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by Rathnathilaga.MelapavoorSankaran@experian.com 0 min read June 2, 2026

A rigorous, tech-driven transformation to develop estimates, identify patient payment solutions, explain billing and collections, and engage with patients.

November 7, 2017 by Experian Health

To keep your healthcare practice out of legal trouble and clear of costly fines, ensure debt collection agencies comply with relevant laws and regulations.

October 31, 2017 by Experian Health

Today’s healthcare consumers are at the center of healthcare transformation. They demand a personalized experience, use devices to monitor their health and are vocal when they are not satisfied with their service or care. Healthcare organizations are being challenged to think differently about healthcare engagement. To succeed, you must become consumer-facing and expand your reach. You need to attract and retain patients for service line growth. Connecting with consumers by tailoring their journey is expected, so you using data to predict health conditions and message effectively is critical. Do you know who your patients are? How to build a relationship with them? Can you improve their satisfaction and retention? Are you providing personalized communications? Superior data with actionable insights can help you remain competitive in this new healthcare landscape. This is a new approach to most healthcare organizations, but it provides an exciting opportunity. Leverage data the right way and gain deeper insights to improve patient and consumer engagement.  To learn more, visit Experian Health’s Marketing Services page, contact your account representative or email us at experianhealth@experian.com

August 29, 2017 by Experian Health

Recent industry shifts, including the transition from volume- to value- based reimbursement, lower reimbursement and shrinking inpatient margins, increased bad debt due to high deductible health plans and other challenges, are causing undue stress for healthcare providers. It’s difficult for some organizations to manage complex reimbursement models or handle complex claims, so providers are often underpaid or write off revenue they are due. The cost to collect continues to rise when staff produces poor results or turnover is high. Additionally, hospital information system (HIS) conversions traditionally result in a backlog of accounts receivable (A/R), requiring incremental staff to support the conversion. 78% of CFOs are concerned about their revenue cycle platform capabilities for value-based payments and will outsource in lieu of investing in new technology.^ Experian Health’s Revenue Cycle Services leverage Experian’s proprietary technologies and experienced staff to optimize revenue cycle management (RCM) performance to help you meet your financial goals, such as increasing A/R yield, lowering operating costs, and resolution of revenue leakage issues and denials. Contact us today to learn more about Experian Health’s Revenue Cycle Services.   ^2015 Black Book Survey

August 28, 2017 by Experian Health

The MongoDB Innovation Awards celebrate organizations building the world’s most innovative applications, recognizing those with a transformative impact on their respective sectors. Recently, Experian Health was recognized for our innovation in healthcare. Our Universal Identity Manager (UIM), which integrates with MongoDB to accurately sequence patient data, can accurately match, manage and protect patient identity. Drawing on more than 40 years of experience managing identities across various industries, Experian Health’s interoperable patient identification solution leverages consumer credit data to improve record quality. Our UIM creates a unique, universal patient identifier to identify patients and link their records to allow entities (pharmacy, lab, payer, and provider) with disparate databases, systems, and data formats to share a single view of the same patient. Accurate and complete information is securely exchanged, minimizing medical and billing errors, and fraud. “We leverage MongoDB to deliver UIM information in real-time – and that makes performance critical,” said Michael Ochs, chief technology officer of Experian Health. “If patient data is delivered out of sequence, it can create multiple issues in the delivery and accuracy of patient information. This technology makes the interoperability and exchange of information across the healthcare ecosystem is an achievable goal. With UIM, it is possible to successfully address problems caused by data integration challenges and fluid patient data.” Our consumer demographic information combined with reference data and referential matching methodologies allow the UIM to achieve higher matching rates and mitigate matching challenges associated with data quality. “We encourage health organizations to adopt universal patient identifiers because there is a well-documented need for it – the absence of which poses both business and safety issues,” said Jennifer Schulz, group president of Experian Health. “Our UIM batch product is being offered to organizations at no charge* to provide a universal patient identifier that will help address the complexities of managing patient identification by identifying consumers in the healthcare ecosystem more accurately.” Michael accepted the award on behalf of Experian Health at the annual MongoDB World event in Chicago on June 21, where he joined 13 other innovative companies being awarded in different categories. This award for Experian Health comes shortly after being recognized in the healthcare industry by Healthcare Informatics as no. 45 on the list of “Top 100 Companies by Revenue.” *Offer is limited to Experian Health’s UIM Batch Process product and shall remain open for such time as Experian Health may decide.

