First Pst after migration to Cloud in Health care Blog

Nearly 46% of patients say being able to manage their health online is their top priority in accessing care, according to Experian Health's State of Patient Access 2024 survey (SOPA). However, the availability of a “digital front door” in healthcare – with online scheduling, mobile registration, and frictionless payments – is not yet meeting demand. Many patients still face convoluted booking systems and stacks of repetitive paperwork. Meanwhile, consumer-friendly tech and retail giants are edging into healthcare. As disruptors set new standards for simple and convenient care, traditional providers are under pressure to open their digital front door to remain competitive. Many are already investing in AI and automation to simplify workflows, cut costs, and upgrade the patient experience. Could 2025 be the tipping point for healthcare's digital transformation? A digital front door strategy could help more providers boost patient engagement, simplify the patient experience and increase profitability. What is a digital front door? The digital front door is more than a well-designed website. It's a single point of access that gives patients convenience, choice and control at every touchpoint in their healthcare journey. It promises patients faster appointments, fewer headaches and more coordinated care. From their mobile device or computer, they can log in to schedule visits, sign intake forms, update insurance details, see costs upfront and even settle their bills. It's secure, easy to use and lets patients handle tasks on their own time. On the back end, patient-facing digital tools can integrate into the provider's existing systems to improve workflows, reduce manual tasks and generate analytics to simplify care. What are the key benefits of implementing a digital front door? Patient satisfaction: According to SOPA, 60% of patients want more digital and mobile options for communicating with their provider, scheduling appointments and managing payments. Fewer no-shows: Patients are less likely to cancel or no-show when they can schedule and manage appointments that work for their time and needs. Frees up resources: Automating repetitive administrative activities means staff can focus on higher-value activities. Fewer errors: Manual processes are rife with data entry errors that increase the risk of denied medical claims and add time on the back end to resolve. Digital patient intake saves time and money by reducing opportunities for human error. Essential features of an effective digital front door What are some of the digital must-haves to simplify access to care? The checklist might include: Online appointment scheduling, to make it easy to book, reschedule, or cancel appointments Digital tools to complete pre-visit paperwork – even better if these automatically prepopulate patient info to save them time and reduce errors Transparent pricing, with tailored information delivered directly to the patient A choice of payment methods, including familiar digital options so patients can pay quickly Access to a patient portal or central hub for managing appointments, medical records and prescriptions Mobile-friendly interfaces and simple designs, so patients can see key data at a glance, from any device, without needing to be tech-literate Secure and compliant communications to protect patient data and privacy. Where to start with a patient-centric digital front door Three specific tools that would check off the above include the following: 1. Multi-channel patient scheduling What matters most to patients is being able to see their doctor quickly. Online appointment booking gives them the 24/7 self-service scheduling options they expect. It delivers quantifiable gains for providers too. For IU Health, automating patient scheduling has been shown to do the work of two full-time schedulers, with more than 35,000 appointments booked with self-scheduling. Experian Health's patient scheduling software guides patients to the appropriate provider and appointment while keeping the provider in control of their calendar. It integrates with a provider's website, call center, and physical office so patients can book their next appointment, even outside of office hours. On-demand webinar: See how IU Health increased one-call resolutions with Patient Schedule 2. Registration Accelerator 49% of providers say that a primary cause of denied medical claims can be traced back to errors in patient registration, forcing health systems to divert revenue to remediate claims that could have been avoided. An automated, data-driven patient registration process improves accuracy, making costly errors less likely. With Registration Accelerator, patients get a text when it's time to register, instead of completing forms in the waiting room. There's no need to download an app or create a user profile: they scan the data from their identity and insurance cards, and Registration Accelerator takes care of the rest. Anthony Myers, Director of Admitting and Registration at West Tennessee Healthcare, says that replacing clipboards with clicks also makes for a much better patient experience: “With our paper-based systems, it seemed like West Tennessee was stuck in the 1990s. We knew our patients expected a more modern experience. We wanted to meet them where they are, rather than forcing them to come to the registration desk. Our goal was to make pre-service registration easier and smoother for patients and staff.” Case study: How West Tennessee Healthcare simplified registration with Registration Accelerator. 