First Pst after migration to Cloud in Health care Blog

Can greater clarity and providing patient estimates at the beginning of the patient's financial journey set the stage for better access to care and a smoother path to payment? Millions of Americans struggle to pay for healthcare. A 2022 survey conducted by West Health and Gallup found four in 10 Americans, or roughly 112 million people, are cost insecure or cost desperate when it comes to healthcare. The issue is not just affordability; it’s also anxiety. Patients who fear they won’t be able to cover their out-of-pocket healthcare expenses may postpone or avoid treatment. At a minimum, anticipated medical expenses are a source of stress, especially for the growing number of patients who have high-deductible health plans. Pre-treatment patient estimates can help alleviate the stress. By taking some of the mystery out of medical bills, accurate estimates help patients understand and plan for costs. By opening a dialogue about treatment costs early in the process, patient estimates pave the way for further discussions about insurance coverage, payment plans, charity help, and more. As inflation wreaks havoc with household finances and talk of recession turns up the volume on financial stress, patient estimates and other tools that ease the payment process offer a bit of welcome relief for patients. A better patient financial journey offers benefits to providers as well. For healthcare organizations that are thinking about adding or improving pre-treatment patient estimates, here are 4 key benefits to consider: 1. Patients are more likely to forgo care if they can’t see how much it will cost. According to Experian Health and PYMNTS data published in July 2022, nearly half of consumers who canceled appointments last year did so because they were concerned about costs. Their concerns were not unfounded: the same survey revealed that one in five respondents spent more on healthcare than they could afford. Especially in uncertain economic times, the ability to understand and plan for out-of-pocket medical expenses is critical to patients. A Commonwealth survey found that deductibles were equal to 5% or more of household income in some cases; out-of-pocket costs were equal to 10% of household income in others. Add in concerns about the rising cost of living and the prospect of lost jobs, and the anxiety level surrounding healthcare costs only intensifies. Patient Payment Estimates help alleviate patient fears by providing clear, easy-to-understand estimates prior to treatment. Armed with this information, patients can make clear-eyed decisions about their care and ask about payment options if they’re needed. 2. Price transparency regulation is helping to create a new competitive environment. The No Surprises Act and CMS price transparency final rule are bringing price transparency into focus for patients and providers alike. These regulations require providers to offer accurate estimates in advance of treatment and disclose their pricing for common procedures. Although these regulations continue to evolve and providers are still working toward full compliance, patients are beginning to see more access to pricing information and a greater likelihood of receiving pre-treatment estimates. That’s creating a new competitive environment—and new choices for patients who are contemplating care. “In this new world, patients have the ability to branch out and research their own options,” says Riley Matthews, Senior Product Manager at Experian Health. “Patients have the pricing information to make informed decisions about healthcare and can shop between different providers based on price.” As a result, patient perceptions around transparency and trust are changing: “If providers want patients to keep walking through the door, they need to provide tools to help patients understand their financial obligations and feel that they’re being treated honestly and fairly.” Price transparency may have an additional benefit. According to Experian Health’s State of Patient Access: 2021 survey, eight in ten providers believe price transparency correlates with patients being more likely to pay bills on time. By simplifying pricing and payments, providers literally make it easier to pay. 3. Patients who know out-of-pocket costs in advance are more satisfied with care. In a March 2022 survey from Experian Health and PYMNTS, 88% of patients who received pre-treatment estimates were satisfied with the care they received from their family doctor, compared to 78% of patients who did not get an advance notice of costs. “Our ideas about patient satisfaction and care are changing,” says Matthews. “Healthcare is about more than physical health: It also encompasses mental, emotional, and financial health, all of which are affected by the patient payment experience. When healthcare costs or confusion stand in the way of patients getting treatment, or when healthcare bills create real financial challenges and stress, a transparent and compassionate billing process can make a crucial difference.” 4. Providing clear and accurate patient estimates is the first step to a better payment experience. Helping patients anticipate their healthcare bills with pre-treatment estimates is only the beginning of the journey. The same patient-centered payment tools that make the healthcare billing and payment process easier for patients also make it easier for providers. PatientSimple, Experian Health’s secure online patient portal, lets patients generate price estimates, apply for charity care, set up payment plans, update insurance information, make payments to hospitals and physicians, and even schedule appointments. Patient Financial Advisor delivers personalized estimates and payment options using the patient’s mobile device. Estimates are based on real-time benefits information and the payer’s contracted rates and pricing. Giving patients access to a range of information, using channels they prefer, helps them navigate the process at their convenience. Collections Optimization Manager helps providers target their collections, so they can direct resources where they’re most likely to succeed. Altogether, digital solutions that help improve the payment experience for patients can also help optimize the payment process for providers by making cost and payment information easily accessible to patients. It also creates behind-the-scenes efficiencies that streamline billing and collections for providers. Providing patient estimates is just the start.  Improving the patient payment experience at every step is a win for both patients and providers. Patients need clear information about treatment costs, insurance, and payment options to proactively plan their treatment and finances. But when providers put the systems in place to improve the patient's financial journey, they benefit too, by making these processes easier and more efficient. An improved patient payment experience may also reduce the need for difficult conversations with patients who are surprised by their medical bills and unsure how to pay them. More information, upfront, sets the stage for a healthier process overall. Learn more about Patient Payment Estimates and the full suite of Experian Health solutions to bring your patient payment experience up to speed.

