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According to a recent survey by PYMNTS, many patients want digital healthcare management tools. 76% of survey respondents said they were “very” or “extremely” interested in using at least one digital method to manage interactions with their healthcare providers, rising to 86% among younger patients. This finding echoes Experian Health’s research from our State of Patient Access 2.0 survey. In this survey, we found that the pandemic had cemented consumer expectations around convenient access to care. Providers that wait too long to open their digital front door risk losing consumers to competitors. The “digital front door” describes how a patient can find and access care through online and digital channels. This can include everything from booking appointments and virtual waiting rooms to contactless payments and telehealth. It’s more than just patient access: digital technology can create convenient and connected patient experiences throughout the entire patient journey. The goal is a patient experience that flows seamlessly between in-person interactions and virtual touchpoints, from finding care to post-visit follow-up. Experian Health’s clients revealed that many have embraced digital tools to deliver a patient experience that matches consumer expectations, driven in large part by the pandemic.* Some are planning to invest in their digital front door within the next year, while resource constraints are hampering others in moving forward. Healthcare providers in the early stages of digital transformation may be wondering where to start. Where should they focus limited resources for the biggest gains? The four opportunities that could offer the greatest return on investment are online scheduling, omnichannel communications, contactless payments and productivity-boosting automation. Help patients find and book appointments with easy online scheduling Last year’s State of Patient Access 2.0 survey found that nearly eight in ten consumers prefer to schedule their own appointments at any time, from any device. This trend is set to continue in 2022 and beyond. Many patients have been using online scheduling platforms to book COVID-19 vaccinations and tests, as well as to reschedule care that was delayed during the earlier months of the pandemic. Opening the digital front door with online scheduling offers patients the control, convenience and choice they desire. No-shows are less likely, which leads to higher physician productivity and satisfaction, greater efficiency, lower costs and better patient outcomes in the longer term. Communicate through patients’ preferred channels to boost engagement With the pandemic necessitating so many rules around daily activities, limits on how and when consumers communicate with their providers can feel even more restrictive. Many don’t want to be forced into phone calls at inconvenient times, especially when a simple text reminder or a quick check of their patient portal would do the job. Providers that allow consumers to customize their patient access experience and engage through their preferred channels will be rewarded with increased patient loyalty. Omnichannel solutions also help to build a consistent care experience. A digital process that looks and feels the same every time, regardless of which platform the patient uses, will make navigating the care process much easier. Additionally, patients will be more likely to schedule appointments and fill out forms in a timely manner on their own, which can alleviate staffing resource constraints. A digital front door can help with contactless payments One part of the healthcare experience that can be notoriously tricky to navigate is paying for care. PYMNTS found that 63% of patients would consider switching healthcare providers over a bad payment experience. Providers can make it easier for patients to pay by offering upfront estimates of what the patient’s portion of the bill is likely to be, running automated coverage checks to make sure no insurance is missed, and sending automated reminders with links to contactless payment methods. According to PYMNTS, less than 20% of patients pay for care before or during their visit. However, if providers made it easier to pay, this percentage would likely shoot up. By offering patients their own mobile financial advisor, they can pay bills and access appropriate payment plans right from their phones. It’s convenient for patients and could help reduce delayed payments. A digital front door can improve patient access and relieve pressure on staff A digital front door doesn’t just open up opportunities for patients; it can increase efficiency and improve staff workflows. Healthcare staffing shortages have put immense pressure on providers to find new ways to automate repetitive tasks and relieve staff burnout while maintaining high-quality patient care. For example, automated scheduling algorithms can optimize patient flow and anticipate bottlenecks, so staff can allocate resources more efficiently. Registration forms that are pre-filled with a patient’s information are less prone to errors, compared to manual processes. Automation helps link the digital front door to the front and back offices, which can speed up workflows, support better care coordination, and create a more consistent patient experience. A high-quality digital patient experience should be built on consumer choice, control and convenience. A digital front door is more than just adding a few online tools or sending some well-timed automated texts; it should be at the heart of the entire patient engagement strategy. By investing in digital solutions that leverage the technology already used by patients and staff, providers can offer a stand-out patient experience and improve collections performance. Contact Experian Health today to find out how digital health solutions can help your organization deliver the best patient experience possible. *Survey of Experian Health clients, October 2021 Are you an Experian Health client? Then we invite you to join our Innovation Studio research community. Your ongoing input is key to driving improvements to our tools and products! Sign up here!

