after treatment. Creating service transparency takes an effort, but there are also hidden benefits for providers. With medical debt skyrocketing past the $220 billion mark and the cost of care increasing, patient estimates apply much-needed rigor to healthcare billing and collections practices. Why are patient estimates important? Pricing estimates enhance the healthcare experience by making the financial responsibilities of treatment more transparent and more manageable. The benefits for patients include: Understanding potential treatment costs, allowing them to plan and avoid unexpected expenses Making informed decisions about their healthcare options by comparing the costs and benefits of different treatment plans Fostering transparency and trust between healthcare providers and patients Better coordination with insurance providers so they know what will be covered and what will be an out-of-pocket expense Reduced financial anxiety, allowing patients to focus more on their recovery and less on potential financial stress Increased cost awareness and acceptance, prompting them to comply more readily with treatment plans and not cancel appointments Providing a price quote empowers patients while creating a more efficient healthcare system of services rendered and payments received. Why are patient estimates useful prior to treatment? It's better for patients, and the healthcare system as a whole, if patients are more focused on healing and self-care than the stress and anxiety of an unexpected medical bill. If they know what's coming, patients can take control and make plans to alleviate any financial turbulence. In the case of planned care and procedures, pre-treatment cost estimates also allow patients to shop around for the best balance between service and price. In addition to helping patients make smarter treatment choices and financial decisions, patient estimates also help people understand, navigate and coordinate their insurance benefits. That also helps them avoid medical billing surprises that can later lead to collections and damage to their credit scores. How do patient estimates help providers? In today's healthcare landscape, where value and patient experience are key factors in reimbursement, transparency has become crucial in four ways: More satisfied patients: Estimates build trust and patient and provider relationships. This trust is essential for effective communication and patient satisfaction and can help reduce patient churn. Better adherence to treatment plans: Patients aware of the financial implications are more likely to stick to their treatment plans and follow through with necessary procedures and lifestyle changes. Adherence leads to better health outcomes and a more efficient treatment process. Better resource management: Knowing each patient's expected costs and required resources allows providers to allocate and schedule resources more effectively. Improved revenue flow: Pricing estimates at the front end of the medical journey establish upfront financial accountability, which can lead to providers being paid more quickly. As healthcare costs rise, improving price transparency is a win-win for both patients and providers. Patients want clear, upfront information about treatment costs, insurance coverage and payment options so they can plan ahead with confidence. When providers make this process smoother, it benefits everyone—saving time, reducing stress, and making things more efficient. Plus, it can help avoid those tough conversations when patients are caught off guard by unexpected bills. Providing the right information from the start creates a more positive experience for everyone involved. Technology can help create accurate patient estimates Experian Health's Patient Estimates tool makes price transparency and providing accurate estimates easier. This solution leverages real-time data, including insurance coverage, payer contract terms and provider pricing, so that everyone knows exactly where they stand before the service is rendered. Patients can focus on getting well while providers create the accountability they need to get paid promptly. With the right technology, patients and providers can come together in a mutually beneficial and less stressful encounter that leads to better relationships and better health. Contact us to learn how Experian Health can help your healthcare organization empower patients with clear, accurate cost estimates to enhance transparency, build trust and improve overall care satisfaction. Patient Estimates Contact us