Hattiesburg Clinic is Mississippi’s largest multispecialty clinic with over 450 physicians serving 19 counties. Claims management, patient collections and payer contract management are handled by the clinic’s Financial Services Department, which includes around 70 staff members. Challenge Hattiesburg Clinic in Mississippi sought to improve financial performance in the wake of the COVID-19 pandemic by focusing on reducing claim denials. The Financial Services Department had been hit by staffing shortages, which affected financial results. A more efficient digital claims management solution would attract and retain a high-performing virtual team, while supporting the shift away from existing paper-based systems. To submit more clean claims the first time, the Department set specific goals to: meet or exceed Epic benchmarks for primary denials maintain accounts receivable (AR) days at 42 or less process secondary and tertiary claims without waiting for the primary electronic remittance advice (ERA) to be posted. Solution Already impressed with Experian Health’s Contract Manager and Eligibility solutions, the Department chose another Experian product, ClaimSource®, to help reduce denials. Loretta McLaughlin, Assistant Director of Financial Services, said she was confident ClaimSource was a good candidate for the clinic’s claims platform: “ClaimSource seemed like the right fit for the department’s goals. The platform’s ability to customize edits, along with the level of customer support available, really set the solution apart from the alternatives.” ClaimSource uses scalable automation to prioritize claims, payments and denials. This allows staff to use their time as efficiently as possible, by working on the highest-impact accounts first. Using customizable edits and extensive national and local payer edits, it checks each claim for inconsistencies before the claim is submitted. ERA data is automatically integrated into Epic so that staff can check a claim’s status quickly and easily. With real-time reporting, staff gets insights from across the entire claim lifecycle to improve performance. Outcome The ability to integrate customizable edits was a big advantage for the clinic. They now have over 90 custom edits that help eliminate time-consuming errors, reduce denials, and allow staff to focus on the right accounts. As a result, Hattiesburg Clinic has achieved a 6.1% primary denial rate, which exceeds the Epic Financial Pulse benchmark. Despite staffing shortages, they’ve been able to accelerate receivables. They’re also seeing accelerated cash flow, now they can pursue claims from secondary and tertiary payers without awaiting the outcome of primary claims adjudication. ClaimSource is also creating a better staff experience: the tool eliminates the need for claims to be printed, so staff can work from any location. Now, over 50% of the team work from home. Thanks to automated workflows, output has been consistent despite a reduced workforce. Being able to submit clean claims the first time has a positive impact on AR days as well as staff workload. Loretta McLaughlin says: “Through ClaimSource’s automation and level of quality work, we have had to do less manual intervention.” To build on this success, the team intends to explore further opportunities to use automation to improve productivity. Options include automatically generating patient estimates, automating bad debt and refund workflows, and allowing patients to verify insurance eligibility through their patient portals. Find out more about how ClaimSource helps hospitals, health systems and physician groups reduce denials, protect profits and increase productivity through automated and scalable claims management.

