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

3-effects-of-rising-healthcare-costs-blog-2024

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AI technology in healthcare: How it’s transforming the industry

Understanding AI technology and machine learning in healthcare AI refers to technology that performs tasks that require human-like reasoning, such as recognizing patterns, interpreting data and solving problems. It learns from experience, spots trends a human eye might miss and generates recommendations based on what users want to achieve. Machine learning is a subset of AI that improves performance over time, helping healthcare organizations turn their own complex information into practical insights. Because these models are trained on each organization’s unique data, they can adapt to local patterns and workflow differences, making their predictions far more accurate. Clinical and operational applications AI and ML are now used in many areas of clinical care, such as: Improving diagnosis by analyzing medical images with greater accuracy. Accelerating drug discovery by tracking side effects and treatment outcomes. Improving surgical safety and precision through robotics. Supporting patients in managing their own health through wearables and remote monitoring.

Nov 14,2025 by Krishna.Nelluri@experian.com

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Nearly 46% of patients say being able to manage their health online is their top priority in accessing care, according to Experian Health's State of Patient Access 2024 survey (SOPA). However, the availability of a “digital front door” in healthcare – with online scheduling, mobile registration, and frictionless payments – is not yet meeting demand. Many patients still face convoluted booking systems and stacks of repetitive paperwork. Meanwhile, consumer-friendly tech and retail giants are edging into healthcare. As disruptors set new standards for simple and convenient care, traditional providers are under pressure to open their digital front door to remain competitive. Many are already investing in AI and automation to simplify workflows, cut costs, and upgrade the patient experience. Could 2025 be the tipping point for healthcare's digital transformation? A digital front door strategy could help more providers boost patient engagement, simplify the patient experience and increase profitability. What is a digital front door? The digital front door is more than a well-designed website. It's a single point of access that gives patients convenience, choice and control at every touchpoint in their healthcare journey. It promises patients faster appointments, fewer headaches and more coordinated care. From their mobile device or computer, they can log in to schedule visits, sign intake forms, update insurance details, see costs upfront and even settle their bills. It's secure, easy to use and lets patients handle tasks on their own time. On the back end, patient-facing digital tools can integrate into the provider's existing systems to improve workflows, reduce manual tasks and generate analytics to simplify care. What are the key benefits of implementing a digital front door? Patient satisfaction: According to SOPA, 60% of patients want more digital and mobile options for communicating with their provider, scheduling appointments and managing payments. Fewer no-shows: Patients are less likely to cancel or no-show when they can schedule and manage appointments that work for their time and needs. Frees up resources: Automating repetitive administrative activities means staff can focus on higher-value activities. Fewer errors: Manual processes are rife with data entry errors that increase the risk of denied medical claims and add time on the back end to resolve. Digital patient intake saves time and money by reducing opportunities for human error. Essential features of an effective digital front door What are some of the digital must-haves to simplify access to care? The checklist might include: Online appointment scheduling, to make it easy to book, reschedule, or cancel appointments Digital tools to complete pre-visit paperwork – even better if these automatically prepopulate patient info to save them time and reduce errors Transparent pricing, with tailored information delivered directly to the patient A choice of payment methods, including familiar digital options so patients can pay quickly Access to a patient portal or central hub for managing appointments, medical records and prescriptions Mobile-friendly interfaces and simple designs, so patients can see key data at a glance, from any device, without needing to be tech-literate Secure and compliant communications to protect patient data and privacy. Where to start with a patient-centric digital front door Three specific tools that would check off the above include the following: 1. Multi-channel patient scheduling What matters most to patients is being able to see their doctor quickly. Online appointment booking gives them the 24/7 self-service scheduling options they expect. It delivers quantifiable gains for providers too. For IU Health, automating patient scheduling has been shown to do the work of two full-time schedulers, with more than 35,000 appointments booked with self-scheduling. Experian Health's patient scheduling software guides patients to the appropriate provider and appointment while keeping the provider in control of their calendar. It integrates with a provider's website, call center, and physical office so patients can book their next appointment, even outside of office hours. On-demand webinar: See how IU Health increased one-call resolutions with Patient Schedule 2. Registration Accelerator 49% of providers say that a primary cause of denied medical claims can be traced back to errors in patient registration, forcing health systems to divert revenue to remediate claims that could have been avoided. An automated, data-driven patient registration process improves accuracy, making costly errors less likely. With Registration Accelerator, patients get a text when it's time to register, instead of completing forms in the waiting room. There's no need to download an app or create a user profile: they scan the data from their identity and insurance cards, and Registration Accelerator takes care of the rest. Anthony Myers, Director of Admitting and Registration at West Tennessee Healthcare, says that replacing clipboards with clicks also makes for a much better patient experience: “With our paper-based systems, it seemed like West Tennessee was stuck in the 1990s. We knew our patients expected a more modern experience. We wanted to meet them where they are, rather than forcing them to come to the registration desk. Our goal was to make pre-service registration easier and smoother for patients and staff.” Case study: How West Tennessee Healthcare simplified registration with Registration Accelerator. 3. Patient Financial Advisor The SOPA report shows that almost seven in ten providers believe their patients postpone care at least occasionally because they don't understand the cost of care. Eight in ten patients agree that accurate estimates help them prepare to pay. While price transparency is improving, too many patients still find themselves with bills that are higher than expected. Patient Financial Advisor delivers a pre-service estimate of the patient's financial responsibility based on real-time benefit information directly to their mobile device. It takes account of current provider pricing, payer contracted rates, and any relevant discounts or payment plans for greater accuracy. A secure payment link allows patients to settle their bills quickly and conveniently, at any time. Read more: How to maximize patient collections with digital technology Choosing the right partner for digital transformation Implementing a successful digital front door strategy comes down to one key factor: keeping it laser-focused on the patient. When choosing a vendor, providers should ask how the platform will make life easier for patients. Will it encourage proactive engagement? Is it easy to navigate and demonstrably secure? And on the back end, will it integrate smoothly with the provider's existing systems and workflows – and even improve them? The right partner will bring specialized expertise for a digital transformation, with the capabilities to meet both patients' and providers' needs. Find out how Experian Health's Patient Access solutions help healthcare providers open their digital front door to simplify patient care across the entire revenue cycle. Open Your Digital Front Door with Experian Health Connect with an Experian representative to discover how our solutions simplify patient scheduling, registration, and payments for better care.

