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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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5 ways patient payment software can improve patient satisfaction

Whether by necessity or choice, the way patients navigate the healthcare payments system has transformed over the last few years. Healthcare’s digital front door swung open during the pandemic, offering patients far greater choice and flexibility in their use of digital payment methods. New legislation around surprise billing and transparent pricing gave patients greater visibility into the cost of care, improving their ability to plan for their financial responsibility. Many individuals switched between health plans and became responsible for a greater percentage of their healthcare bills. And the economic downturn continues to exert pressure on patients’ ability to pay, causing concern to patients and providers alike. Patient payment software can help ease these challenges. In this context, providers looking to attract and retain loyal patients must ensure the patient payments experience aligns with these changing needs and expectations. Clear communication, straightforward billing procedures and seamless payment options are essential to make it easier for patients to pay and protect provider profits. Here are 5 ways the right patient payment software can create a more satisfying patient experience and accelerate collections. 1. Offer clear and transparent medical billing processes As deductibles, co-payments and co-insurance arrangements become more complex, calculating patient financial responsibility is more challenging. Patients may find it hard to gauge what their final bill will be, prompting some to delay payments or even forego care altogether. A study by Experian Health and PYMNTS found that 46% of patients had canceled care after receiving a high-cost estimate, while 19% had experienced financial distress after spending more than they could afford on healthcare. Accessible, easy-to-understand billing procedures give patients a sense of control and encourage engagement in the healthcare process. This starts with reliable price estimates. In fact, around 60% of patients who received inaccurate pricing estimates would consider switching providers. With digital tools such as Patient Payment Estimates, providers can generate accurate estimates and give patients a clear breakdown of their financial responsibility before they come in for care. They also have the option to make secure payments via their mobile device. At the same time, insurance coverage discovery tools can be used to verify the patient’s insurance coverage and check for any forgotten coverage, so they have a better idea of what payer(s) will cover. Not only does this make the billing process more transparent and manageable for patients (resulting in faster payments for providers), but it also helps providers comply with new price transparency regulations. 2. Deliver flexible patient payment options Experian Health’s State of Patient Access surveys confirmed that patients want choice and control when it comes to paying for care. Experian Health President Tom Cox notes that “digital-first consumers are digital-first patients.” They want to see the “Amazon experience” replicated in their healthcare payments experience: “I will tell you, for myself as a patient, I much prefer to pay before I get there. Or I’d like to pay when I leave so that I don’t have to get the bill. If I do get the bill, I want to be able to pay online. What I don’t want is to fill out the slip with a check — the worst — or my credit card information and mail it to someone.” Digital payment methods can help providers remove friction in the payment experience by giving patients 24/7, self-service payment options, with options to pay by credit card, mobile wallets, online portals and peer-to-peer services. Experian Health’s suite of Patient Payment Solutions gives patients the flexibility they crave while helping providers increase patient satisfaction and accelerate collections. 3. Prioritize a personalized financial experience Just as there’s no one-size-fits-all remedy when it comes to clinical care, financial options must be tailored for each patient. Some patients will be willing and able to pay their bills in full and be keen to do so pre-service so they can forget about billing and focus on their health. Some may need to spread out payments into manageable chunks. Others may have no means of paying and feel unsure about their options. Patient Financial Clearance gives providers the data they need to customize payment plans based on each patient’s individual financial circumstances. With PatientSimple, patients can manage their payment plan through a user-friendly self-service portal, which allows them to generate pricing estimates, update insurance information, store credit card details, apply for charity care, combine payments to different providers and schedule appointments. This personalized service helps providers avoid missed payments and reduces the risk of having to involve multiple collections agencies, as patients have more confidence in their capacity to meet their financial responsibility. 4. Reduce patients’ financial worries While the uninsured rate has dropped, there are still more than 27 million Americans without health coverage. More will potentially lose coverage when the COVID-19 public health emergency ends. But even those with coverage may still worry about being able to pay for their out-of-pocket costs. Coverage Discovery runs automated checks to scan for any missing or forgotten billable coverage. Accounting for all possible coverage often reduces the patient’s financial responsibility and the accompanying anxiety that comes with a higher medical bill. Automation can also be used to pull together information from a provider’s chargemaster, claims history, payer contracts and patient benefits to generate accurate good faith estimates of the patient’s financial responsibility, which can eliminate ambiguity and help a patient better prepare for what they may owe. Read the report from Experian Health and PYMNTS, The Healthcare Conundrum: The impact of unexpected patient costs on care. 5. Improve operational performance Automation and digital tools also support operational efficiencies. Time-consuming manual tasks can be reduced or eliminated, allowing staff to focus on activities that need a human eye, or to support patients who need more personal assistance. Automation also reduces the risk of error, which can lead to contested bills and more work for staff to resubmit denied claims. For example, Kootenai Health used Patient Financial Clearance to automate presumptive charity checks and streamline a clunky workflow. They observed an overall accuracy of 88% in assigning patients to the right financial assistance program, reducing the number of accounts written off to bad debt. Sixty hours of staff time were saved, which were re-directed to priority tasks, eliminating unnecessary paperwork and improving the patient experience. Similarly, self-service payments allow patients to pay quickly and easily with minimum interaction with their providers. Not only does this reduce the burden on staff, but it also improves the patient’s financial journey. Patient payment software can increase satisfaction and accelerate collections What’s clear in these examples is that patient payment software and automation lead to faster, more flexible, and friction-free payment experiences for patients, while increasing recovery rates and operational efficiencies for providers. Find out how Experian Health’s Patient Payment Solutions help healthcare organizations reinvent patient billing and collections to boost revenue and improve patient satisfaction.

