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Published: November 21, 2025 by Adam.Lewis@experian.com, joseph.rodriguez

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Match, manage and protect patient data

This week, Experian Health is a proud partner of National Health IT Week. U.S. National Health IT Week is a nationwide awareness week focused on catalyzing actionable change within the U.S. health system through the application of information and technology. Comprehensive healthcare reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers. Initiated in 2006 by the Healthcare Information and Management Systems Society (HIMSS), National Health IT Week has emerged as a landmark occasion for using health IT as part of the overall solution to improve America’s healthcare as a bipartisan, federally led, market driven initiative. While the healthcare industry has transformed in the last decade as health organizations have moved to electronic health records (EHRs), it brings us one step closer to the vision of comprehensive care coordination, but fully achieving care coordination across the vast health enterprise is still a long way ahead. While a recent American Hospital Association (AHA) survey showed that nearly all reported hospitals (96 percent) possessed certified EHR technology in 2015, the Office of the National Coordinator for Health Information Technology reports that there is very little coordination of patient data across the healthcare ecosystem. Much of this disconnect begins with the inability to transfer data in a secure manner that will match, manage and protect patient identities across enterprises. "As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies to managing patient information are no longer sufficient," says Karly Rowe, Vice President of New Product Development, Identity and Care Management Products for Experian Health. "Leveraging sophisticated matching technology and outside data sources, can improve patient identification and prevent duplicate or overlapping records which result in inappropriate care, redundant tests, and medical errors – as well as make data accuracy higher for clinical, administrative, and quality improvement decision purposes." To solve the industry problem of matching, matching and protecting patient identities across the healthcare ecosystem, we must start by creating a universal patient identifier (UPI) to make patient data truly interoperable. For example, one of the biggest challenges in managing patient data begins when patients move, change names, or switch doctors and their EHR doesn’t follow them. They have to start over, trying to recall events and dates in their medical history with a new doctor, who is tasked with providing care without the detailed insight into the patient’s medical record. But if that same patient had a universal identifier that allowed healthcare providers to communicate with another healthcare provider about a patient, the new provider would know all the ins and outs of that patient’s history, leading to a more holistic approach to care and higher patient satisfaction. Simply put, a UPI can be thought of as a mechanism to link all patient information and associate it with the right individual based on patient data. This is similar to how credit bureaus link an individual’s credit history to the right individual to ensure accurate reporting. Using a similar model, patient data — and supporting patient demographic data — can be used for the common good to improve patient safety, increase quality of care and reduce mistaken identity risks. The benefits of a UPI extend across the entire healthcare system as well, as it improves the quality of patient identities, which can have duplicate, overlapping and incomplete records. Additionally, a UPI can help eliminate incorrect medical treatments; deliver current and accurate patient data; and prevent identity fraud, HIPAA breaches and incidental disclosures of protected health information (PHI). Ultimately, this will build patient trust through increased visibility and record accuracy. Knowing that preventable medical errors, many of which are the result of incorrect patient identification, are the third leading cause of death in the United States. The creation of a UPI will allow the healthcare industry to facilitate accurate information exchange to stop problems before they start. For example, if a patient shows up to fill a prescription and is mistaken for another patient with the same name and given the wrong prescription, there could be fatal interactions with other medications that patient is taking. The National Council for Prescription Drug Programs (NCPDP) has already started using this technology to establish national patient safety identifiers. A national patient safety identifier, or UPI, is a vendor-neutral, cost-effective solution that will link patient data at scale efficiently and accurately to improve patient safety and care coordination. Identity management is a critical, underlying component to every interaction, and healthcare is no exception. To fully achieve the goal of comprehensive care coordination, creating a UPI to help match, manage and protect patient data is the first step in achieving the interoperability of patient data. Participate in National Health IT Week’s Virtual March and help catalyze actionable change within the U.S. health system through the effective use of health IT.