Convenience, speed, and control are the triad of better patient experiences. Experian Health's 2024 State of Patient Access survey showed that 89% of patients want to schedule their appointments online or on a mobile device. Today, patients expect provider scheduling, registration, and other administrative tasks to match the convenience of their typical online shopping experience. However, too many patients face obstacles when booking appointments and accessing care. With more than 6 out of 10 patients saying they would switch to a provider that offers a patient portal, making digital channels available is now a baseline requirement for providers seeking to improve care delivery. Patients want a digital front door that circumvents the inconvenience of traditional call center booking systems. Self-service patient scheduling software helps providers keep pace with patients' digital demands. But the case for scheduling software goes beyond these expectations, offering real benefits for patients and their doctors. Here are 8 reasons to use online scheduling to benefit both patients and providers: The benefits for patients 1. Patients enjoy the convenience and accessibility of online scheduling Online appointment scheduling provides unparalleled convenience and accessibility for patients. These solutions allow them to schedule their appointments anytime, without being constrained by office hours. This flexibility benefits individuals with demanding work schedules, family responsibilities, or other commitments. The user-friendly interface of online scheduling platforms enables patients to quickly navigate the system, select their desired service, and book an appointment without any hassle. Additionally, remote access means that patients can schedule their appointments from any device with internet connectivity, whether at home, work, or on the go, eliminating the need for physical visits or phone calls. 2. Patients can experience reduced wait times and greater access to care Nearly 8 in 10 patients who say they're unhappy with their provider experience cite the speed at which they see their doctor as a big frustration. By using online appointment scheduling, patients can significantly reduce their wait times. They have immediate access to the real-time availability of appointment slots, allowing them to choose the most convenient times without waiting for a receptionist to check the calendar. The streamlined booking process minimizes the back-and-forth communication typically required when scheduling via phone, leading to quicker confirmation and less time spent coordinating. Patients who need to reschedule can easily do so online, viewing available slots and selecting a new time without delays. 3. Patients can schedule anytime and from anywhere One of the most significant advantages of online appointment scheduling is its 24/7 availability. Patients can book appointments anytime, including evenings, weekends, and holidays. This flexibility primarily benefits those who find making calls during standard office hours challenging. With the ability to address their scheduling needs instantly, patients can book or change appointments whenever it is most convenient for them. Additionally, for practices serving patients in multiple time zones, online scheduling ensures everyone can book appointments at a time that suits them best. 4. Online scheduling provides immediate confirmation, reducing uncertainty and the need for follow-up Online scheduling provides patients with instant confirmation of their appointments, offering real-time updates that reduce uncertainty. Once an appointment is booked, patients receive immediate confirmation, often via email or SMS, which helps to alleviate anxiety and ensure they know their appointment is secured. Many online scheduling systems also offer automated reminders via email, SMS, or app notifications to help patients remember their appointments and reduce the likelihood of missed visits. This instant confirmation and reminder system also reduces the need for administrative staff to follow up with patients to confirm appointments, freeing up their time for other tasks. The benefits for providers 5. 24/7 self-scheduling increases appointment bookings and reduces no-shows One of the major challenges healthcare providers face is the issue of patient no-shows. According to the Medical Group Management Association (MGMA), the average provider no-show rate is 5% to 7%. The cost to healthcare providers is around $150 billion annually. Yet there is growing evidence that allowing patients to conveniently and quickly schedule, cancel and reschedule appointments decreases no-shows, which is money in the bank for providers. Studies at the Mayo Clinic and Johns Hopkins showed that the percentage of appointments kept increased when patients scheduled their visits online. Automated reminders and confirmations are integral features of online scheduling systems that help mitigate this problem. By sending reminders via email, SMS or app notifications, these systems ensure that patients know about their upcoming appointments. These reminders reduce the likelihood of patients forgetting their scheduled visits, decreasing missed appointments. Fewer no-shows translate to more consistent patient flow and better utilization of the provider's time and resources. 6. Digital scheduling reduces pressure on staff The convenience factor extends beyond patients. Self-scheduling platforms also improve efficiency and ease the burden on call center staff. Experian Health's “Short-staffed for the long term” report showed that 73% of providers say finding staff is challenging. As the chronic staffing crisis continues, providers should look to automated solutions to remove bottlenecks, increase capacity and improve the experience for call center staff. After partnering with Experian Health, Indiana University (IU) Health found that automated self-scheduling helped them do more with fewer staff while engaging patients. They stated, “Self-scheduling does the work of two full-time schedulers.” Of the patients who used the online scheduling tool, 87% arrived for their visit. Patient appointment scheduling software offloads call volumes and cuts call times in half. It also gives providers control over their calendars while integrating seamlessly with electronic medical records and practice management systems. Providers can also use these solutions in parallel to patient intake software to help accelerate registration, saving even more valuable time and resources. 