The COVID-19 pandemic has highlighted the need for a more responsive, flexible and resilient approach to revenue cycle management, underscored by provider staffing shortages across the country. Automation is gaining momentum as a way to address the staffing issue while improving efficiency and collections optimization to levels better than those prior to the pandemic. Furthermore, with the No Surprises Act effective as of January 1. 2022, automation and digital tools can help providers deliver transparent pricing with real-time cost estimates. With automated healthcare collections, providers can help patients plan for their healthcare costs. This is especially important, given that half of Americans currently have unpaid medical bills. In North Carolina, Novant Health is already seeing an impressive return on their investment in automated patient collections technology. The provider logged over 5.8 million medical encounters in 2020. Novant Health’s patient finance team wanted to address growth while continuing to deliver an improved patient financial experience. They wanted to automate workflows and processes to reduce the need for staff intervention, using a wide-ranging platform that would easily integrate with Epic and provide robust reporting and insights. Compiling agency performance reports for 21 agencies each month was another cumbersome task, so the team also wanted a partner who would help elevate and monitor agency performance. Watch our webinar with Novant Health to see how they used Collections Optimization Manager to increase patient collections and create better patient financial experiences. Delivering a “human experience” with the right patient collections partner Wendi Bennett, Director of Patient Finance at Novant Health, said it was important for them to find a strategic and collaborative partner who would understand their commitment to providing a remarkable patient experience: “The patient can have a wonderful clinical experience but face a financial experience that falls short of expectations," said Bennett. "We wanted a dedicated consultant who would recommend best practices and provide valuable industry insights, and a system with proven results in back-end automation, operational improvement and analytical performance. We were looking to propel our patient experience to the next level and that’s why we partnered with Experian Health.” Automated healthcare collections insights for a better patient experience and fewer unpaid medical bills Cari Cesaro, Senior Director of Enterprise Healthcare Consulting at Experian Health, is the Collections Consultant who has been working with Wendi’s team to implement the Collections Optimization Manager. Cari explains how the Collections Optimization bundle delivers the data insights and execution support that Wendi and her team were looking for: “We’re able to extract data from the facility’s accounts receivable file and produce robust analytics and insights. That allows us to screen or scrub out those accounts that we should not be scoring or segmenting. Then, we shift to the customized segmentation which provides the client the ability to better narrow down those accounts that represent the highest potential for payment and match these to their calling capacity in-house.  Customized segmentation also gives the client the ability to keep the best, most collectible accounts in-house longer and give the lower yield accounts to their early out agency sooner. We drive revenue back in the door by focusing on these accounts. Finally, we monitor for new insights into patients’ propensity to pay. And with Collections Optimization Manager, our clients receive consultant support as part of the bundle, who provide best practices, insights and analysis throughout the relationship.” Highly predictive patient segmentation means that Novant Health knows which patients are most able to pay, those eligible for charitable support, and who should be directed to different payment plans. This supports more compassionate financial conversations and communications with patients. It also creates opportunities for personalized recommendations, such as reminding new parents to ensure their child is included on their healthcare insurance. The more transparency, simplicity and compassion that can be built-in, the easier the process will be for patients. For providers like Novant Health, that means fewer bills being written off. Efficient allocation of patient collections staff resources Collections Optimization Manager also allows providers like Novant Health to focus their efforts on the right accounts. It doesn’t make sense for staff to spend valuable time following up with patients who have a low co-pay amount and a high likelihood to pay. Simple automated reminders address that situation. The Novant Health team used automated dialer campaigns to reduce manual outbound calls and allocated limited staff resources to more complex accounts. A split-screen shows staff all the information they need during the call, eliminating the need to log into multiple systems at once. Call recordings stop automatically before the patient shares their credit card information, ensuring PCI compliance without extra steps. Keeping track of collections agency performance – and costs With Collections Optimization Manager, Novant Health can prioritize high propensity-to-pay accounts in-house, which helps to manage agency costs. A customized scorecard and dashboard keep track of agency benchmarks, giving the executive leadership team a real-time snapshot of performance, informing decisions about vendor management. The Compliance Manager function helps Novant Health ensure agency collections have compliance at top of mind and are not solely focused on the highest yield accounts. This function, combined with better segmentation and a higher call connection rate, results in higher recovery rates. With Collections Optimization Manager, Novant Health has seen a 5.8% increase in unit yield year-over-year, and an overall recovery rate of 6.5%. Overall increased revenue and cost savings amount to an impressive rolling average return on investment – 8.5:1. Watch the webinar to find out more about how Novant Health boosted its patient collections recovery rates with an automated healthcare collections platform. Find out more about how Collections Optimization Manager can help your organization use automation and digital tools to create a more efficient patient collections process and a more streamlined patient financial experience.

