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Consumers can order groceries or rent a car with just a few clicks, so paying for medical care often feels frustratingly complex in comparison. Bewildering pricing information and limited payment options leave patients with a poor impression of their healthcare experience, no matter how good their clinical care is. If patients are confused about what they owe and how to pay, they’ll end up missing payments and even delay care. Creating streamlined billing and payment processes and automating patient payments makes life easier for patients and providers, especially as they shoulder more healthcare costs. Here are 6 reasons why providers should consider automating patient payments with tools like PaymentSafe®, to increase patient satisfaction and accelerate collections. 1. Customized payment options One of the top reasons to automate patient payments is the ability to deliver a personalized experience to each patient. No two patients have the same financial situation, employment circumstances or desire to use digital technology. Why expect them to thrive with a one-size-fits-all billing and payment solution? Automated patient payment services draw on multiple sources of data to generate individualized insights at a scale, speed and level of detail that would be impossible manually. For example, Patient Payment Estimates produce instant, pre-service cost estimates based on the patient’s specific care requirements and coverage. It pulls in real-time payer rates and provider charges to make sure the patient has an accurate estimate from the start. By giving patients accurate, timely and relevant billing information and payment options, providers can increase collections earlier in the revenue cycle and meet patient expectations for a convenient consumer experience. 2. Reduced operational costs The longer a patient bill goes unpaid, the less likely it is to be recovered in full. Each additional billing cycle adds to the cost to collect. Staff must spend more time making outward collections calls, handling billing queries and issuing monthly billing statements. Automating patient payments eliminates much of this expensive extra work and reduces overall collections costs. Providers can automate manual tasks such as checking for charity eligibility or clearing up patient records, as well as, leveraging automated dialing and texting solutions to communicate with patients and help short-staffed teams focus on the tasks that matter. 3. Timelier patient payments The common denominator in these automated payment solutions is that they all help patients clear their balances sooner rather than later. Patients can move on with their lives without bills hanging over them, and providers will see a healthier bottom line. With convenient and compassionate tools, each patient encounter can be an opportunity to collect. For example, PaymentSafe® enables providers to accept secure payments anywhere, anytime, using eChecking, debit or credit card, cash, check and recurring billing, through a single, easy-to-use web tool. A connected healthcare collections ecosystem can deliver the data needed for pre- and point-of-service payments, including insurance verification, patient responsibility assessments, financing options, and payment methods. 4. Better balance management According to Experian Health and PYMNTS data published in July 2022, nearly half of consumers who canceled appointments last year did so because of cost concerns, while a fifth spent more on healthcare than they could afford. Making bills manageable with automatically generated payment plans will take a huge weight off their shoulders. And in another joint report, Experian Health and PYMNTS find that patients welcome more flexible ways to spread out the cost of care. Financial stability seems to influence whether patients embrace payment plans. Of those living paycheck-to-paycheck, patients who struggled to pay bills were twice as likely to use a payment plan than those who did not struggle to pay bills. However, lower-income patients may be underutilizing payment plans, as 9% had yet to pay the bill from their last visit. Manually setting up payment plans can be time-consuming and tricky to get right. Patient Financial Clearance automatically calculates the most appropriate and affordable payment plan for each patient, based on their individual financial situation. Those that are likely to be able to pay upfront can be encouraged to do so, otherwise, they can pay in more manageable chunks. Read the report: “Managing Healthcare Costs: How Patients are Using Payment Plans” 5. Reduce the risk of errors A significant downside to manually managed patient collection processes is that it’s all too easy to replicate errors. Patient information may be outdated, causing statements to be mailed to the wrong address. Active insurance may be undisclosed, leading to missed opportunities for reimbursement and higher patient bills. Inaccurate financial or employment data may prompt staff to chase accounts that have a very low chance of being paid. In short: errors are expensive. Automation solves these challenges. Coverage checks, pre-authorizations and eligibility verifications can be completed automatically, giving providers and patients greater confidence in billing breakdowns. Error-free billing means patients are more likely to pay their bills sooner, saving providers time and money across the entire revenue cycle. 6. Improve patient experience Ultimately, automation helps providers deliver a more streamlined, secure and satisfying patient experience. Experian Health’s State of Patient Access 2.0 survey found that more providers were offering alternative payment methods and upfront billing estimates to make payment easier for patients. They were also introducing payment options at the start of the patient journey, which gives patients control over how and when they pay, and minimizes the risk of late and missed payments. Patients feel empowered when they have more control over their healthcare spending; when they are unsure about what they owe or how they should pay, payments will take much longer. This is about more than prompt payments: 6 in 10 patients who received an unexpected bill or inaccurate estimate say they would switch healthcare providers for a better payment experience. Automating patient payments is table stakes These are just a few examples of the advantages of using automated payment services for patients. Patient demand for convenient and flexible digital payment methods is not going anywhere. Providers must keep pace or risk patient attrition later. Digital processes can make the collections team’s jobs easier and more satisfying and are viewed as a way to retain staff as managers continue to address the many challenges that remain from the pandemic and now, inflation and economic uncertainty. Experian Health’s suite of healthcare collections solutions is designed to be user-friendly to minimize training requirements, and collections consultants are on hand to support whenever needed. Tips to maximize the benefits of automating patient payments When choosing a patient payment solution, providers should look for ones that: use robust data sources offer tracking and reporting tools come with adequate training, support and service-level agreements deliver a seamless experience for patients in alignment with client product offerings. Collect payments anytime, anywhere, with Experian Health’s PaymentSafe®, the automated payment processing solution that helps you increase collections earlier in the revenue cycle and avoid bad debt.