Oct 10,2018 by

Keeping up with Payer Alerts

Healthcare providers are always balancing a million tasks at once. The most important of these tasks, obviously, is serving patients, which can sometimes crowd out the important but thankless business functions — like keeping tabs on the insurers you're processing. Payers are changing their policies and practices constantly, and those changes are easy to miss when you're focused on everything else you have to do to keep a healthcare organization running. But if a payer policy changes without you knowing, it’s going to cost you. If your denial rate ticks up because of an unknown change in payer policy, you could end up spending thousands of dollars per year to rework those extra claims. The good news, though, is that there’s a tool that can lighten the load. Experian Health’s Payer Alerts service keeps you in the loop about the payer policies and procedure changes you’re too busy to catch. That way, instead of poring over the mergers, acquisitions, and countless other details that affect the insurance industry, you can stay focused on what’s really important — without making sacrifices to your bottom line. How it works With Payer Alerts, every notification you receive is the result of extensive behind-the-scenes work by our software. The program monitors more than 50,000 web pages that payers visit and records any relevant policy changes before preparing an alert for you. The alert contains a detailed summary of those changes and a link to the affected policy. Once you receive the alert, you can just follow the link and make the necessary adjustments to your internal procedures. But given the variety of potential policy changes, those adjustments can be tough to pin down. That’s why every alert categorizes each change by healthcare specialty, allowing you to receive the alerts most related to your organization. And the customization goes further than that.Want an email that describes all relevant administrative changes? Done. Want a web-based portal where you can identify any reimbursement issues? Easy. Regardless of what you need, the alert will be waiting for you in the right platform. Finding ROI in new information Being privy to policy changes without having to sift through insurance jargon can mean a lot for a healthcare organization. “When things change and information is always current, that’s a huge benefit,” says the director of managed care at Rocky Mountain Cancer Centers, a longtime user of Experian Health’s services. When you’re in the loop about what’s covered and what's not, you’ll also be in better shape to increase your revenue and cash flow. RMCC, for instance, reduced its denial rate to 27 percent in its first year using the service and has reached a $1 million ROI on the investment year over year. Payer Alerts isn’t some app that bombards you with pointless notifications every five seconds. By giving you the necessary information to make timely, strategic decisions, the software can help you start running your practice more like a lucrative business. Building the perfect defense Payer Alerts helps healthcare organizations streamline their workflow and maximize revenue through more than just its immediate features; its compatibility with other Experian Health services can provide the perfect defense against the myriad payer issues that might arise. Combining Payer Alerts with our Contract Manager and Contract Analysis solutions not only keeps you up-to-date with policy and procedure changes, but it also helps you target those changes in ways that meet your unique needs. When RMCC realized that sending out individual forms for different information was wasting time, it used its Experian Health software package to aggregate all the data from those separate appeals into a single form. This helped the company reach its efficiency improvement objectives, satisfying both patients and staff. Ultimately, you can’t fix any issues with your insurance processing if you don’t know they exist, and you won’t even know there’s an issue if you aren’t aware of the constant policy changes in the industry. While you can’t stop these changes from occurring, you can invest in a system to adapt to them and avoid the agony of having to scrutinize it all yourself. If you're ready to learn more about Experian Health's Payer Alerts, get in touch with us today. To learn more about how RMCC used Payer Alerts to increase revenue and cash flow, download the case study.