3. Patient Financial Advisor The SOPA report shows that almost seven in ten providers believe their patients postpone care at least occasionally because they don't understand the cost of care. Eight in ten patients agree that accurate estimates help them prepare to pay. While price transparency is improving, too many patients still find themselves with bills that are higher than expected. Patient Financial Advisor delivers a pre-service estimate of the patient's financial responsibility based on real-time benefit information directly to their mobile device. It takes account of current provider pricing, payer contracted rates, and any relevant discounts or payment plans for greater accuracy. A secure payment link allows patients to settle their bills quickly and conveniently, at any time. Read more: How to maximize patient collections with digital technology Choosing the right partner for digital transformation Implementing a successful digital front door strategy comes down to one key factor: keeping it laser-focused on the patient. When choosing a vendor, providers should ask how the platform will make life easier for patients. Will it encourage proactive engagement? Is it easy to navigate and demonstrably secure? And on the back end, will it integrate smoothly with the provider's existing systems and workflows – and even improve them? The right partner will bring specialized expertise for a digital transformation, with the capabilities to meet both patients' and providers' needs. Find out how Experian Health's Patient Access solutions help healthcare providers open their digital front door to simplify patient care across the entire revenue cycle. Learn more Contact us

Patient eligibility verification is a critical part of the healthcare revenue cycle. It can help prevent errors with claim submissions, reduce denials, boost the bottom line, and help patients understand what their insurance will cover. However, checking insurance eligibility isn't always efficient or accurate, thanks to outdated systems and complicated manual processes. Ever-evolving payer requirements and new regulations, like the No Surprises Act, add even more complications during insurance eligibility checks. In 2024, providers also treated more patients than they did five years ago, making it harder to keep up with patient eligibility verification. This growing volume of patients have more complex health issues and may struggle to afford medical bills, putting a more pressing urgency on providers to run accurate eligibility checks before service. Having the right health insurance eligibility verification solution can make or break a provider's revenue cycle and allow staff to stay focused on patient care instead of digging for insurance information and correcting errors. This article takes a closer look at why patient eligibility matters, common challenges providers face and strategies to improve insurance eligibility checks, reduce payment delays and minimize denials. What is patient eligibility verification? Patient eligibility verification is an administrative process providers use to check whether or not patients have active medical insurance. It's typically completed before service occurs to confirm coverage for treatment and care. Sometimes called a health insurance lookup, the eligibility check verifies different aspects of a patient's coverage, including insurance status, coverage details and medical service benefits. During patient eligibility verification, billing information is also confirmed. Why is it critical for healthcare providers? Patient eligibility verification offers providers a first line of defense to protect revenue cycles against revenue leakage. It can help healthcare organizations with accurate billing, reduce claims denials and avoid footing the bill for uncompensated care. When eligibility checks are conducted diligently, providers see improved cash flow, staff efficiency is gained, the risk of bad debt is lower, and patients are empowered with accurate upfront estimates. The importance of patient eligibility verification Claim denial rates are growing and show no signs of slowing down. Experian Health's State of Claims 2024 survey reports that nearly three-quarters of respondents saw a rise in denials, with four in ten saying claims are denied 10% of the time. Eligibility issues, along with missing or inaccurate data, are a top reason for denials, according to 15% of providers surveyed. A reliable eligibility verification process is crucial to minimizing the claim denials, rework and billing errors that arise from inaccurate insurance information. It also lets patients know their financial responsibility upfront so there are no surprises when the bill comes. This trust and transparency fosters positive patient-provider relationships while ensuring patients get the care they need and providers get paid. Common challenges in patient eligibility verification Findings from Experian Health's State of Patient Access and State of Claims surveys point to several common challenges in patient eligibility verification. Evolving payer policies and pre-authorization requirements Insurance provider prior authorization requirements change often, making it hard for providers to keep pace. More than 75% of providers report an increasing amount of payer policy changes, and secondary eligibility checks take time and impact efficiency. When a necessary authorization is missed due to manual verification or rushed eligibility checks, it can result in denial, delayed payment and extra work – especially when care is urgent. Incomplete or outdated insurance information Insurance details in the provider's system don't always match the payer's record. This can happen for a wide range of reasons, including job switches, insurance plan changes or patients not being aware of or forgetting to mention secondary coverage. When these changes aren't caught before service, they can lead to rejected claims, billing delays and extra work for staff.  