Up to 15 million Americans may find themselves without healthcare insurance when the COVID-19 public health emergency (PHE) ends. The PHE has been renewed until January 11, 2023, and while further extensions haven’t been ruled out, the Centers for Medicare and Medicaid Services (CMS) has advised healthcare providers to prepare for a return to pre-pandemic rules. Looming uncertainty over coverage has consequences for both providers and patients. This article looks at what providers may expect as the PHE comes to an end, and specifically, how to proactively verify insurance eligibility to maintain cash flow and help patients navigate the changes. How will insurance coverage change when the PHE ends? Emergency legislation has required Medicaid and the Children’s Health Insurance Program to maintain continuous enrollment for the duration of the PHE. When the previous rules resume, states will have 14 months to process eligibility checks for Medicaid and CHIP enrollees. The US Department of Health and Human Services (HHS) estimates that around 8.2 million Medicaid enrollees will no longer be eligible for coverage. Another 6.8 million eligible individuals may lose coverage through “administrative churn.” Churn occurs when patients fail to provide annual confirmation of Medicaid eligibility. This can occur because of short-term changes in circumstances or because they don’t reply to or understand requests for information. Some patients will qualify for Marketplace tax credits under the Affordable Care Act and others may seek employer-sponsored coverage. But a large proportion may fall into the “coverage gap,” earning too much to be eligible for Medicaid, but too little to qualify for Marketplace credits. The Inflation Reduction Act of 2022 extends access to enhanced Marketplace provisions until 2025, which may bridge the gap for some. HHS lists a number of additional actions that may be taken at the state level to mitigate potential coverage loss. This includes the adoption of Medicaid expansion, outreach and engagement campaigns. It also includes investments in end-of-PHE preparedness, staffing capacity and in eligibility and renewal systems. What do these changes mean for providers? Providers must be proactive in managing the disruption that could occur when millions of patients lose or change coverage. If more patients are without coverage and unable to pay for services, this could lead to an increase in uncompensated care, which costs providers millions in lost revenue. The process of verifying insurance for those with coverage is likely to be more complex, which could also affect providers’ bottom lines. Changes can increase the risk of errors, which could lead to more claim denials. Longer verification checks may cause delays in patient registration and higher call volumes, creating extra work and stress for staff and a poor experience for patients. The end of the PHE may also affect access to vaccines and food benefits, both of which were expanded under the emergency legislation. These changes could lead to an influx in calls and queries which could compound pressure on staff. These staff pressures are a particular concern given ongoing hospital staff shortages. A possible surge in COVID-19 and flu hospitalizations over winter could ramp up the challenge even more. How can providers verify insurance eligibility? The process of verifying insurance eligibility and benefits involves confirming that: the patient’s insurance information is valid and current they’re eligible to have the services in question covered under their existing plan. A patient insurance ID card is useful, but it’s not enough to prove eligibility. Patient access staff will often check payer websites or call payers directly to verify coverage. This can be a time-consuming and laborious process. Some providers use clearinghouses to run these checks in batches. This can be more efficient than verifying each account in-house but usually takes time to receive confirmation. Another option is to deploy insurance verification software. Experian Health’s Insurance Eligibility Verification solution allows providers to confirm patient eligibility in real-time. The tool connects with over 890 payers to access up-to-date eligibility and benefits data. Responses from multiple payers are modified so registrars can view patient information in a consistent format. Staff gets notifications when edits or follow-ups are needed. The tool also checks self-pay patients against Medicaid databases, which will be invaluable when the PHE ends. Why are automated, real-time insurance checks so important? No one wants patient care to be delayed. By validating a patient’s coverage before the patient arrives, Insurance Eligibility Verification helps fast-track registration. Automated checks also ease the manual burden on staff and handle higher patient volumes more efficiently. This improves operational efficiency, increases cleaner claim submissions and accelerates reimbursement, creating a more satisfying patient experience. Patients will have a clearer idea of what they’ll owe at the time of service, leading to fewer payment delays. What else can providers do to close the gaps in health insurance coverage and verify insurance eligibility? Providers can streamline coverage checks by incorporating automated searches for any missing or forgotten active coverage. Coverage Discovery runs multiple checks throughout the patient journey, using proprietary data repositories, advanced search heuristics and matching algorithms to comb through government and commercial payers to find previously unknown insurance coverage. Fewer accounts end up going to bad debt or written off as charity. This maximizes reimbursement for providers, while reassuring patients who may have believed they were uninsured. A further step to ease the financial burden on patients and increase the likelihood of reimbursement is to combine these solutions with tools that give patients greater clarity about their healthcare bills. For example, Patient Payment Estimates offer patients clear and accurate estimates of their financial responsibility before they come in for care. Patient Financial Advisor provides personalized payment plans so patients can spread out payments in a way that works for them, together with easy payment methods. Find out more about how Insurance Eligibility Verification helps providers verify insurance eligibility, speed up eligibility checks, maximize reimbursements and ease pressure on patients and staff as the continuous enrollment provision unwinds.