Apr 24,2025 by Ryan Mccusker

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Challenge The University of Tennessee Medical Center (UT Medical Center) is a leading 710-bed acute care hospital with a rich history of exceptional patient care and award-winning services. During the pandemic, the hospital faced revenue losses around $45 million that put serious strain on its capacity to invest in bigger and better facilities. UT Medical Center needed to find a strategy to recover some of this revenue by reducing claim denials at the point of patient registration. UT Medical Center relied on eligibility checks that often missed errors in patient registration, resulting in increased claims denials, costly reworks, and wasted staff time. The hospital urgently needed a solution to help staff identify and resolve potential patient registration errors in real time to prevent denials before they occur. Finding a more efficient way to capture accurate patient and benefits data would be essential. Proactively preventing claim denials would provide the hospital with the much-needed boost in cash collections it needed and free up staff to focus on patient care. Solution To address its claims denials challenge, UT Medical Center partnered with Experian Health and implemented Registration QA, a solution designed to find and fix registration errors upfront. Now, when patients first arrive, front-end staff enter their data to verify insurance. If Registration QA finds an error, it alerts staff in real time so they can resolve it within 72 hours. Alongside more than 400 alert rules curated by Experian Health, UT Medical Center also built custom alerts based on the organization’s specific requirements, using demographics and benefits data. Learn more

Mar 25,2025 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.

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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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