July 12, 2017 by Experian Health

Reimbursement pressures and the real potential of changing regulations require that revenue cycle leaders leverage data and technology to be as efficient and nimble as possible to maximize net revenue, reduce denials, and lower operating costs. Shifting reimbursement models, complex benefit designs and limitations, increased patient responsibility, and growing regulatory pressures are driving near-constant change in the healthcare revenue cycle. Healthcare organizations that used to be paid by the encounter are adapting to emerging trends of also being selected, measured, and paid for how they perform and collaborate with other providers to improve outcomes. This value versus volume movement has forced hospitals, physicians, and other providers to focus on delivering high-quality, collaborative care at a lower cost while enhancing the patient experience, including efficiency and patient sensitivity in the revenue cycle. Experian Health’s Revenue Cycle Analytics provides visibility across the revenue cycle continuum, transforming operational and financial information into actionable insights. By tapping into Experian Health’s vast product workflow data and revenue cycle transactions, you can hone in to optimize specific workflows and compare your facility’s operations and processes against industry peers to make more informed business outcomes. Relevant data is presented for users based on responsibilities. With your internal data, we can Improve your workflows, operational performance, and financial results by leveraging your data across the revenue cycle, matching it, and analyzing the account across the various revenue cycle workflows and transactions Ensure accurate reimbursement by analyzing workflows and optimizing activities Create and monitor revenue cycle KPIs around pre-service, point-of-service, post service, denials, etc. to provide data points needed for process and financial optimization Provide comparative analysis and benchmarking that scores payer performance based on claim, rejections, denials, and exceptions Identify trends by drilling down to the staff, department, and service levels to uncover insightful details Maximize return on investment in Experian Health revenue cycle management products Enable the calculations of HFMA Map Keys and NAHAM Access keys for true peer-to-peer benchmarking With decades of Big Data experience, and as experts in gathering and securely managing huge quantities of data, Experian Health’s Revenue Cycle Analytics manages an unrivalled breadth and depth of data to help clients gain a deep understanding of people, businesses, places, economics, and health.  

June 8, 2017 by Experian Health

Yale New Haven Health (YNHH) established a goal to elevate the patient financial experience by compassionately educating patients about the finances surrounding their care, and educating staff on the tools and methods for delivering that message. YNHH embarked on a two-year patient financial advisory initiative, including patient and family advisors, to hear opinions and learn valuable information directly from consumers. According to Sharlene Seidman, Executive Director Corporate Business Services, with Yale New Haven Health: “We needed a consumer-focused price transparency strategy that would bring us on par with other industries, like retail. Our goal was that when patients discuss their overall YNHH experience, it is not just reflective of their clinical care, but their financial care as well.” Since going live with Eligibility and the Epic integration in May 2016, YNHH has made major strides toward meeting its pre-service excellence goals in four key areas 1) the right technology, 2) best practices, 3) patient interaction/engagement, and 4) employee culture and education. Read the full case study here

June 8, 2017 by Experian Health

Consumers have come to expect the ability to check things off their to do list while online, like booking travel, shopping, etc., so it only makes sense for healthcare organizations to empower patients to schedule their medical appointments online, too. Not only is it easy and convenient for them, but it also saves your staff time. With today’s focus on value-based care, providers must ensure patients follow through with orders for care. Typically, over one-third of patients receive an order, but 20% never schedule a visit, putting their health—and your organization’s reimbursement levels—at risk. Using an online scheduling platform enables patients to schedule appointments online—improving patient access by fostering the integration and communication to make sure both patients and providers have a better care experience. Experian Health’s Patient Schedule is an online, data-driven scheduling platform that enables patients to schedule their appointments online. Patient Schedule helps you ensure patients are being scheduled for follow-up into your network, automates scheduling workflows with business rules to enable you to define appointment criteria, and even integrates in real-time with your practice management system and electronic medical records. If you’re ready to upgrade the patient experience, improve completion rates, optimize capacity, outcomes and practice performance, acquire new patients and keep them engaged, save time by enabling call-center agents to schedule directly into referral providers’ systems and improve staff efficiency and optimize provider calendars, find out more about Patient Schedule. Read our press release: Experian Health and MyHealthDirect team up to improve practice workflow with cloud-based patient scheduling across healthcare networks On Demand NAHAM-hosted Webinar: “You Can Book Flights Online – Why Not Medical Appointments?