As the flu season collides with COVID-19—and an unexpected surge in respiratory syncytial virus (RSV) strains hospital capacity—healthcare providers need digital tools that give patients simple, easy access to appointment scheduling and self-registration, while helping staff meet increased demand. Digital appointment scheduling software, together with online registration solutions and automated patient outreach, help providers create a better patient experience, achieve greater operational efficiency, and ultimately improve access to care. 24/7 self-scheduling opens the digital front door A surge in seasonal viruses presents numerous challenges for healthcare providers. The sheer volume of patient calls can be overwhelming for staff. Meanwhile, patients need immediate help, often 24/7. “Patients who are feeling sick, or who have a sick child, are in a vulnerable position,” says Sanju Pratap, Vice President, Product Management at Experian Health. “They need care, but they may also need help figuring out where they should receive that care and how urgent their situation is. Can they wait until the next available appointment, or should they go to the emergency room now?” With patient scheduling software, providers can configure the online self-scheduling process to include key questions about the patient’s symptoms that help determine what the next steps should be. Patients who need immediate medical treatment receive a recommendation to seek emergency care; patients with less urgent needs can schedule appointments online or may be directed to telemedicine visits or urgent care. Digital appointment scheduling tools provide patients with the kind of around-the-clock access they enjoy every day. They already use online portals and mobile apps to book flights, make dinner reservations, and even schedule their COVID-19 vaccinations. They expect scheduling healthcare to be equally convenient. “Patient scheduling software changes the way patients feel about the availability of care. When patients have to wait for the office to open or negotiate with a call-center representative to make an appointment, scheduling feels like a hassle,” Pratap says. “For patients who are accustomed to online scheduling in other areas of their lives, this lack of access could be a reason to look elsewhere for care. Meanwhile, our experience is that providing online self-scheduling can add as many as eight new patients per provider per month. Self-scheduling opens the digital front door.” Making the waiting room a safer space As the flu, COVID, and RSV cause the number of patients needing appointments to surge, online self-scheduling can relieve front desk and call center staff by offloading a large volume of calls—both from patients needing immediate care for viral illnesses and from patients needing to cancel unrelated appointments due to illness. From there, digital tools also improve efficiency and make the waiting room a safer space once patients come in for care. “Patient scheduling software that integrates with patient self-registration and targeted patient outreach can further ease the workload for over-burdened staff,” says Pratap. “After patients schedule online, they receive automated reminders and the opportunity to complete registration forms before they come in for their appointments.” Recent data from Experian Health and PYMNTS found that a third of patients chose to fill out registration forms for their most recent healthcare visit using digital methods, while 61% of patients said they’d consider changing healthcare providers to one that offers a patient portal. Pre-appointment registration keeps sick and contagious patients out of the waiting room, which reduces exposure to other patients and staff, and makes everyone more comfortable. Automated patient outreach can send appointment reminders and follow-up emails to patients who miss their appointments and may need to reschedule. Preparing for a busy season—and beyond Getting ready for a busy virus season is just one reason providers are adding digital tools to improve the patient experience and lighten the burden on staff. Expanded access to appointments, automated outreach, and online registration gives patients the digital engagement they expect from their healthcare providers. Digitalization also improves efficiency. Experian’s Patient Scheduling Software can also provide insights into patient demand and capacity and allows providers to better optimize appointment capacity and the patient scheduling experience. Integrated digital tools make scheduling, intake, verification, billing, and collections more efficient while reducing the need for human input. The result is not only greater capacity for providers, but also greater resilience. The fall and winter virus season may be annual, but it takes on a different magnitude each year. Meanwhile, no one can predict whether a new or recurring virus (think RSV or Monkeypox) will trigger a surge in care needs. Adding digital solutions that can flex with changing patient volume takes some of the strain off staff members who may be stretched thin—and may require care or downtime after catching a seasonal virus themselves. “The challenge for providers lies in identifying and implementing the digital solutions they need to move their operations to a new level, keeping in mind patients’ needs as digital consumers. Patients expect and demand constant and real-time connections. These solutions can help providers grow and thrive even as they experience continued staffing shortages and pressure to find new operational efficiencies and timely access to care,” Pratap says. Learn more about how Experian Health can help organizations implement digital appointment scheduling software, registration solutions, and increase patient outreach.