Sep 18,2018 by Experian Health

Wasteful ordering? Meet Order Manager

Last year, the National Academy of Medicine estimated that excessive and unnecessary medical tests waste at least $200 billion a year in the United States. The same report estimated that, in addition to the monetary costs, the mistakes resulting from unnecessary tests and treatments can lead to 30,000 deaths annually. No healthcare organization wants to write wasteful and unnecessary medical orders — they're bad for patients and for business. Unfortunately, given the fact that so many providers might be submitting and fulfilling orders for one patient, finding a way to organize a patient's treatment schedule in the most effective and efficient way can be difficult. For many healthcare organizations, however, Experian Health can provide a solution: Order Manager, a web-based platform for tracking treatment orders. Order Manager in action Experian Health’s Order Manager is a component of its comprehensive eCare NEXT® suite of healthcare workflow solutions. Order Manager facilitates communication between every player in a patient’s course of care — hospitals and health systems, standalone clinics, community physicians, and even testing facilities can all verify or update a patient’s testing and treatment schedules when necessary. Order Manager integrates data into a patient's electronic medical record so all supplementing data or documents he or she accumulates are captured and organized within a centralized interface that has actionable suggestions. The all-in-one platform gives providers a GPS-like ability to track an order until it's completed, and every provider in the patient’s circle of care can see what tests have been ordered, what medications have been prescribed, and what the results have been. With Order Manager, staffers don’t have to manually place orders or call the patient’s original hospital or doctor to verify prior authorizations — no more duplication, no more conflicting and dangerous treatment plans, and no more confusion. When ordering systems aren't automated, it doesn’t just affect patient care; the labs that fulfill the orders are getting squeezed by inefficiencies, too. For Aegis Sciences Corporation, a leader in healthcare and forensic laboratory sciences, Experian Health’s Order Manager helped optimize order processes as efficiently as it has for hospitals. Aegis Sciences wanted to provide staff members with the tools they need to consistently provide a positive experience to patients and the physicians they work with, and Order Manager has been an important tool in helping the company do so. The web-based platform improved efficiency and reduced costs by transforming operations into fully paperless processes. Healthcare staff at Aegis Sciences said Order Manager was key in supporting the quality of the organization’s work, particularly the processes that require certain authorizations to be completed before tests can be ordered. With the help of Order Manger, Aegis Sciences was able to reduce the time spent on tasks such as accessioning — the arduous process of logging and sorting a sample in a larger data collection — to less than a minute. In fact, according to Aegis Sciences: "Experian Health's Order Manager teams were key in helping us realize our vision of a fully paperless process that could improve our workflows and processes to keep pace with our exceptional growth. We're now able to offer a fully paperless process to our clients and require that certain fields, such as demographics and diagnosis codes, be completed on the front end." Client satisfaction at Aegis Sciences has risen thanks to a 27 percent reduction in errors and necessary follow-ups, as well as a 76 percent drop in attestation statements during the verification process. To learn how Experian Health's Order Manager can help your organization improve the quality of care for your patients and consumers, feel free to contact us today. Our team can assess the role that Order Manager could play in your organization's workflow and help you implement it in the most efficient way. To read more about Ageis Sciences' experience, download this case study.

Sep 11,2018 by Experian Health

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Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

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Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

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Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.

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How healthcare providers can prepare for flu season