Jan 13,2023 by Experian Health

4 key benefits to providing patient estimates

Can greater clarity and providing patient estimates at the beginning of the patient's financial journey set the stage for better access to care and a smoother path to payment? Millions of Americans struggle to pay for healthcare. A 2022 survey conducted by West Health and Gallup found four in 10 Americans, or roughly 112 million people, are cost insecure or cost desperate when it comes to healthcare. The issue is not just affordability; it’s also anxiety. Patients who fear they won’t be able to cover their out-of-pocket healthcare expenses may postpone or avoid treatment. At a minimum, anticipated medical expenses are a source of stress, especially for the growing number of patients who have high-deductible health plans. Pre-treatment patient estimates can help alleviate the stress. By taking some of the mystery out of medical bills, accurate estimates help patients understand and plan for costs. By opening a dialogue about treatment costs early in the process, patient estimates pave the way for further discussions about insurance coverage, payment plans, charity help, and more. As inflation wreaks havoc with household finances and talk of recession turns up the volume on financial stress, patient estimates and other tools that ease the payment process offer a bit of welcome relief for patients. A better patient financial journey offers benefits to providers as well. For healthcare organizations that are thinking about adding or improving pre-treatment patient estimates, here are 4 key benefits to consider: 1. Patients are more likely to forgo care if they can’t see how much it will cost. According to Experian Health and PYMNTS data published in July 2022, nearly half of consumers who canceled appointments last year did so because they were concerned about costs. Their concerns were not unfounded: the same survey revealed that one in five respondents spent more on healthcare than they could afford. Especially in uncertain economic times, the ability to understand and plan for out-of-pocket medical expenses is critical to patients. A Commonwealth survey found that deductibles were equal to 5% or more of household income in some cases; out-of-pocket costs were equal to 10% of household income in others. Add in concerns about the rising cost of living and the prospect of lost jobs, and the anxiety level surrounding healthcare costs only intensifies. Patient Payment Estimates help alleviate patient fears by providing clear, easy-to-understand estimates prior to treatment. Armed with this information, patients can make clear-eyed decisions about their care and ask about payment options if they’re needed. 2. Price transparency regulation is helping to create a new competitive environment. The No Surprises Act and CMS price transparency final rule are bringing price transparency into focus for patients and providers alike. These regulations require providers to offer accurate estimates in advance of treatment and disclose their pricing for common procedures. Although these regulations continue to evolve and providers are still working toward full compliance, patients are beginning to see more access to pricing information and a greater likelihood of receiving pre-treatment estimates. That’s creating a new competitive environment—and new choices for patients who are contemplating care. “In this new world, patients have the ability to branch out and research their own options,” says Riley Matthews, Senior Product Manager at Experian Health. “Patients have the pricing information to make informed decisions about healthcare and can shop between different providers based on price.” As a result, patient perceptions around transparency and trust are changing: “If providers want patients to keep walking through the door, they need to provide tools to help patients understand their financial obligations and feel that they’re being treated honestly and fairly.” Price transparency may have an additional benefit. According to Experian Health’s State of Patient Access: 2021 survey, eight in ten providers believe price transparency correlates with patients being more likely to pay bills on time. By simplifying pricing and payments, providers literally make it easier to pay. 3. Patients who know out-of-pocket costs in advance are more satisfied with care. In a March 2022 survey from Experian Health and PYMNTS, 88% of patients who received pre-treatment estimates were satisfied with the care they received from their family doctor, compared to 78% of patients who did not get an advance notice of costs. “Our ideas about patient satisfaction and care are changing,” says Matthews. “Healthcare is about more than physical health: It also encompasses mental, emotional, and financial health, all of which are affected by the patient payment experience. When healthcare costs or confusion stand in the way of patients getting treatment, or when healthcare bills create real financial challenges and stress, a transparent and compassionate billing process can make a crucial difference.” 4. Providing clear and accurate patient estimates is the first step to a better payment experience. Helping patients anticipate their healthcare bills with pre-treatment estimates is only the beginning of the journey. The same patient-centered payment tools that make the healthcare billing and payment process easier for patients also make it easier for providers. PatientSimple, Experian Health’s secure online patient portal, lets patients generate price estimates, apply for charity care, set up payment plans, update insurance information, make payments to hospitals and physicians, and even schedule appointments. Patient Financial Advisor delivers personalized estimates and payment options using the patient’s mobile device. Estimates are based on real-time benefits information and the payer’s contracted rates and pricing. Giving patients access to a range of information, using channels they prefer, helps them navigate the process at their convenience. Collections Optimization Manager helps providers target their collections, so they can direct resources where they’re most likely to succeed. Altogether, digital solutions that help improve the payment experience for patients can also help optimize the payment process for providers by making cost and payment information easily accessible to patients. It also creates behind-the-scenes efficiencies that streamline billing and collections for providers. Providing patient estimates is just the start.  Improving the patient payment experience at every step is a win for both patients and providers. Patients need clear information about treatment costs, insurance, and payment options to proactively plan their treatment and finances. But when providers put the systems in place to improve the patient's financial journey, they benefit too, by making these processes easier and more efficient. An improved patient payment experience may also reduce the need for difficult conversations with patients who are surprised by their medical bills and unsure how to pay them. More information, upfront, sets the stage for a healthier process overall. Learn more about Patient Payment Estimates and the full suite of Experian Health solutions to bring your patient payment experience up to speed.

