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Did you know that it costs an average of $25 to rework a single claim?  It’s true, according to a recent Health IT News article. The article goes on further to state that as many as 65 percent of denied claims remain unresolved because they are too costly to rectify. These unpaid claims eventually become lost revenue. Experian Health’s Denials Workflow Manager and Enhanced Claim Status solutions are part of an integrated revenue cycle platform for healthcare providers to manage payer billing and payment processes.  Effective management of these processes directly results in improved cash flow, lower days in A/R, and more efficient operations. Clients converting to our integrated claims and denial solution are experiencing a 50% increase in clean claim rates and faster turnaround on cash. Learn more by visiting our Claims Management page or reserve your spot at one or both of our Claims sessions at the upcoming HFMA ANI conference: June 27 | 1:30pm | Manage Denials to Maximize Reimbursement, Revenue and Cash Flow June 28 | 9:45am | Claims Management

Experian Health has launched Coverage Discovery® on demand, which is integrated into Epic’s EMR. We are the first-to-market with this functionality for Epic. In addition to Coverage Discovery’s batch reclassification of uncompensated care by finding previously misidentified patient coverage across both government and commercial payers by using advanced analytics, multiple data sources and a proprietary coverage optimization engine, the “on demand” feature provides Epic clients with additional opportunities to find coverage early in the revenue cycle—reducing additional downstream processes. By adding the on demand option, Experian Health’s clients can now run Coverage Discovery within their Epic workflow, which will help to reduce errors, save time and ultimately improve their revenue cycle. Every dollar found in our proactive, automated Coverage Discovery solution is a dollar that our clients are not spending pursuing patients for payment, paying for expensive collection agencies, or writing off to bad debt. Coverage Discovery is also available via eCare NEXT®, OneSource and Batch for non-Epic users. Coverage Discovery is providing significant results for over 300 Experian Health clients. In 2015, the solution discovered coverage associated with over $1.1 billion in charges. According to Murry Ford, Director, Revenue Strategy at Grady Health System, “Coverage Discovery consistently delivers value to our organization. Since our June 2015 go-live of the batch product and November 2015 go-live of the on demand product, Coverage Discovery has protected $2.3 million in reimbursement, $509,000 of which resulted from Coverage Discovery on demand queries for inpatient admissions over a two month period.” Read our latest press release, which further highlights Grady’s success using this solution.

Welcome Katie Zibelin, Experian Health Marketing’s newest team member. Katie made her Experian debut in August 2015 as an intern where she supported client events, tradeshows and proposal efforts behind the scenes.  Upon securing her advertising degree from the University of Texas at Austin in December 2015–one semester ahead of schedule–Katie joined the team full time this February. In her current role as a Marketing Coordinator, Katie is responsible for tracking projects, managing vendor activities, conducting tradeshow and vendor research, developing new vendor relationships, coordinating and supervising tradeshow activities and communicating programs and events. Katie also serves as the project leader of our 2016 Regional User Conferences. In her first solo performance at our Southeast Regional Conference in New Orleans, Katie received rave reviews for demonstrating project management and event planning maturity and grace under pressure. Fun Fact: Katie is also an accomplished contemporary dancer/performer/instructor. Please do not hesitate to reach out to Katie with questions regarding any of the upcoming Regional User Conferences at Katie.Zibelin@experianhealth.com.

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.