Hospital margins remain below pre-pandemic levels, leaving providers needing a revenue-boosting remedy. According to a recent report commissioned by the American Hospital Association, margins for 2022 may be down by 37% (at best) compared to before the pandemic, with expenses heading in the other direction. Could automated collections software offer some relief? Expenses are predicted to increase by nearly $135 billion over 2021, of which a significant slice is labor costs. At the same time, healthcare has a vacancy rate second only to the hospitality industry. Resource-saving solutions are essential to ease pressure on existing healthcare staff and maintain operational performance. Patient collections stand out as a ripe opportunity to use automation to improve efficiency, increase revenue and allow staff to make the best use of their time. By streamlining the billing and payments workflow, automation can facilitate faster payments, improve the patient experience and reduce the heavy lift on staff. How should providers leverage automated collections software to maximize the benefits and build a strong foundation for 2023? Automated collections software in practice: PatientDial One example of how automation can improve patient collections is PatientDial, Experian Health’s cloud-based dialing platform. Instead of relying on manual processes to call patients about outstanding balances, providers can use PatientDial to automate patient outreach with inbound interactive voice response (IVR) and data-driven outbound collection strategies, and take payments after hours. This offers three major benefits to providers: 1. Saves staff time and maximizes resources Making phone calls to patients is resource-intensive and time-consuming, especially when patients are increasingly hesitant to answer calls from unknown numbers. Alex Liao, Product Manager at Experian Health, says, “You have a significant portion of the population that won’t answer their phone, but you still have those that do. With a solution like PatientDial we can automate these contact attempts, so collectors don’t have to spend time dialing and leaving voicemail messages.” PatientDial offers inbound, outbound and blended call environments that can accommodate both live agent and messaging campaigns. In 2021, the automated dialer saved clients 900,000 labor hours, while automated voicemail saved more than 1.5 minutes per voicemail. Automation helps to streamline collection efforts and gives staff time to focus on accounts most likely to pay. To leverage this, PatientDial integrates seamlessly with Experian Health’s Collections Optimization Manager. This solution uses advanced data and analytics to segment accounts and routes them to the right collectors and agencies, further maximizing staff time. 2. Increases cash flow and new revenue opportunities The biggest advantage of automated collections software is expediting the payment process. Like many providers, Dayton Children’s Hospital faced difficulties growing in-house collections during the pandemic. Making patient calls was their most effective way of collecting payments, but it had become a lengthy and cumbersome process. After integrating PatientDial, staff was able to increase the number of calls per day from 50-60 to 600, resulting in a corresponding uptick in collections. New patient appointments increased by 70%, creating more opportunities to bring in additional revenue. Liao says, “One of the key takeaways here is that automated collections tools like PatientDial allow you to cast a larger net and maximize collections. The uptick in daily calls was a direct result of the ability to make automated contact attempts, leave messages, and connect those who answered the phone with a live agent standing by.” PatientDial helped clients collect over $50 million in 2021, collecting an average of $176 per transaction. 3. Improve patient engagement with automated collections software Jason Considine, Chief Commercial Officer at Experian Health, notes that it’s not just operational costs and staffing shortages that are giving providers cause for concern. He says, “Federal aid packages are being unwound and the country’s opening back up, so people are spending money on things they weren’t spending money on before. To compound that problem, we have inflation coming in at levels we haven’t seen in decades.” Pressure on household finances could cause patients to start missing healthcare payments. Any steps providers can take to make it easier for patients to understand, plan and manage their bills will pay off in the long term. Automated collections software such as PatientDial removes hurdles for patients so they’re more likely to pay and more satisfied with the process. “We have seen that when patients are provided with the right options, they typically do want to pay. But life gets in the way,” says Liao. “Having phone call reminders and self-pay options through a payment IVR helps increase collections by giving patients additional options that they can use when convenient for them.” PatientDial is just one tool in the box. When used alongside other patient-friendly digital tools, the results will be exponentially greater as the overall patient experience improves and further efficiencies are unlocked. For example, PaymentSafe® is a natural fit. This automates payment processing so patients can pay at any point in their healthcare journey. Every patient encounter becomes a collections opportunity. While financial forecasts may be daunting, there are opportunities to streamline and simplify patient collections to boost revenue and reduce expenses. Automated collections software punches above its weight by providing neat solutions that make better use of limited staff resources, improve patient engagement and boost revenue. Find out more about how PatientDial and other automated collections solutions can help healthcare organizations increase collections in 2023.