7. Embracing digital scheduling gives providers a competitive edge Getting patient scheduling right is crucial to patient acquisition and retention strategies and is increasingly vital as patient volumes fluctuate. Making a strong first impression with easy self-scheduling is more likely to attract new patients and gives providers a competitive edge. Online appointment scheduling systems allow healthcare providers to manage their schedules more effectively. Providers can easily view and optimize appointment slots, ensuring effective time utilization. These features improve workflows and productivity as providers can balance their schedules to avoid overbooking or underutilization. Additionally, the ability to analyze scheduling data can help providers identify peak times and adjust their staffing and resources accordingly, further enhancing operational efficiency. In a competitive healthcare market, staying ahead of the curve with advanced technology solutions like online scheduling is crucial. Providers who embrace digital scheduling not only improve their operational efficiency and patient satisfaction but also position themselves as leaders in the industry, attracting tech-savvy patients who seek modern and convenient healthcare services. 8. Patient scheduling software can protect against the unexpected A final reason to embrace patient scheduling software is to future-proof scheduling capacity against unforeseen events. During the COVID-19 pandemic, flexible self-scheduling tools helped providers maintain operational stability as patient numbers surged with each new wave of infections. In a climate of chronic staff shortages, augmenting employee numbers is challenging and can be impractical to manage during periods when patient volumes subside. Patient self-service software is a DIY solution patients want, and providers need to stretch staff efficiency and work smarter. Today, these tools continue to improve, and providers increasingly rely on them to meet patient needs. A 2024 survey showed that 60% of patients want more digital tools to manage their health. Patient scheduling software gives patients the self-service experience they're accustomed to with 24/7/365 online appointment scheduling. New uncertainties will always be on the horizon, but with the right digital patient scheduling software, providers will be well-positioned to face whatever's next. Learn how Experian Health's patient scheduling software can help healthcare organizations meet patient expectations, improve operational efficiency and prepare for future patient scheduling demands.

“For too many, coverage is either unavailable or insufficient.” This is the harsh reality the American Hospital Association highlighted in a recent statement to the US Senate, urging action to address growing medical debt. Despite efforts to expand insurance coverage, hospitals continue to lose billions of dollars through unpaid bills. The statement notes that hospitals provided over $42 billion in uncompensated care in 2020 alone. Guiding low-income patients to appropriate charity care programs can mitigate a significant portion of this uncompensated care. Unfortunately, many eligible patients are either unaware of these options or choose not to apply, causing hospitals to waste time and money chasing bills from people who cannot afford to pay. Helping those patients find and apply for financial support is critical to reducing bad debt. But that's a challenging prospect without automation. Presumptive screening with Patient Financial Clearance offers a faster route to reliable charity care classifications and a reduction in uncompensated care. What is charity care? Charity care programs provide free or discounted healthcare to patients who can't afford to pay their bills, covering medically necessary inpatient and emergency room services. Typically, programs offer full or partial discounts to uninsured patients, but those with insurance may be entitled to assistance if their plan doesn't cover their care. Eligibility depends on the hospital's financial assistance policies and relevant state regulations. Hospitals do not expect to be reimbursed for charity care, though tax exemptions and government funding may offset some of the cost. In this way, charity care is distinct from “bad debt,” which refers to unpaid patient bills that hospitals expect to collect. Frustratingly, too many accounts that could have been eligible for charity care are written off to bad debt—perhaps because patients don't realize they're eligible, don't know how to fill out the application, or feel embarrassed to seek help. The problem is further exacerbated by the growth in high-deductible and “skinny” health plans, as patients without sufficient coverage assume support is only for the uninsured. Several states are tackling medical debt by bolstering charity