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Challenge: a disconnected healthcare ecosystem Exchanging information across the healthcare ecosystem and achieving interoperability is a goal and challenge all healthcare organizations share. While regulations such as the Affordable Care Act introduced incentives and requirements to drive adoption of electronic medical records, they also highlighted a critical gap in healthcare – a universal patient identifier. Impact: Felt downstream across your enterprise The lack of a universal patient identifier, compounded by data integration challenges and the increasing fluidity of patient data, has created significant issues downstream – billing errors, redundant treatments and testing, HIPAA breaches, incorrect administration of treatments and prescriptions, and more. These issues contribute to the pool of preventable medical errors, which is currently the number three leading cause of death in the United States. Solution: Universal Identity Manager Experian Health’s Universal Identity Manager (UIM) accurately identifies patients and matches records within and across disparate healthcare entities, creating a universal patient identifier to facilitate information exchange. Drawing on more than 40 years of experience managing universal identifiers across various industries and leveraging Experian’s consumer demographic information, the UIM achieves higher match rates than traditional industry solutions. Integration flexibility The UIM is integrated within eCare NEXT®, but also supports various API options. It can also be leveraged in conjunction with biometric and traditional Enterprise Master Patient Index solutions. Batch: Receives, processes, and loads patient demographic information via patient data file. Starting with an initial historical patient data file in batch is recommended. The UIM algorithm is applied to accurately identify duplicate records and assign a Universal Patient Identifier (UPI) that can be used to facilitate information exchange across different healthcare entities. The UIM Batch is currently being offered at no charge to the entire healthcare industry. Duplicate Merge Tool: Provides a workflow tool to address duplicate patient records identified through the UIM batch. The Duplicate Merge Tool encompasses robust access and issue assignment management, configurable merge strategies, customizable search and filter capabilities, comprehensive audit trails, and postback or file output options. Search & Duplicate Medical Record Number (MRN) Alert: Leverages in process scripting to perform a real-time search the UIM as patient demographic information is being entered into an HIS during registration. The optimized patient record for each potential patient match is returned. If the search is circumvented, a Duplicate MRN alert will be created within eCare NEXT and prompt manual user review. Real-time search can also be facilitated through a direct API integration. Experian Single Best Record: Leverages an algorithm to look across all linked patient accounts that exist within a client’s enterprise database and aliases and addresses from Experian’s demographic information and returns back a patient’s single best record by demographic field. Data Analysis: Offers standard, premium, and custom reporting options with detailed data analysis across your patient data file. Learn more about Universal Identity Manager here, or contact your account representative for more information.

Sanford Health vetted four revenue cycle vendors to meet their challenges of manual collection processes, bad debt and low employee collection rates. They selected Experian Health largely based on ease of implementation with the Epic platform, products that required little intervention from Sanford’s IT department, a strong team of consulting resources and previous success with other Experian Health products. According to Mike Beyer, Director Patient Accounts, Sanford Health, “Collections Optimization Manager really allows me to segment out and find those patients that have the ability to pay; and to avoid chasing those who instead qualify for our Presumptive Financial Assistance/Charity program.” With Collections Optimization Manager, Sanford Health realized a total in-house patient collection lift of $40+ million since they first implemented in October 2014; with an average monthly lift is $2.3 million. Contributing drivers of this success: leveraging segmentation and Federal Poverty Level (FPL) within Collections Optimization Manager to determine Presumptive Financial Assistance and account routing to our new cloud-based dialer solution, PatientDial. Download the full case study Watch the video

Don’t miss Frank Abagnale at HIMSS17

Experian Health is very pleased to announce that we’ve ranked #1 in the 2025 Best in KLAS: Software & Services report, for our Contract Manager and Contract Analysis product, for the third consecutive year. Contract Manager, when paired with Contract Analysis, empowers healthcare providers by ensuring payers comply with contract terms, identifying and recovering underpayments, and arming them with real claims data to negotiate contracts. This enables providers to negotiate more favorable terms and maintain financial stability.  Clarissa Riggins, Chief Product Officer at Experian Health, says, “In the ever-evolving healthcare landscape, our Contract Manager solution has once again been recognized as the #1 Revenue Cycle Management tool by KLAS for the third consecutive year. This prestigious ranking underscores the significant value our solution delivers to our clients by identifying underpayments and facilitating revenue recovery. We are honored to continue supporting our clients with innovative solutions that drive financial success and operational efficiency.”  Learn more about how Contract Manager and Contract Analysis can help your healthcare organization validate reimbursement accuracy, recover underpayments and boost revenue.   Learn more Contact us

Explore the top reasons for healthcare claim denial and learn effective strategies to minimize denials and improve claim approval rates.

Learn how to build a proactive denial prevention strategy with automation and AI, to streamline claims processing and nip denials in the bud.