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

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Better care starts with better patient identity management

No healthcare organization is immune to the problem of bad data. One in five patients has found errors when looking at their electronic health record (EHR). This includes incorrect information about their diagnosis, medications, test results and more. If the data held in patient records is incomplete, inconsistent, or inaccurate, this can lead to poor clinical decision-making, substandard patient experiences, and gaps in treatment or follow-up. In Experian Health’s State of Patient Access 2.0 survey, patient identity management emerged as a major challenge for healthcare providers, with almost half of the respondents saying that inaccurate and incomplete patient data hindered follow-up contacts and patient outreach. “Dirty” data also presents a major financial risk, costing healthcare organizations millions of dollars per year. Many providers have stepped up their digital offerings in the last few years, particularly in response to the pandemic. While digitalization offers huge advantages, it does have an unfortunate side effect. As more data is created, shared and accessed, there are more opportunities for mistakes. Some industries may accept a certain amount of rogue data as inevitable, but in healthcare, it mustn’t become the norm. Patient data needs to be consistent, complete and standardized to ensure the highest standards of care. The Centers for Medicare and Medicaid Services (CMS) recognizes the need for an easier and more secure exchange of healthcare data, and are taking steps to facilitate interoperability. As these provisions are finalized, providers can act now to embed data standardization in their digital services. Better data means better decisions, better care and lower costs. As the digital transformation continues, providers must implement strategies to eliminate inaccuracies, enable consistent identity management, and ensure data is standardized across all their systems and networks. In this article, we share three steps to help your organization ensure that patient data remains complete and consistent for better patient identity management. 1. Start with the right patient data As the saying goes: garbage in, garbage out. Reliable patient records require the right information to be added from the start, or errors will follow the patient throughout their healthcare journey. This will only continue compounding over time. A 2021 survey of Experian Health clients revealed that incomplete data arises for a variety of reasons. This ranges from patients not filling out forms correctly prior to their visit or forgetting their insurance cards, to staff having limited time to complete documentation. Typos, misspellings, duplicate data and missing information can also cause identity errors.* Providers should reduce the risk of inaccurate data from being added to a patient’s record in the first place. A standardized approach to data formatting is a good place to start. For example, if a patient is accustomed to writing their date of birth in a European format, with the day before the month, they may enter this incorrectly when filling out online patient access forms. Configuring calendar drop-down menus in such a way that prevents this will avoid these basic but costly errors. With a Universal Identity Manager (UIM), each patient’s record can be maintained in a standardized format. Probabilistic and referential matching techniques are used to check the patient’s identification information against existing databases, for a more complete view of the patient regardless of any data gaps. 2. Solve patient matching challenges with robust identity verification It doesn’t matter if patient records are accurate if staff pull up the wrong record when they speak to a patient. Providers should prioritize consistent identity management to ensure clinical and non-clinical staff see the same and correct information, regardless of where or when a patient interacts with their organization. Identity Verification validates the patient’s identification information during pre-registration and check-in by instantly accessing demographic information. This includes the patient’s name, address, Social Security number, date of birth, phone number and insurance coverage data. If there’s a mistake, it’s easily found and corrected. 3. Standardize data to maintain clean patient databases Victoria Dames, Vice President Identity Management at Experian Health explains why standardization is so important: “The increasing use of digital services means that more healthcare data is being exchanged within and between health systems than ever before. However, in order to leverage the opportunities that come with a more connected healthcare system, we need that data to be as reliable as possible. Preventing inaccuracies before they occur will be much more cost-effective than scrambling to fix them after the damage is done. With a standardized approach to data collection and management, healthcare organizations can maintain reliable records for every individual patient and stay ahead of the game as more data is generated and shared.” Unique Patient Identifier (UPI) helps providers eliminate duplicate records so there’s a “single source of truth” for each patient. After the UIM matches the patient’s information within a single and accurate patient file, a UPI is assigned to that record and maintained in a master index. This is far more secure than a traditional matching algorithm based on Social Security numbers, which can be vulnerable to errors. Together, these tools help healthcare providers create and maintain a “golden record” for each patient. Data quality will always be a challenge. However, with the right data standardization strategies, providers can make better decisions. This will create better patient experiences and better health outcomes while limiting the financial impact of dirty data. Contact Experian Health today to find opportunities to clean up your healthcare data for better patient identity management. *Survey of Experian Health clients, October 2021 Are you an Experian Health client? Then we invite you to join our Innovation Studio research community. Your ongoing input is key to driving improvements to our tools and products! Sign up here!