Flu season is rapidly approaching, which means healthcare providers must ramp up their preparedness efforts. What can they do to ensure they're ready to meet the seasonal surge in demand? Recent data from the southern hemisphere, often a forecast of what's to come in the US, suggests that this year's flu season will likely be similar to last year. The CDC warns that while “we cannot predict what will happen in the United States this upcoming season, we know that flu has the potential to cause significant illness, hospitalizations and deaths.” With hundreds of thousands of people hospitalized each year, providers must find ways to prepare for rising patient volumes and manage the risk of infection among patients and staff to keep services running smoothly. Making it as easy as possible for patients to book and attend vaccination appointments will be critical. Digital patient access will be the key to streamlining patient care. Using digital tools to prepare for flu season 2024-25 As services face increasing pressure, digital and automated tools can help healthcare providers prepare for flu season by easing staff burdens. More patients mean more appointments to schedule, more registration forms to fill out and more people in waiting rooms. Opening the digital front door helps manage high volumes by allowing patients to complete more access tasks online and prevent bottlenecks. Here are three strategies to implement to support staff and patients through a challenging season: 1. Manage infection risk with online self-scheduling An online patient scheduling platform has two clear benefits – it relieves pressure on staff during busy times and gives providers control over patient flow. Fewer calls need to be made by call center agents. No-shows are less likely because patients can book, reschedule and cancel appointments, and receive automated reminders, which makes the best use of physicians' time. Online scheduling also plays a part in infection control as providers can incorporate screening protocols to identify patients with symptoms of COVID-19 or flu, and manage their onward care pathway appropriately. Empowering consumers to take control of their healthcare with a patient scheduling system might encourage vaccine registrations, which could help reduce the burden on health services when staffing shortages remain stubbornly high. What's more, patients now expect the flexibility and convenience of scheduling appointments at a time and place that suits them. Experian Health's 2024 State of Patient Access survey found that six in ten patients want more digital tools to manage their healthcare. This indicates a growing demand for easy, simple and transparent processes. Watch the webinar: See how IU Health used self-scheduling to manage increasing patient volumes with less staff – and gain insights on using digital scheduling to scale operations beyond flu season. 2. Offer mobile registration to manage demand Should patient volumes increase, patient access staff will be under even more pressure than usual. Anything that can reduce the administrative burden will be a win. Experian Health's Registration Accelerator allows patients to complete intake forms and insurance checks through their mobile devices before stepping through the door. Their details can be pre-filled automatically, reducing the risk of error. This creates a quicker, more efficient patient registration experience that minimizes issues for staff to resolve. Mobile-enabled registration is also far more appealing for patients, who'd rather complete registration from the comfort of home than sit in a waiting room filling out lengthy forms. Plus, it reduces in-person interactions, thus minimizing exposure to infection among staff and patients. Given that 89% of patients say digital or paperless pre-registration is important to them, providers that offer online patient intake solutions will have a clear advantage in attracting potential new customers during times of high demand. In practice: See how West Tennessee Healthcare replaced clipboards with clicks with Registration Accelerator. 3. Reduce no-shows and increase engagement with automated patient outreach Providers must communicate proactively with patients to keep them in the loop as the situation evolves. With an open rate of 98%, text messages are a direct and convenient way to communicate quickly with patients. Automated patient outreach can increase vaccination rates by notifying patients about flu shot availability and offering a direct link to schedule an appointment. Automated reminders reduce no-show rates and help ensure no slot goes unused as patient volumes increase. Messages can also include tailored instructions for specific at-risk groups to emphasize the importance of timely vaccination and provide directions. This approach helps manage patient flow, increase patient satisfaction and ensure providers are prepared for the seasonal surge. Contact Experian Health today to learn how digital patient access solutions can help healthcare providers prepare for flu season in 2024. Learn more Contact us