Jan 09,2023 by Experian Health

Case study: Accelerate cash flow by automating claims management

Hattiesburg Clinic is Mississippi’s largest multispecialty clinic with over 450 physicians serving 19 counties. Claims management, patient collections and payer contract management are handled by the clinic’s Financial Services Department, which includes around 70 staff members. Challenge Hattiesburg Clinic in Mississippi sought to improve financial performance in the wake of the COVID-19 pandemic by focusing on reducing claim denials. The Financial Services Department had been hit by staffing shortages, which affected financial results. A more efficient digital claims management solution would attract and retain a high-performing virtual team, while supporting the shift away from existing paper-based systems. To submit more clean claims the first time, the Department set specific goals to: meet or exceed Epic benchmarks for primary denials maintain accounts receivable (AR) days at 42 or less process secondary and tertiary claims without waiting for the primary electronic remittance advice (ERA) to be posted. Solution Already impressed with Experian Health’s Contract Manager and Eligibility solutions, the Department chose another Experian product, ClaimSource®, to help reduce denials. Loretta McLaughlin, Assistant Director of Financial Services, said she was confident ClaimSource was a good candidate for the clinic’s claims platform: “ClaimSource seemed like the right fit for the department’s goals. The platform’s ability to customize edits, along with the level of customer support available, really set the solution apart from the alternatives.” ClaimSource uses scalable automation to prioritize claims, payments and denials. This allows staff to use their time as efficiently as possible, by working on the highest-impact accounts first. Using customizable edits and extensive national and local payer edits, it checks each claim for inconsistencies before the claim is submitted. ERA data is automatically integrated into Epic so that staff can check a claim’s status quickly and easily. With real-time reporting, staff gets insights from across the entire claim lifecycle to improve performance. Outcome The ability to integrate customizable edits was a big advantage for the clinic. They now have over 90 custom edits that help eliminate time-consuming errors, reduce denials, and allow staff to focus on the right accounts. As a result, Hattiesburg Clinic has achieved a 6.1% primary denial rate, which exceeds the Epic Financial Pulse benchmark. Despite staffing shortages, they’ve been able to accelerate receivables. They’re also seeing accelerated cash flow, now they can pursue claims from secondary and tertiary payers without awaiting the outcome of primary claims adjudication. ClaimSource is also creating a better staff experience: the tool eliminates the need for claims to be printed, so staff can work from any location. Now, over 50% of the team work from home. Thanks to automated workflows, output has been consistent despite a reduced workforce. Being able to submit clean claims the first time has a positive impact on AR days as well as staff workload. Loretta McLaughlin says: “Through ClaimSource’s automation and level of quality work, we have had to do less manual intervention.” To build on this success, the team intends to explore further opportunities to use automation to improve productivity. Options include automatically generating patient estimates, automating bad debt and refund workflows, and allowing patients to verify insurance eligibility through their patient portals. Find out more about how ClaimSource helps hospitals, health systems and physician groups reduce denials, protect profits and increase productivity through automated and scalable claims management.

Jan 06,2023 by Experian Health

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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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