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Managing the revenue cycle draws in considerable resources for healthcare organizations, even when it’s working as planned. The American Medical Association puts direct transaction costs and inefficiencies associated with the “claims management revenue cycle” at around 25-30% of overall healthcare spending. But when errors are made and claims end up being denied, providers could end up missing out on as much as The total revenue leakage is probably higher, when you consider the opportunity cost of staff time spent sorting out denials. Among the most common reasons for denials are missing or incorrect billing information, non-covered charges for care, and absent authorizations. Thankfully, these are all issues that can be minimized with the right strategies and tools. By optimizing your revenue cycle from the outset so that claims are right first time, you can save hassle and expense later on. Here are 7 ways to proactively reduce claim denials in your health system. Figure out why claims are denied First things first. You need to understand where denials are occurring in your revenue cycle and why. You can determine the root cause of denials by analyzing data that’s already available to you alongside information on industry trends. A business intelligence tool can help you use advanced data analytics to find opportunities for improvement, and generate actionable insights that are focused on your specific KPIs. Once you know where the weak points are, you can get the ball rolling with solutions. Prioritize the big-impact fixes In all likelihood, most providers will have the opportunity to improve the claims process at several points in the revenue cycle. You can’t do everything at once, so identify the areas with the greatest potential impact on your hospital’s bottom line. Can denials be traced to a particular department, service line or physician? Has a certain payer changed their approach? Compare the cost of implementing processes to tighten up the weak points in the cycle with the amount of revenue likely to be recovered to ensure you get the biggest ROI for your efforts. Automate patient access for more accurate claims Up to half of denied claims occur early in the revenue cycle, during patient access and registration. Automating the patient access workflow with real-time data can create a more efficient and accurate process, linking front and back office staff with shared systems that minimize errors and staff time. Martin Luther King Community Hospital experienced these efficiencies first-hand, when they integrated eCare NEXT® within their existing Cerner® system. As a result, their registration process became more streamlined, enabling them to cut two to three minutes from more than half of their registrations. Ensure patient matching is as accurate as possible Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1000 for each mismatched pair of records, that’s a lot of lost revenue. Resolve your patient identities with the most robust data sources, and not only will you reduce claim denials, you’ll also have a more complete picture of each patient, which in turn will give them a better patient experience. Streamline prior authorization checks A survey by the American Medical Association found that prior authorization checks created a substantial burden for providers, with physicians spending an average of nearly 15 hours per week dealing with related tasks. For patients, this process can lead to delayed or even abandoned treatment. Using automated software, you can check claims against payer rules for medical necessity, frequency, duplication and modifiers, so you can quickly spot any claims that may be denied and correct them before submission. Process claims effectively Once you’ve streamlined the front-end of the claims process, you should of course look for ways to improve efficiencies throughout the rest of the cycle and immediately before the claim is sent to the payer. In fact, providers are expected to invest up to , as the need to crack down on denials grows. Submitting claims in the correct format is a common and frustrating challenge. Since each payer has different requirements and formatting preferences for claim forms, edits should be customized. A revenue cycle service provider can help you build these custom edits and check each claim line by line, so you can submit with confidence and avoid having to redo them later. Monitor and analyze your revenue cycle Regular analysis is essential to consistently improve denial rates. By monitoring your internal processes across a range of metrics, you can gain a holistic view of the entire revenue cycle to see where there are further opportunities to optimize performance and prevent denials. When you have confidence in the freshness and accuracy of your data – including patient access data, payer performance information and patient matching – you can make confident decisions about exactly what needs to happen to improve your claims denials. Learn more about how leveraging data-driven insights to tighten up your claims management systems and take proactive steps to find lost revenue.