June 8, 2017 by Experian Health

Look forward to a better bottom line—and increased patient satisfaction Many providers face a of lack insight into agent performance and call durations, as well as the ability to route telephone calls to representatives based on experience or inquiry type. Others use manual vs. automated processes to call patients with outstanding balances. Having the ability to both contact patients and take inbound calls using a cloud-based dialing platform can significantly increase your collections and penetration rates. Some platforms can even provide the ability to monitor agent activity for performance and take payments after hours when no live agents are available, and provide access to actionable insight into call volumes and durations, giving you the ability to make more strategic decisions and adjust process flows. Increase the effectiveness of your collection and patient engagement strategies by pairing online and print communication channels using outbound and inbound dialing technology. Experian Health’s new cloud-based dialing solution, PatientDial, arms providers with the tools and data needed to make strategic decisions and increase calling campaign effectiveness and the collections bottom line—all without the need for costly hardware and software upgrades. PatientDial assists with patient outreach for patient collections and patient engagement processes and workflows. Services include inbound, outbound and blended call environments and can accommodate both live agent and blaster (unattended) messaging campaigns. IVR services are available to route calls to the proper type of agents and handle payments after hours. When combined with our PaymentSafe solution, PatientDial enables patients to make automated payments via telephone, and combining with our Collections Optimization Manager solution further increases ROI by leveraging screening results and segmentation to drive strategy solutions. Learn more about PatientDial Read the Sanford Health case study  

June 8, 2017 by Experian Health

Multi-specialty, academic, non-profit healthcare delivery system increases productivity and improves resource efficiency The prior and pre-authorization inquiry and submission processes within patient access can be challenging for healthcare providers, as it’s often manual, cumbersome, and steps within the process can be missed or poorly integrated—frustrating both staff and patients. Experian Health’s Authorizations helped one of its healthcare delivery system clients increase efficiency and empower staff to spend more time with patients to discuss estimated liability and financial responsibility and provide them with payment plan options. “We needed an authorization solution that was integrated within our Epic workflow, easy-to-use and that our team could rally behind. We found that solution in Experian Health’s Authorizations tool.” —Director, Pre-service Center, multi-specialty, academic non-profit healthcare delivery system Inquiries are now automated and take place behind the scenes without user intervention. Submissions guide the user through the workflow, auto-filling all payer data and only prompting the user only when manual intervention is required. Hear more about this client’s success using Authorizations. Read the full case study.

June 8, 2017 by Experian Health

During HIMSS17 in Orlando, Jason Wallis, Senior Vice President, Patient Access at Experian Health, sat down with IntrepidNOW to talk patient access and how Experian Health’s solutions help providers across the revenue cycle. Excerpt below: “We have the eCare NEXT platform that drives a lot of our integration and patient access products. So anywhere from orders, all the way back to collecting payment from the patients, so right identity, checking eligibility, authorizations, medical necessity, patient estimates and then a tool to collect payment from that patient for those estimates. …we’ve really taken this eligibility rail that has been pretty standard in the industry, and we’ve added a lot of content and innovation on top of those rails. So I almost call our clearing house a content network. So we drive more value in that transaction by normalizing, cleaning the data and enriching it with other data assets, so that downstream our clients and our products are better because of that advanced content. …our integrated platform takes this data and be able to start chaining products together, and deliver back to the provider an exception based workflow that really has their staff only looking and working when something’s gone wrong. And the more we can automate around products and even products chaining off of other products, so eligibility to notice of admission, we are able to remove some of those manual single point solutions because it’s integrated in a single workflow.” Listen to the full podcast Learn more about Experian Health’s patient access solutions and eCare NEXT platform  

