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Artificial intelligence (AI) is changing the healthcare industry. From disease detection to chatbots, AI is having a significant impact on the way healthcare providers operate and deliver care to patients. Additionally, AI is transforming the revenue cycle management process by automating tasks, such as claim denials management. By leveraging AI tools, healthcare providers can reduce the time and resources required for manual claims processing, ensuring that claims are paid faster and with greater accuracy. As claim denials continue to rise by 10-15%, healthcare organizations continue to grapple with the adverse effects on their finances. That's why Experian Health created AI Advantage™ – an innovative solution that helps providers with better claim denial management. The first component, AI Advantage – Predictive Denials, proactively identifies claims that are at high risk of being denied, so providers can edit the claim prior to submission. The second component, AI Advantage – Denial Triage, steps in after claims have been denied to identify those with the highest potential for reimbursement. Schneck Medical Center is one example of a healthcare organization that has seen significant results from implementing AI Advantage. After just six months, they successfully reduced denials by an average of 4.6% each month. Corrections that would previously have taken their organization 12 to 15 minutes to rework could now be processed in under 5 minutes. With AI Advantage, healthcare organizations can improve their claim denials management processes, increase efficiency, and reduce administrative costs. The solution's ability to prevent and reduce claim denials in real time can help healthcare providers maximize revenue while delivering high-quality patient care. As healthcare organizations continue to face mounting financial pressures and staffing shortages, AI-powered solutions will be increasingly important in helping them navigate these challenges and achieve long-term success. Learn more about how healthcare organizations can begin their journey towards improving efficiency and reducing claim denials with AI Advantage.

Several major healthcare operators reported major losses for 2022, as revenue growth failed to outpace increasing expenses. McKinsey’s projections for provider profit pools suggest a more promising outlook over the next few years, with the fastest growth expected in virtual and non-acute care segments. As labor costs rise, organizations are looking for ways to cut spending and increase cash flow. Healthcare contract management is a key area to focus on, as underpayments and denied claims can significantly impact revenue. A third of providers report up to 15% of claims being denied, and underpayments continue to remain a significant concern. Securing reimbursements at already-agreed rates can help healthcare organizations significantly benefit financial performance. Unfortunately, managing payer contracts is not a straightforward process. Payer regulations and policies are in constant flux, and providers often lack the insights to negotiate and monitor payer performance effectively. Implementing a contract management solution can help providers negotiate favorable terms, check payer compliance, and reduce the risk of denials and underpayments. Why is healthcare contract management so challenging? Multiply thousands of vendors by thousands of service providers and again by thousands of patient encounters – and the scale of the healthcare contract management challenge becomes apparent. An average health system deals with hundreds of different payers, each with its own policies, processes, and paperwork. This lack of standardization makes it difficult to process claims efficiently and ensure payer compliance with agreed terms, not helped by soaring patient volumes and increasingly complex claims. The growing resource burden means the payer-provider relationship is coming under strain. But the challenge begins even before the contract is signed. Providers split their focus between numerous clinical and financial objectives. In contrast, payers can concentrate their attention more fully on fee negotiations. There’s an inherent imbalance in the resources each party brings to the negotiating table. As a result, providers are often on the back foot and can end up signing up for less favorable terms. Without a robust approach to negotiating and managing payer contracts, providers will struggle to achieve full reimbursement for services rendered. They may submit claims that do not adhere to payer policies, and find claims are being denied or not paid in full. More accounts will end up going to collections, and patients may be exposed to the threat of balance billing. At the extreme, providers may be forced