Medical identity theft is a growing problem for the healthcare industry: nearly 15.1 million patient records were compromised in 2018, an increase of nearly 270% on the previous year. While providers are busy rolling out patient portals and electronic medical records to better serve consumers, criminals are sneaking through the cracks to steal patient data and profit from vulnerable health systems. The rapid rise in medical identity theft is partly explained by the fact that it goes undetected for much longer than other types of identity theft, giving criminals more time to use stolen personal information for financial gain. It’s also a lot more lucrative. Medical identities can be used to access treatment and drugs, make fraudulent benefits claims and even create fake IDs to buy and sell medical equipment. This can be devastating for victims, both emotionally and financially. Unlike credit card theft, where victims aren’t considered financially liable, 65% of people who fall prey to medical identity fraudsters are left with hospital bills running into the tens of thousands. The compromised medical record is tough to reconcile, jeopardizing future medical treatment. For providers, a data breach can mean significant reputational damage and loss of trust, and huge financial consequences – each breach costs an average of $2.2 million. But what’s most alarming for providers is that more than half of data breaches originate within the organization. Unfortunately, many providers lack sufficient security protocols and detection tools to safeguard the data they’re holding. The good news is that the tools exist to help you protect your patient data. What can healthcare providers learn from other industries about identity protection? Banking and financial services have pioneered identity protection over the last twenty years, and healthcare can learn a lot by looking at what’s worked in those industries. For consumers, using digital technology to pay your bills, book flights and buy pretty much anything is the norm, all with reassuringly quick fraud detection and resolution. Healthcare has been a little slower to embrace digitization in this way. Despite the opportunities, fears around security, privacy and inconveniencing patients have stalled efforts to transform outmoded processes. Drawing on two decades of innovations in other fields, fast-paced technological developments mean many of the early challenges around implementing safe and secure patient portals have been overcome. 6 strategies to keep patient data safe Here are six smart ways to ensure your organization has done everything possible to safeguard patient data. Tell your patients how you’re keeping their data safe Patient trust is at the heart of a successful patient-provider relationship. Share the steps your organization is taking to secure patient information, so patients feel reassured and confident in using their portal. Data security should be a key strand in your patient engagement messaging. Verify patient identities to protect access to medical records To avoid HIPAA violations, it’s critical to ensure you’re giving access to the right patient. Secure log-in monitoring and device intelligence can help you confirm that the person trying to log in is who they say they are. When something doesn’t add up, identity proofing questions can be triggered to provide an extra check. In an exciting new development, the healthcare industry is also starting to see the use of biometrics to supplement existing identity-proofing solutions. Just as you might use facial recognition to unlock your smartphone, there are now ways to authenticate your healthcare consumers’ identity using the same technology. Automate patient portal enrollment You want your portal to be as secure as possible, but not at the expense of your patients’ time and effort. An automated enrollment process can eliminate the hassle of long, complicated set-ups and reduce errors at the same time. Arm your organization with a multi-layered security strategy There is no silver bullet for protecting patient information—it will require various tools. A robust data security strategy will be multi-layered, including device recognition, identity proofing and fraud management. Educate staff on security threats and warning signs Data breaches aren't all malicious – human error is a massive component, from mailing personal data to the wrong patients, to accidentally publishing data on public websites or leaving a laptop behind after getting off the subway. Training staff on the potential pitfalls will help them help you in protecting confidential patient information. Develop a robust device strategy ‘Bring Your Own Device’ arrangements (BYOD) are convenient for staff and patients, but personal devices need to be secured when accessing patient information across the network. Make sure your teams, patients and visitors are aware of how to log-on securely to WiFi and follow best practice to keep data safe. In a climate of ‘doing more with less’, healthcare leaders are turning to other industries to find ways to boost quality of care and streamline operational efficiency. Automation, digitization and consumer-centric approaches make good business sense across the board, but they’re sensible investments for your data security strategy too. Investing in secure patient identities is a way to prevent painful and unnecessary losses down the line – and it’s what patients have come to expect. — Find out what more you could do to shore up your data security and prevent medical identity theft.