More than four in ten providers report adding at least 10 minutes of staff time per incomplete eligibility check. Inadequate technology to verify eligibility Staff must often wrangle a wide range of disjointed solutions, processes and logins during eligibility checks. While more than 70% of providers feel their organization runs insurance verification checks efficiently and accurately, nearly 60% of providers still use at least two different tools to gather the necessary patient information for claim submission. This can make navigating patient eligibility verification tedious and error-prone, and leads to staff burnout, denied claims and patient dissatisfaction. Strategies to improve patient eligibility verification In today's changing health insurance landscape, providers need to pay more attention than ever to their patient eligibility verification processes. Accurate and timely insurance verification streamlines the claims process, clarifies how bills will be covered (or not) ahead of time and helps patients prepare to pay their bills. Adopting the following strategies to improve patient eligibility verifications can help providers reduce the risk of denied claims, improve the revenue cycle and create positive patient experiences. Automate eligibility verification processes Verifying coverage early in the billing process increases the chance of submitting clean claims the first time. However, it can be tedious for providers to navigate outdated methods like online portals, file batching, automated systems and stay on top of ever-changing payer policies. Automated eligibility verification software helps providers optimize intricate insurance checks, access verified and comprehensive resources to confirm eligibility (with solutions like the MBI Lookup tool), and improve efficiency. Automatically track changing payer policy requirements With payer requirements undergoing constant updates, providers need to have access to solutions that keep up in real-time. Eligibility Verification, for example, seamlessly connects to more than 900 payers and features advanced patient matching tools. It can also be used with Experian Health's automated prior authorization tool, which tracks national payer requirements and flags providers when mandatory pre-authorization information is missing. Offer upfront, accurate cost estimates Patients want to know their financial responsibility up front. When armed with accurate estimates that help patients understand their coverage, co-pays and deductibles, more than 80% of patients say it helps them prepare financially. Eligibility tools allow providers to create more accurate estimates based on actual insurance coverage. This helps patients know what they're responsible for out-of-pocket and reduces surprise billing. Patient eligibility verification is more critical than ever in ensuring smooth and efficient revenue cycle management. With rising patient volumes, evolving regulations and other challenges impacting revenue cycles, providers need to maintain accurate insurance eligibility checks to reduce costly errors, streamline workflows and improve claims success rates. More importantly, accurate eligibility checks empower healthcare staff to focus on delivering quality care, while helping patients better understand and manage their financial responsibilities. Find out more about how Experian Health's insurance eligibility verification solution helps revenue cycle managers prioritize reimbursements with automated eligibility checks. Learn more Contact us

Collecting payments from patients has always been tough. Confusing bills, missed reminders and affordability concerns often lead to delays. Billing teams get bogged down in follow-up calls and paperwork, leaving little time for complex cases and a big question mark over whether they're using their time efficiently. As patients shoulder a greater share of their healthcare costs, there's increased pressure to make billing more accessible, transparent and manageable. Could automation be the answer? This article looks at how automation can simplify patient collections for everyone. With faster reminders, more accurate estimates, tailored payment plans and efficient collections management, providers can improve the patient experience and increase collections simultaneously. The importance of automation in patient collections One of the biggest frustrations for billing staff is seeing patients struggle to pay their bills. Medical costs can be daunting, and as patients are confronted with rising prices at the gas pumps and grocery stores, they may feel forced to delay healthcare payments or forego care altogether. Complicated bills with unclear charges and terminology only compound the problem: Experian Health's 2024 State of Patient Access (SOPA) survey found that 69% of providers see patients postpone services when they don't understand the financial impact. Many patients are able to pay their bills, but need clearer and more flexible payment options. In their attempts to support patients, billing teams spend a lot of time managing routine tasks like sending reminders, setting up payment plans and fielding questions about bills and unresolved insurance issues. What if these tasks could be handled automatically? There are opportunities to take advantage of automation, advanced data analytics and artificial intelligence in just about every corner of the collections process. Providers integrating automation in patient collections find it easier to help patients keep up with payments and maintain a steady cash flow — without draining staff resources. The benefits of automation for patient collections Here is a run-down of a few key automation benefits for patient collections: 1. Clearer billing, which boosts better cash flow In the SOPA survey, 88% of providers recognized that upfront price estimates contribute to collections success. Automation makes it easier to calculate accurate estimates based on the provider's current prices and the patient's specific insurance benefits. With user-friendly bills, patients can quickly grasp what they owe without needing to ask their provider for clarification. Automated systems can also issue friendly reminders to patients via text or email so they don't miss payment deadlines. Including quick payment links allows patients to click and pay in an instant. 