to undergo lengthy appeals processes or even resort to legal action. The challenge of underpayment is especially fraught in emergency care, where disputes around reimbursement for services provided by out-of-network physicians at in-network facilities are common. It pays to invest in provider-payer relationships The solution lies in improving payer-provider relationships.. Smooth contract negotiations, clean claims and fair reimbursement rates are only possible when each party is clear about what they need from the other and delivers what they have agreed. By promoting better communication, transparency and accountability, providers can catch more underpayments and ensure more claims are clean the first time, leading to better financial performance. With a reliable contract management solution, providers can monitor payer compliance with contract terms and clarify what’s expected to ensure clean claims every time. Contract Manager and Contract Analysis: best in KLAS for healthcare contract management The 2023 Best in KLAS report identified Experian Health’s Contract Manager and Contract Analysis products as #1 in Revenue Cycle, Contract Management. This solution leverages Experian’s data, analytics, and technology to help hospitals and health systems improve contract management and financial performance in three ways: 1. Validating reimbursement accuracy Contract Manager helps providers find inconsistencies between amounts claimed and amounts paid. It accurately adjudicates each claim and compares expected payments to actual reimbursements. By continuously monitoring payer compliance with agreed contract terms, the tool identifies patterns of non-reimbursement to improve denial prevention and avoid missed revenue opportunities. Administrators can monitor reimbursement using online dashboards and real-time variance reports, which make it easy to manage multiple payer contracts and reimbursement methodologies. The tool also defines specific contract terms and fee schedules and can adapt to changing payer policies, to ensure that claims are processed and valued in line with current payment rules. 2. Preventing and recovering underpayments One of the biggest advantages of automation is the ability to find patterns that a human eye might miss (or take longer to spot). Manual processes (often based on a patchwork of Excel spreadsheets) are not only labor-intensive and costly, but do not consistently identify payment errors. Contract Manager offers a standardized approach to underpayment analysis, identifying sources and patterns of errors so recurring issues can be avoided in the future. Administrators can also use Contract Manager to generate data to support contract-based appeals, so they know which claims to appeal and can communicate more effectively with payers. 3. Negotiating favorable terms with payers Contract Manager’s automated system enables better management of collections data, payer performance and under-or over-payments. This puts providers in a stronger negotiating position when modeling new and amended contracts – a process that can be further improved with Contract Analysis. Contract Analysis assesses the potential financial impact of proposed contract terms down to individual service lines so providers can tailor their negotiation strategy to maximize reimbursement. It arms providers with real-world “what if” scenarios to provide insight into how contract terms could affect cash flow before they sign on the dotted line. Using real claims data to evaluate payer proposals gives providers insight into the true impact of proposed terms on reimbursement. It accelerates the negotiation process and gives providers leverage with payers that they might not otherwise have. Since the responsibility for proving that a claim has been wrongly denied or underpaid lies with the provider, it is on providers to make sure that agreed terms are favorable and to understand how they will ensure compliance. With Contract Analysis, they can reduce contract risks and prevent issues before they arise to drive down denials and underpayments. Using a healthcare contract management solution As the healthcare industry evolves, providers need to find ways to maintain resiliency and financial success. Healthcare contract management is an area where providers can make a significant impact on their financial performance. Unfortunately, managing payer contracts is a complex system with fluctuating regulations and policies. A dedicated contract management solution can help reimbursements maximize reimbursements and can provide the data insights providers need to efficiently negotiate better payment terms. Learn more about how Experian Health’s healthcare contract management solutions help providers improve contract negotiations, monitor payer compliance and recover more revenue.

