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Patient Experience and HIX: An Underexplored Connection

Published: October 3, 2013 by Steve Millhouse

Americans who do not currently receive health insurance through their employers or a government program such as Medicaid or Medicare are now required to obtain insurance coverage or pay a penalty tax per the Affordable Care Act’s individual health insurance coverage mandate. These consumers can go to newly created health insurance exchanges (HIX) — offered through the state or federal government, depending on where an individual lives — to enroll in a private insurance plan.

It’s definitely a patient-driven process. So, how can healthcare organizations help? They can take advantage of this opportunity to improve the patient experience by connecting patients with much-needed insurance, while simultaneously mitigating patient payment risk.

Today’s patients want to be armed with as much information as possible. With this new initiative, healthcare providers can help patients navigate the various options offered through the exchanges by calculating how much patients might spend on insurance and by providing a comparison of plan benefits. However, it’s important for healthcare organizations to take this process a step further by screening patients to determine if they qualify for federal subsidies and beginning the enrollment process. Assisting patients in this way not only improves the patient experience, but also benefits the hospital by getting more patients enrolled with insurance, ultimately leading to higher reimbursement for services provided.

That leads to the next likely question: how can healthcare organizations successfully aid in this process? Solutions powered by data and analytics are the key. By using a data-driven approach to HIX screening and enrollment, an organization can identify patients that meet the income criteria for subsidy payments and tax credits, and automate the enrollment process by prepopulating the state’s HIX application form. In much the same way that data is used to screen for various financial assistance programs such as Medicaid or charity care, HIX screening uses key information about a patient’s unique financial situation to accurately determine if the patient qualifies for subsidies to help them pay for their insurance.

Interested in learning how you can improve the patient experience when it comes to insurance coverage? Check out our newest product, HIX Screening and Enrollment, and see how it can help support your patients as they begin to navigate the new aspects of healthcare reform.

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Published: February 6, 2025 by QA MarketingTechnologists

You may also like: Supercharge your COVID-19 vaccine management plan with digital solutions “Experian Health’s ability to move quickly and adapt their self-service platform to schedule vaccines for patients has been an invaluable improvement not only for our operations, but to the patient experience. The power to schedule the vaccine’s second dose after the first is administered helps us deliver on our commitment to providing reliable, quality care.” - Julie Frahm, director of consumer digital products at Sharp HealthCare The unpredictable nature of patient volume is a large part of what makes scheduling for the COVID-19 vaccine so difficult. Before now, providers haven’t had to manage mass appointment slots and registrations tied specifically to vaccinations. And even with those features streamlined, providers are still unsure of the best way to reach out to patients who are eligible for the vaccine to prompt them to schedule their appointment. Already a user of Experian Health’s Patient Schedule solution, Sharp HealthCare turned to online self-scheduling to improve patient access to the COVID-19 vaccine. With the solution in place, patients of Sharp HealthCare who are eligible for the vaccine can schedule their first dose online via computer or mobile phone. After answering a short set of questions, the scheduling solution will guide patients to a calendar of available day and time slots for receiving the first vaccination. After the first shot is administered, Sharp HealthCare staff can schedule patients for their second dose onsite, prior to leaving the office. Patients of Sharp HealthCare are consistently utilizing online self-scheduling to book appointments for their vaccinations. More than 1,000 vaccinations were scheduled in the first three weeks of online self-scheduling being available to patients. The ability for provider staff to help book the second dose of the vaccine for patients has also helped Sharp HealthCare deliver on their commitment to quality care, further ensuring the efficacy of the vaccine for each and every patient. Patients are also enjoying the expanded use of a self-service digital service, especially for a process that has been widely known to, at least thus far, be a detriment to the patient experience. Discover how Patient Schedule can improve vaccine management.

Published: March 26, 2021 by Experian Health

Other blog posts in this series: Segmenting your patient population for the COVID-19 vaccine Engaging patient segments with convenient, secure scheduling solutions Authenticating portal access with automation As the vaccine management process continues to ramp up, providers are focused on how to administer the vaccine to as many people as quickly and efficiently as possible. While certain features like online self-scheduling have helped to speed this process up, especially for those locations that are servicing thousands of patients per day, there are portions of the intake process that are being left behind that will consequently cost providers in the end. We interviewed Dustin Whittier, senior director of product management at Experian Health, about how providers can increase reimbursements for both the vaccine itself and the administration of the vaccine.  How will the volume of patient traffic and offsite administration of the vaccine challenge the reimbursement process? What we’re seeing, particularly at some of these large-scale roll outs, is the entire registration process being stripped. With so many individuals presenting at once for the vaccine, on site staff have significantly less time than usual to collect patient information such as insurance. Many are focused on capturing the bare necessity to quickly and efficiently serve patients. Some are even choosing to forego collecting insurance entirely. Obviously, rushing through the eligibility and insurance process, or bypassing the process itself, will have an impact on a provider’s ability to submit for reimbursement. The ability to confirm identify insurance after the fact may be feasible for a small number of patients, but at this volume, it is nearly impossible. Think of the volume a major vaccine pop-up site might see in a single day, maybe upwards of 20,000 patients. Imagine having a backlog of 20,000 patients to identify and confirm insurance for. It’s a nightmare. What can be done to mitigate these issues? A tool like Coverage Discovery automatically finds available coverage that was previously unknown or forgotten, whether Medicare, Medicaid or commercial insurance. Scans for coverage can be done in bulk, before or after services are rendered, helping providers better identify insurance for patients receiving vaccines. Providers are not only paid faster but can also avoid the collections challenges of self-pay receivables. Interested in learning more about how Experian Health can help supercharge the COVID-19 vaccine management process?

Published: March 23, 2021 by Experian Health

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