2. Personalized payment options, which create a compassionate and convenient patient experience A survey by Experian Health and PYMNTs found that patients welcome tailored payment plans that allow them to pay their bills in stages. This is backed up by SOPA findings, which show that 40% of providers have seen reduced friction in patient intake thanks to payment plans. Automation can be used to calculate customized options that fit different budgets. Aligning payment plans to the patients' ability to pay improves the consumer experience and minimizes bad debt. Today's consumers want to choose how they pay for care, yet many providers lack the online and mobile-enabled payment options to support fast and convenient payments. With automation, healthcare organizations can enable multiple secure payment methods across their services and departments, giving patients more hassle-free ways to pay. 3. Increased efficiency, which reduces the admin burden for staff With automation handling routine billing tasks, staff can spend less time on paperwork and more time on patient care, leading to a more efficient and patient-focused service. Overall, automation creates a smoother billing experience. Patients appreciate clear information, convenient payment options, and timely reminders, which makes them more satisfied with their care. Key tools and technologies for automating patient collections When building a toolkit for automated patient collections, providers can choose from a growing range of technologies. For example: 1. Analytics-based collections optimization One way to simplify patient collections is to use data analytics to screen, segment and prioritize self-pay accounts so that each one can be handled in the most efficient way. Collections Optimization Manager screens patient accounts for bankruptcy, deceased status, Medicaid, and charity so staff can focus on higher-yield accounts. After screening, accounts are given a score based on the patient's propensity to pay and then routed to the most appropriate servicing channel. Users can access real-time dashboards and expert consultancy support to monitor and improve collections strategies. This improves the experience for patients, reduces repetitive manual work for staff, and maximizes collections while reducing the overall cost to collect. See it in action: How Wooster Community Hospital collected $3.8M in patient balances with Collections Optimization Manager 2. Financial aid automation Many patients with high out-of-pocket costs and co-pays are unaware that they might be eligible for financial assistance. By using Experian’s comprehensive data, Patient Financial Clearance automatically determines which patients may qualify for financial assistance and even auto-enrolls them in relevant programs. To make this process as easy as possible for patients, the tool prompts them to complete applications whenever it is convenient, either online or through their smartphones. This releases staff from time-consuming manual work and accelerates approvals and payments. In addition, the tool creates individualized payment plans that account for what the patient is likely to be able to afford, thus helping providers collect from patients who do not qualify for charity support, too. See it in action: How Eskenazi Health boosted Medicaid approvals by 111% with financial aid automation 3. Automated upfront, accurate estimates For patients with out-of-pocket bills, getting ahead of any surprise charges with accurate pre-service estimates is essential. Patient Estimates is a web-based pricing tool that pulls together every last detail about chargemaster pricing, payer contracts, insurance benefits and financial assistance policies to generate an accurate estimate for patients. It applies any prompt-pay discounts or payment plans so the patient knows what to expect. Helping patients understand and prepare for forthcoming bills smooths out the payment process and leads to more revenue being collected, sooner. 4. Digitally enabled payment technology The patient-friendly collections experience can be rounded out by offering a choice of digital-first payment methods. PaymentSafe® allows providers to securely accept patient payments at any time, expanding the number of collection points available to patients. The tool automatically integrates data from across the payments ecosystem to pre-populate fields in the patients' accounts, allowing them to pay multiple bills at once, and automatically settles and remits payments. Making it easy for patients to pay accelerates payments, including before and at the point of service. The future of patient collections through automation Bringing together automation and patient collections will continue to simplify and make these processes more patient-friendly. Automation and digital tools will enable more self-service options, making it easy for patients to manage bills, choose payment plans, and make payments at their convenience. Moving toward greater transparency and personalization will also give patients more control. Emerging technologies such as predictive analytics, machine learning and artificial intelligence will give providers greater insights into their patients' financial needs, so they can offer proactive and compassionate support to navigate the process. As these trends gather steam, patient collections will become faster, more adaptable and better aligned with the needs of today's healthcare consumers. Find out more about how simplifying patient collections with automation can improve patient experiences and increase collections. Learn more Contact us