Claims denials are a major source of headaches for healthcare organizations. On average, denied claims can take more than two weeks longer to pay out than first-time claims, if they get paid at all. Denials can have major downstream impacts, including lower annual net revenue, additional hours spent on administrative work, and potential disruptions to patient care. Claims denials aren’t just an occasional inconvenience, either. A recent American Hospital Association (AHA) survey found that 89% of all hospitals and health systems have seen a rise in denials over the past three years, with half of the participants describing the increase as “significant.” Data from Healthcare.gov confirms this trend. The Kaiser Family Foundation (KFF) states that in 2019, health plans available on the individual market denied an average of 17% of all claims – up from 14% the year before. It’s becoming more critical than ever for healthcare organizations to employ integrated, intuitive, and technology-driven strategies to get their claims paid in a timely and efficient manner. Reduce claim denials by eliminating administrative errors and manual processes Health plans can deny claims for any number of reasons. The good news is that in 2019, KFF found that less than 1% of claims were denied based on medical necessity. The bad news is that the remaining 99% were denied largely due to other reasons. This included referrals, prior authorizations, coverage disputes, data errors, and clearinghouse problems. Many claims denial issues occur when organizations rely on manual processing of complex documents that are subject to ever-changing requirements from a wide variety of payers. Mistakes are not uncommon, and that ends up costing time and money. Smart, intuitive claims management workflows that take advantage of automation technology can augment staff resources and reduce the likelihood of errors. Automation contributes to clean and accurate claims the first time around. According to the Council for Affordable Quality Healthcare (CAQH), manual processing can take an average of four minutes per claim. Automation cuts this time by 25%, bringing the total time per claim down to just three minutes. This might not seem like a lot in isolation; however, it becomes more material when the time savings is applied to a large, multi-hospital health system that partnered with Experian Health to revamp its claims processes. The health system gets through 200,000 claims per month. That could translate into 200,000 minutes saved – or more than 3,300 hours – every 30 days. Amidst the staffing shortages that are persistent in healthcare, those numbers are significant. For providers of all sizes, the right automation tools use an expansive library of national payer edits, supplemented by custom edits, to ensure that claims are clean before they get out the door. These tools can also organize and prioritize accounts to help staff members use their time most efficiently. If a claim does have an issue, organizations can use additional technologies to stay one step ahead of the denials process. Enhanced claim status monitoring can give providers insight into potential problems long before the ERA and Explanation of Benefits are processed. This allows organizations to address known issues and predict their revenue cycle outcomes earlier and more accurately. Automation can also help providers slash even more time off the claims management process. The Council for Affordable Quality Healthcare (CAQH) estimates that it takes between 14 and 30 minutes to complete a manual claims status inquiry. Automated status monitoring can potentially shave 9 minutes off this task, freeing up staff to complete other tasks. There’s still plenty of options when claims do get denied. Providers can complement their claims capabilities with denials workflow management tools that can generate customized worklists, highlight ANSI reason codes and payer proprietary codes, and identify payer-specific denial trends to help inform decision-making. Automation creates a faster, more accurate claims processing ecosystem Most healthcare organizations use a number of different technologies to manage their revenue cycles, and all these systems must work together in harmony. Unfortunately, interoperability across disparate clinical and financial systems isn’t easy to achieve. In the case of the provider that chose Experian Health to improve its claims process, integration with Epic, its medical records system of choice, was very important. For example, ClaimSource easily loaded customized edits and the edits library into Epic, tracked and corrected claims, and found and repaired issues with the system build, creating opportunities for cross-training and centralized reporting. Thanks to this automated, integrated process, this provider improved its acceptance rate by 10 percent, consistently seeing 99 percent of its claims accepted. Additionally, its clean, paid claims percentage increased by over 10 percent, creating a more predictable, profitable revenue cycle. With denials on the rise in an increasingly challenging claims management environment, providers will benefit from replacing manual processes wherever possible.  Automation is the key to optimizing staff resources and significantly reducing reimbursement obstacles. To see sustained success with your revenue cycle, get in touch with Experian Health and start automating your claims process today.