May 10, 2017 by Experian Health

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Key takeaways: Revenue cycle teams can use automation to reduce repetitive work and apply AI where data-driven prediction, matching or prioritization can improve a workflow. Experian Health’s 2025 State of Claims survey found that 41% of providers now face denial rates of 10% or higher, while 68% say submitting clean claims is more challenging than a year ago. Patient Access Curator™ (PAC) uses AI to support front-end data validation and insurance discovery, while AI Advantage™ helps teams predict denial risk and prioritize denial follow-up. Artificial intelligence (AI) and automation can support administrative work in healthcare. In the revenue cycle, teams depend on accurate information, timely decisions and efficient follow-up to keep claims moving. In revenue cycle management, AI and automation can help organizations reduce manual checks, find data gaps, predict denial risk and prioritize work queues. These tools are most useful when they support staff judgment, payer expertise and compliance oversight. They can handle repetitive, data-heavy tasks so staff can focus on exceptions and decisions that need human review. In 2023, McKinsey & Company reported that research suggests effectively deploying automation and analytics could eliminate $200 billion to $360 billion of spending in U.S. healthcare. For revenue cycle leaders, the practical question is where to apply those capabilities first. The case for applying AI and automation in healthcare Revenue cycle teams juggle many daily tasks. Staff collect and verify patient information, confirm eligibility, identify the right payer, submit clean claims, monitor status, work denials and manage collections. Small data gaps at the beginning of the process can create downstream rework and delays. Rework also consumes staff time, adding to these operational pressures. As costs rise and revenue cycles tighten, there is increasing pressure to do more with less. Experian Health’s 2025 State of Claims survey found that 54% of providers say claim errors are increasing and 90% of claim denials are reworked with at least some human review before resubmission. Providers are also managing broader financial and administrative pressures. The American Hospital Association has reported that prior authorization requirements, claim audits, denials and other payer policies add administrative burden and cost for hospitals and health systems. These requirements also consume staff time to appeal denials and manage payer processes. AI and automation are different but complementary. Automation follows defined rules to complete repeatable work. AI models can identify patterns in data, predict risk and help teams decide where to focus attention. When used together, they can support more consistent revenue cycle workflows. How AI and automation can support revenue cycle workflows Revenue cycle management automation and AI are most useful when tied to a specific workflow and a measurable operational problem. The goal is to help teams act earlier, reduce avoidable rework and focus staff time where judgment is needed most. For example, automation can complete rule-based eligibility checks. AI can help identify claims with a higher likelihood of denial. In insurance discovery workflows, AI can also help identify coverage that wasn’t captured at registration. When these tools fit into existing workflows, they can support more consistent decisions and reduce manual work. Three practical applications include: 1. Improving front-end data quality with Patient Access Curator Patient and coverage information collected early in the revenue cycle can affect downstream claim outcomes. Incomplete or outdated demographic details, eligibility responses, coordination of benefits or Medicare Beneficiary Identifier information can create problems that lead to claim delays or denials later in the cycle. Experian Health’s Patient Access Curator helps prevent claim denials by validating demographics, eligibility, insurance discovery, coordination of benefits and Medicare Beneficiary Identifier data in seconds. PAC’s AI and machine learning capabilities help improve match accuracy, coverage sequencing and data confidence by writing the validated data back into the host system and sequencing payers before the claim is created. This automates work that would otherwise require manual coverage checks. 2. Using insurance discovery to find coverage not captured at registration When active coverage isn’t identified during registration, claims may be delayed or submitted with incomplete insurance information. Insurance discovery looks for coverage that may not have been captured during registration. Patient Access Curator includes insurance discovery as part of its front-end validation workflow. It can help identify and correct missing or incorrect insurance information so claims can be submitted with more complete coverage data. 3. Using AI to prevent and prioritize denials Even with strong front-end processes, some claims still require additional attention. AI can help claims teams decide which claims to review before submission and which denials to work first after payer response. Experian Health’s AI Advantage supports two denial management use cases:1. AI Advantage – Predictive Denials uses a client’s historical claims data and Experian’s knowledge of payer rules to identify claims with a high likelihood of denial before submission so teams can take corrective action.2. AI Advantage – Denial Triage uses AI to segment denials and identify those with the highest potential for reimbursement. This approach can help teams prioritize with more confidence. Rather than treating every claim or denial the same way, teams can use predictive models to focus on the work that needs the most attention. Potential benefits of AI and automation in the revenue cycle A high-performing revenue cycle depends on timely, accurate and consistent work. AI and automation can help providers modernize that work without losing the expertise of the people who manage complex payer and patient situations every day. When applied to the right workflows, these tools can help organizations: Reduce manual data searches that take staff away from higher-value work Improve front-end data quality before claims are created Identify missing or incorrect coverage information earlier Spot claims that may be at higher risk of denial Prioritize denied claims by potential reimbursement Reduce rework caused by inaccurate or incomplete information Give staff more consistent information for follow-up decisions A focused AI strategy starts with the workflow problem, uses data that is relevant to that problem and keeps staff in control of judgment-based decisions. A more proactive approach to revenue cycle management Revenue cycle teams can move from reactive work toward a more proactive approach: catch errors earlier, validate coverage before claims are created and prioritize the claims and denials that need the most attention. Experian Health offers revenue cycle solutions that use AI and automation in targeted ways to support front-end data quality, reduce rework and manage denials. Patient Access Curator supports registration and coverage validation, while AI Advantage supports denial prediction and triage. Learn more about Experian Health’s Patient Access Curator and AI Advantage.

October 2, 2026 by Andy.Monte@experian.com
Experian Health ranked #1 in Best in KLAS for 2025

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

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