“Build it and they will come” might work for 1980s movie characters, multinational coffee franchises and beloved sports teams, but it’s not a great engagement strategy for most consumer-facing organizations – especially in healthcare. Take patient portals, for example. Giving your patients a way to access their health records can help improve their health outcomes, increase compliance with care plans, and create a more positive healthcare experience overall. But do your customers know the portal exists? Do they know how it could serve them? Do they trust it? You’ve built it, but how many patients are actually logging on? In 2017, over half the US population had access to a patient portal. Around half of those people used it at least once in the previous year. Of those who didn’t, 59% said it was because they didn’t feel they needed to access an online medical record, and 25% were worried about privacy and security. This tells us two things: If healthcare providers want to increase the number of patients using their portal, they need to proactively communicate the benefits to those patients, and healthcare providers could do more to reassure patients they take portal security seriously. If patients discover that using the portal is better than not using it, and that they can do so securely, they will be more likely to log on. You can address both in your patient engagement and marketing strategies. Perhaps the better mantra is: “if you solve their problem and tell them about it, they will come”. Balancing portal security and patient convenience Your patient portal is more than just a platform for patients to access test results, sort out bills or schedule appointments. It’s a way to nurture the patient-provider relationship. And at its heart, that relationship is about trust. One way to build trust is to ensure your portal meets the strictest of security measures without creating an excessive admin burden for patients. You can do this with a security strategy that layers up several protective measures to help you tackle common areas of vulnerability, including weak ID verification, over-reliance on password-protection, and failure to encrypt sensitive data. A few practical ways to keep your patient portal secure include: using ID verification when someone signs up for the portal using device intelligence and identity proofing when a user signs in to the portal deploying extra security checks where the risk of identity fraud is higher putting systems in place to flag and respond to security breaches as fast as possible. A solution like PreciseID® can help you take care of your patients’ privacy and security behind the scenes. They’ll see just enough to reassure them that you’re taking their security seriously, without any protracted log-in process that puts them off using the portal altogether. Marketing your patient portal so more patients benefit from it Solving your patients’ concerns about security is just one route to boosting portal utilization. Another important way to ensure more patients use and benefit from the patient portal is to actively encourage them to access their online records regularly. Research suggests individuals who are encouraged to use their online medical record by their provider are almost twice as likely to access it, compared to those who weren’t actively encouraged. So how do you convince your patients of the benefits of regularly logging on? That it’s not just a convenient way to manage their medical journey, but could result in better health? The answer lies in consumer data – the lifestyle, demographic, psychographic and behavioral information that gives you a fuller understanding of what drives your patients. Experian Health’s ConsumerView data analytics can capture insights that let you reach out to your consumers with the right message, in the right way, at the right time. Do they live a busy lifestyle? Reassure them that the portal can save them time. Are there lifestyle factors that may hinder their adherence to medication? Encourage them to use the portal to make sure their prescriptions are up to date. If you discover your consumers are big social media users, you might target your portal engagement campaign through those channels. Equally, if a consumer doesn’t have any social media accounts, there would be no point investing in Facebook ads. Personalization makes your patients feel taken care of, leading to greater trust, loyalty and satisfaction. Increase patient portal engagement today In the wake of consumerism and IT transformation across many other industries, a tailored and digitally secure healthcare service is a must. “Consumers now expect to be provided with a turnkey, individual experience that is fast and seamless,” said Kristen Simmons, Experian Health’s senior vice president of strategy and innovation. Your patient portal must be seen to provide a valuable and secure service. While there’s a way to go to increase the number of patients making full use of portals, the tools exist to support healthcare providers’ engagement goals. Learn more about how your organization can leverage consumer insights to improve patient retention and engagement.
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- How to test the Yoast Blocks
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Just add them to any page/post and it should work as expected
Just a SEO-based block that was configured by the Yoast team
Just a SEO-based block that was configured by the Yoast team
This is a classic block test, we are testing different features and there baseline functionalities.
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