Oct 22,2024 by Experian Health

Finding insurance coverage without SSN

Finding previously unidentified insurance coverage is a high-stakes treasure hunt for healthcare providers. If patients are unaware of active coverage or eligibility for Medicare and Medicaid, they will be left footing a bill that could have been covered by a payer. If they can't afford it, their account may end up being written off to bad debt, and providers will miss out on reimbursement opportunities, leaving millions of revenue dollars on the table. Hunting down missing or forgotten coverage on the spot is a challenge for providers, particularly if the patient does not have a Social Security Numbers (SSN) or the payers in question do not use SSNs to verify eligibility. It's a problem worth solving though and can improve the patient financial experience while preventing avoidable revenue loss. The shift away from Social Security Numbers Historically, providers have used demographic information like Social Security Numbers (SSN) to verify patient identities and locate coverage information. Without a unique patient identifier, SSNs were a stable way to link a person's health information across multiple health systems and payers. However, the use of SSNs for identification and verification purposes has dropped in recent years due to concerns about patient privacy and the risk of identity theft: SSNs give identity thieves a mechanism to assume a person's identity and access financial information and health records illegally. Moreover, SSNs are unreliable identifiers, as it is possible for more than one person to use the same number. Recognizing the need for more secure and trustworthy identifiers, many payers have moved away from SSNs. In 2018, the Centers for Medicare & Medicaid Services began the process to remove SSN-based Health Insurance Claim Numbers (HICNs) from Medicare cards, replacing them with Medicare Beneficiary Identifiers (MBIs). These are now the primary means of checking a person's identity for Medicare transactions like billing, eligibility status and claim status. Similarly, many health plans also shifted away from using SSNs as primary identifiers, instead opting for member IDs or other secure identifiers to verify and track coverage for their members. Find billable coverage with historical data With demographic searches on the decline, providers need a more efficient and reliable way to search for coverage. As a data-driven company with a historical repository of claims data, Experian Health is uniquely positioned to help providers search for coverage. Combining search best practices, multiple proprietary databases and historical information, Experian Health's Coverage Discovery® locates patients' billable commercial insurances that were unknown or forgotten, and combs through Medicare and Medicaid coverage. This flags accounts that may have been destined as a write-off or charity and maximizes reimbursement revenue by identifying primary, secondary and tertiary coverage. Not only do fewer accounts go to bad-debt collections, but providers can automate the self-pay scrubbing process. In 2022, Coverage Discovery tracked down billable coverage in almost 30% of self-pay accounts and found more than $64.6 billion in corresponding charges. Closing the coverage gap caused by Medicaid disenrollment Coverage Discovery offers another important benefit: helping providers offer additional support to patients on lower incomes who find themselves without Medicaid, at least for a short time, following the end of continuous enrollment. As of July 2023, more than 1.6 million Medicaid enrollees were disenrolled. Providers can use the tool to confirm whether Medicaid coverage remains in place, or to uncover any additional billable government or commercial insurance that could give patients peace of mind. Patient Financial Clearance can also help screen patients for Medicaid eligibility before or at the point of service, then route them to the Medicaid Enrollment team or auto-enroll them in charity care if appropriate. Case study: Read the case study to find out how Luminis Health used Coverage Discovery to locate $240k in billable coverage each month. Leverage technology to locate unidentified coverage Thanks to advanced tools like Coverage Discovery and Patient Financial Clearance, it's much easier for providers to locate alternative coverage options for patients, using multiple sources of data. These tools leverage secure identifiers and comprehensive searches across databases, allowing providers to reclaim revenue that may otherwise go unclaimed, and reassuring patients that they won't be left holding an unexpected bill. Find out more about how Coverage Discovery can help find previously unidentified coverage and reduce bad debt.