According to the State of Patient Access 2023, speeding up patient access is the fastest route to patient satisfaction. “Seeing a practitioner quickly” tops the list of patients' pain points based on the survey, which was carried out in December 2022. The number of patients citing this as their biggest access challenge has almost doubled over the last three years, up from 15% in 2020 to 27% in 2022. There is a clear correlation between efficient scheduling processes and patient satisfaction when it comes to access to healthcare. Those who believe that access has improved in the past two years credit faster scheduling, while those who believe it has worsened point to lengthy appointment wait times. Enhancements in speedy and streamlined mobile patient appointment scheduling have translated directly to improved patient access experiences. Beyond the frustration factor, delays can result in longer recovery times, higher medical expenses, and even life-threatening situations. Providers are highly motivated to expedite care for these reasons. Despite significant advancements in the industry, staffing shortages continue to hinder patient access and care. The lack of available staff to schedule appointments and provide necessary clinical services can result in frustrating bottlenecks that leave patients waiting and in limbo. This article examines 5 ways in which mobile patient appointment scheduling can mitigate manual labor for staff while simultaneously providing enhanced care services to patients, enabling faster and more efficient healthcare. How mobile scheduling benefits healthcare staff and patients 1. Reduce paperwork associated with appointments Four in ten patients who think patient access has worsened specifically blame the scheduling process. Outdated methods of appointment scheduling and registration can hinder the seamless digital experience that patients desire. Not only that, but they also consume staff time and can be cumbersome to maintain. Mobile patient scheduling reduces paperwork by allowing patients to book appointments through a mobile app or patient portal, directly from their device. The patient can book at their convenience, without needing to wait for a phone call. They can check appointment confirmations on the go and get real-time updates, reducing the risk of misunderstandings or missed appointments. 2. Streamline operations with real-time scheduling information Mobile patient scheduling is more than a simple switch from paper to digital processes. It leverages automation to reduce staff workload, eliminate data entry errors and make better use of clinician time. Traditionally, schedulers would need to work through a list of questions with patients to match them to the right provider and appointment time. A mobile scheduling solution allows the patient to answer these questions online, then offer appointment times that fit with the providers' scheduling protocols. Patient Schedule automates scheduling protocols with customized business rules to give clinical staff control over the calendars. Real-time information means gaps can be filled quickly, so patients get earlier appointments and no available slots are wasted. John Mercer, Executive Director of Online Scheduling at HCA Healthcare, says Patient Schedule has been convenient for both patients and providers, with 35% of appointments booked outside of working hours: “Experian Health's Patient Schedule has been well received by our provider population, both employed and affiliated. They can receive new patients from a digital domain even when the office is closed. We can also specify certain appointment types and dedicated inventory for patients with acute needs.” 3. Reduce no-shows with appointment reminders Easy online scheduling is only the first step. How can providers ensure patients turn up? Even the most organized patients can forget about an appointment. Proactive measures must be taken to ensure patient attendance after scheduling has been accomplished. Even the most responsible patients can accidentally overlook an appointment, causing longer wait times for both patients and doctors due to missed appointments. Fortunately, providers can mitigate the risk of no-shows by utilizing a mobile scheduling solution that integrates the option to add appointments directly to patients' digital calendars, followed up with automated reminders via text or email as the scheduled date nears. Mobile scheduling also makes it easy for patients to cancel or reschedule appointments. With the click of a button, patients can avoid being a no-show and free up their appointment time for someone else. Same- and next-day appointment scheduling means patients can see if any cancellations have led to new slots opening up, so they can see their doctor sooner. 4. Improve communication between medical teams By reducing no-shows and enabling patients to see their doctor quickly, digital scheduling also helps close gaps in care. Care teams can see a patient's recent and upcoming visits to specialists and view the patient's real-time information, facilitating more informed decisions about care. Mobile scheduling improves communication between medical teams, allowing them to respond quickly to referral requests and coordinate care across multiple providers and settings, all through a single platform. Automated patient outreach can take this a step further, by prompting patients to self-schedule appointments via targeted interactive voice response (IVR), text message or email. 5. Reduce time-consuming administrative tasks with automation Ensuring efficiency has become increasingly important amidst staffing challenges. Automated and self-service scheduling tools are key for reducing the amount of unnecessary administrative work. Clients that use Experian Health's Patient Schedule solution reduce call times by 50%, as patients are able to manage their own bookings online and through text and IVR campaigns. Analytics can help providers further optimize capacity, outcomes and practice performance by drawing out trends and opportunities for efficiency. Opting for mobile scheduling can help healthcare providers save valuable time and resources, elevating the effectiveness and profitability of their operations. Opening the digital front door with mobile scheduling Mobile patient scheduling has gained traction, with 40% of providers implementing self-scheduling solutions in the last year. For those that haven't yet adopted this technology, there's a huge opportunity to help patients navigate their healthcare journey with ease. Patient satisfaction is heavily dependent on how much friction processes add or remove to the patient access experience. Integrating mobile scheduling tools with automated registration, payment systems and patient outreach solutions can amplify these benefits and help providers streamline their operations. Find out more about how Experian Health's mobile patient appointment scheduling software is helping providers improve the patient experience and operational efficiency.
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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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