care programs. For example, North Carolina plans to boost federal payouts to hospitals that agree to waive medical debt for low-and middle-income patients. In Milwaukee, County Supervisors are taking a preventive approach, using income data to automatically enroll at-risk patients into charity care programs to stave off bad debt before it takes root, in a process known as presumptive charity. What is presumptive charity? Checking eligibility and helping patients apply for charity care is predictably form-heavy. Patients must provide tax returns, pay stubs, and bank statements to confirm their household income and financial status. Manual reviews are time-consuming for providers, while the overall experience can feel intrusive or confusing to patients. Presumptive charity screening expedites charity care checks by automatically screening patients for financial assistance eligibility. It uses automation and data analytics to quickly evaluate the patient's credit information, financial data and demographic details to make a 'presumptive' determination of eligibility for charity care, regardless of coverage status. Better charity care classifications reduce bad debt Automated charity care checks mean more patients will be classified correctly so hospitals can confidently seek reimbursement from the appropriate source. This offers several advantages, such as: Reducing bad debt: Presumptive charity screening results in fewer eligible patients missing out on financial support, so they're less likely to be sent bills they can't pay. Increasing efficiency: More accurate screening allows staff to cut time spent on administrative tasks and stop chasing collections from patients who are unlikely to be able to pay. Expediting classification decisions: Automation means eligible patients don't have to wait for long periods to find out if they'll get financial support, which is especially important in urgent and high-volume services, such as emergency departments and large hospital systems. Improving the patient experience: Speedy systems with fewer forms reduce the patient's involvement to a minimum, contributing to a more convenient and compassionate financial journey. Maintaining compliance: Hospitals comply and maintain their non-profit status by providing charity care to their community. Supporting patients: Providing accessible healthcare to those who are low-income and are most vulnerable. How can Patient Financial Clearance help providers improve charity care classifications? Patient Financial Clearance (PFC) is a presumptive screening tool designed to help providers quickly determine which patients may be eligible for financial assistance. It then connects those patients with relevant charity care programs and automatically enrolls them, or establishes tailored payment plans for the amount they owe based on their financial situation. First, Patient Financial Clearance triggers automatic checks before or at the point of service to rapidly assess whether the patient qualifies for Medicaid, charity care or other financial assistance programs. It uses Experian Health's superior data and analytics to accurately estimate the patient's income, household size and Federal Poverty Line (FPL) percentage, and it calculates a Healthcare Payment Risk Score to predict their propensity to pay. Unlike alternative models which are built to estimate incomes for consumers with higher incomes, PFC's income estimates are optimized to predict incomes below 400% of the FPL. Then, if patients are likely to be eligible for charity care, the tool pre-populates application forms and initiates auto-enrollment to reduce staff manual input and the risk of errors. There needs to be a prompt process to help patients who do not qualify for charity care manage their bills. For patients who do not qualify for charity care, there also needs to be a prompt process to help. Patient Financial Clearance recommends optimal payment plan amounts per the organization's terms and policies. Staff can pull up summarized and detailed views of the patient's credit history and custom scripts to guide financial counseling discussions. Alex Liao, Product Manager for Patient Financial Clearance at Experian Health, explains how better charity classifications help reduce bad debt and increase collections: “The obvious benefit is that clients can accelerate the charity care application process and ensure eligible patients get assistance quickly. However, having a more accurate picture of patients' financial needs offers wider benefits across the revenue cycle: it ensures each patient account is handled appropriately to increase upfront collections and reduce bad debt. Those with a low ability to pay receive a payment plan they can afford, while those with a greater capacity to pay are not just paying the minimums.” Patient Financial Clearance in practice See how UCHealth used PFC to create a more streamlined approach to charity care classifications, resulting in: $26 million in disbursed charity care. More than 1,700 patients covered. 600 charity cases closed in one month alone (August 2023). To hear more about how automating charity care classifications with Patient Financial Clearance could help your organization reduce bad debt, contact us today for a demo. Patient Financial Clearance Contact us