Sep 13,2023 by Experian Health

6 effective revenue cycle strategies for healthcare providers

Compared to other industries, healthcare tends to be more resilient to economic turbulence. But the weight of the pandemic, labor shortages, rising costs and increasingly complex reimbursement structures are squeezing hospital margins. A Kaufman Hall National Hospital Flash Report in July 2023 found that many hospitals underperformed, and the gap between high-performing hospitals and those struggling continues to widen. Providers must find new and effective ways to improve revenue cycle management, should any new uncertainties emerge. With pressure mounting to increase efficiency and reduce expenses, more providers are turning to automation and artificial intelligence (AI) to eliminate unnecessary manual work and optimize revenue cycle management processes. For example, Stanford Health Care leveraged automation to reduce their cost to collect. Banner Health improved patient collections with transparent price estimates. Schneck Medical Center zeroed in on claims management and incorporated AI to reduce denials. In the face of a cashflow crunch, healthcare providers increasingly turn to data-driven revenue cycle management (RCM) strategies that span the entire patient journey. This article lists six of the most effective income-generating digital RCM strategies that providers are using to maximize profits. Building blocks of a healthy revenue cycle At its core, revenue cycle management is about ensuring providers are fully reimbursed for the care they provide. The true ROI is much broader – efficient financial and administrative processes for patient billing, claims management and collections contribute to better care, satisfied patients, high-performing staff and good financial health. Realizing these benefits calls for revenue cycle processes built on three principles: Efficiency – streamlining processes to reduce resource utilization across the entire billing cycle Accuracy – ensuring all patient and claims data is correct and complete to avoid denials and delays Transparency – giving patients, providers and payers relevant and timely information, so they can act with confidence in each financial transaction. To achieve this, providers are moving away from slow, costly manual systems. Digital RCM tools are becoming non-negotiable. 6 data-driven strategies for effective revenue cycle management 1. Increase efficiency in patient access Revenue cycle management starts when the patient books their appointment and ends when the final bills are settled. Claim denials and delayed payments often arise from data errors and miscommunications in the early stages of the patient journey, which means patient scheduling and registration processes are critical to streamline RCM. With automated, data-driven patient access tools, providers can simplify tasks across the patient journey, so patients can move from one stage to the next with as little friction as possible. Fewer errors mean delays and disappointment are more easily avoided. Automated registration and online self-scheduling can also lead to savings through more efficient use of staff time and reducing the number of appointment no-shows. Experian Health clients find that online tools allow them to make relatively minor adjustments to their workflows, with a major impact on productivity. 2. Deliver accurate and timely patient billing Patients want the payment process to be as painless as possible. In multiple surveys, Experian Health has found that patients are worried about the cost of care, while 63% of providers believe patients frequently postpone care because of cost concerns. Clear, comprehensive estimates, billing and collections practices can make it easier for patients to navigate their financial journey. And with the end of continuous Medicaid enrollment, it's likely that more patients will find themselves unsure of their coverage situation, and in need of greater support to manage the financial process. For Stanford Health, the key to improving revenue cycle management centered around patient billing and collections. To achieve the dual goals of improving the patient experience and increasing collections, they used data-driven insights and automation to remove uncollectible accounts, prioritize accounts with a high propensity to pay, find missing coverage and reduce the manual workload. Collections Optimization Manager helped Stanford Health identify the best possible collections strategy, by scoring and segmenting patient accounts with the highest propensity to pay. Coverage Discovery® supplemented this strategy by checking for any unidentified primary, secondary or tertiary coverages that can potentially reduce self-pay amounts and avoidable charity designations. As a result, Stanford Health achieved a $4.1m increase in average monthly payments and efficiency gains of $109k per month. 3. Provide transparent price estimates Experian Health's State of Patient Access 2023 report suggests that fewer than three in ten patients know how much their care will cost in advance, while nine in ten consider it important. Delivering accurate pre-care estimates to help patients plan for bills could therefore be an easy win to improve the patient experience and recoup more revenue. Banner Health used Patient Estimates as part of a wider strategy to improve patient collections. This solution generates detailed estimates of the patient's financial responsibility along with recommendations for payment plans and financial assistance, if appropriate. Listen in as Becky Peters, Executive Director of Patient Access at Banner Health, talks about streamlining the patient registration process and improving patient access with pre-care estimates. 4. Effective claims management Perhaps the biggest opportunity to improve revenue cycle performance lies in claims and denial management, which accounts for a major proportion of wasted healthcare dollars. Summit Medical Group Oregon–BMC paired Enhanced Claim Status with Claim Scrubber to submit cleaner claims the first time and avoid lost revenue. These tools help providers submit accurate claims and monitor claim status to prevent denials and resolve issues quickly. For Summit Medical Group, this led to a 92% primary clean claims rate, and a reduction in accounts receivable days and volume by 15%. Experian Health also offers a new solution that leverages machine learning and artificial intelligence for predictive reimbursement. AI Advantage™ uses AI to predict and prevent claim denials based on historical claims data. In the first six months, this solution helped Schneck achieve a 4.6% average monthly decrease in denials and decreased time spent on denials by 4x. 5. Easy ways to pay (plus clear pricing and payment policies) How easy is it for patients to pay? This simple but important question points to another vital element of effective revenue cycle management. A compassionate and convenient patient payment experience that matches consumer experience in other industries can encourage earlier payments. Easy digital options are especially important for millennial and younger patients: research by Experian Health and PYMNTS found that 60% of younger patients are looking for digital services. Experian Health's patient-friendly payment tools are designed to help patients navigate their financial responsibilities with confidence and ease. For example, PaymentSafe® allows providers to securely collect payments anytime, anywhere, including mobile payments and patient portals. 6. Operational efficiency with automation, data and analytics RCM processes generate vast amounts of data, providing valuable insights into the organization's operational performance, revenue trends and areas for improvement. Being able to parse and translate this data into actionable insights is essential to determine the right strategies to pursue to optimize financial performance. But this in itself can be a major lift. Revenue Cycle Analytics is a web-based tool that breaks down data into actionable insights across billing, reimbursement and payer performance, presenting KPI data via comprehensive dashboards. Effective revenue cycle management strategies from start to end From labor shortages to rising costs, healthcare providers are finding creative ways to manage cash flow. While each healthcare organization’s needs and goals are different, understanding these six key strategies of successful revenue cycle management can help hospitals manage their revenue cycles more effectively and efficiently, while responding to new uncertainties. Find out more about how Experian Health helps healthcare organizations leverage automation and AI to streamline processes and boost revenue cycle performance.

Aug 16,2023 by Experian Health

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