Feb 07,2022 by Experian Health

Reduce revenue loss with insurance Coverage Discovery

US hospitals have provided more than $702 billion in uncompensated care over the last two decades. To protect profits, healthcare organizations must be vigilant about finding any available insurance coverage for their patient’s care. But for many, recent regulatory changes and pandemic-related disruption have made navigating an already complex reimbursement landscape even more challenging. Checking for missing insurance coverage and chasing payments consumes staff time that could be better spent elsewhere. However, with the right revenue cycle management tools, healthcare organizations can reduce profit-eating write-offs and denied claims. Experian Health’s new white paper sets out an end-to-end strategy to help healthcare providers find missing and forgotten coverage. With a comprehensive game plan for minimizing lost revenue at every touchpoint in the patient journey, providers can optimize the patient experience, reduce revenue leaks, and ease the burden on staff. Here, we explore some of the trends that are challenging reimbursements, identify opportunities to find missing coverage quickly, and present best practices to eliminate the risk of bad debt at every stage of the patient journey. Trends that make revenue recovery tougher Healthcare providers must keep abreast of regulatory changes that affect the reimbursement process, which often challenges profitability. For example, the American Rescue Plan Act of 2021 made some key changes to the Affordable Care Act. This included expanding Medicaid provision, decreasing Medicare premiums, and accelerating the COVID-19 vaccination program. For providers, this means an influx of patients who are newly entitled to government assistance, requiring new processes to avoid delayed claims and payments and recover Medicare debt. Many of these measures are a response to the pandemic. COVID-19 has squeezed household finances, leaving some patients without jobs and access to health insurance. Although employment rates are showing signs of recovery, tracking coverage as patients start new jobs remains highly resource-intensive for collections teams. Chasing self-pay revenue can often be more expensive than writing off the initial bill. The growing focus on price transparency may mitigate some of these challenges. Proactive patient engagement can help patients understand and plan for their bills while improving the overall patient experience. The No Surprises Act, effective January 1, 2022, aims to protect patients from unexpected bills for out-of-network care in emergency and non-emergency settings. The regulation protects patients but creates significant work for providers to modify existing processes and systems in order to meet compliance standards. Dustin Whittier, Senior Director of Product Management at Experian Health, explains that automating early coverage checks can be an efficient way to help consumers manage their changing healthcare obligations. He says, “With the increase in high deductible plans, the urgency surrounding COVID-19, regulations such as the No Surprise Act and Notice of Care, and a strategic focus on patient satisfaction and transparency, the impetus to automate knowing the full scope of insurance coverage – as  close to the point of care as possible – has never been greater.” In 2021, Coverage Discovery tracked down previously unknown billable insurance coverage in more than 27.5% of self-pay accounts. The Experian Health team can help healthcare organizations keep on top of changing regulatory requirements and implement solutions that ensure compliance, improve the patient experience, and protect against uncompensated care. Optimizing for revenue recovery at every step of the patient journey Successful revenue recovery starts with a patient engagement strategy that simplifies the steps to reimbursement at every patient touchpoint. A three-pronged approach can increase the likelihood of payment by identifying the opportunities to check for coverage before the patient comes in for care, at the time of service, as well as aftercare. 1. Pre-service insurance coverage checks Verifying and tracking the patient’s insurance status before they come in for care means their financial obligations will be clear from the start. Advance knowledge makes it much easier for patients to plan – and pay ­– their medical bills. An automated coverage identification solution such as Coverage Discovery can scan patient information as soon as they schedule an appointment to find any previously unknown coverage, using multiple proprietary databases and historical information. 2. Identifying coverage at the point of care When the patient receives their treatment, Coverage Discovery can check for any billable commercial and government coverage that may have been missed during pre-service. Providers should also give patients opportunities to pay for care at this point too, to avoid the need to chase for payments later. A simple and quick payment experience can reduce the risk of additional A/R days and collections agency fees. 3. Post-service checks for unidentified coverage Finally, for any accounts that haven’t been settled at the point of care, providers should run further coverage checks before determining whether to send statements and payment reminders to the patient, to write the amount off as bad debt, or to engage a collections agency. Coverage Discovery can detect any discrepancies that could lead to denied claims. It also offers weighted confidence scores so that accounts are reclassified and rebilled appropriately. Automated scrubbing can eliminate manual processes so staff can use their time more efficiently. These steps will help plug revenue leaks at every stage of the patient journey. Not only will that improve cash flow and reduce the risk of bad debt, but it also helps create a more satisfying patient experience. Learn more about how Coverage Discovery helps recover revenue throughout the patient journey and gives patients peace of mind.

Feb 02,2022 by Experian Health

Open your healthcare organization’s digital front door

According to a recent survey by PYMNTS, many patients want digital healthcare management tools. 76% of survey respondents said they were “very” or “extremely” interested in using at least one digital method to manage interactions with their healthcare providers, rising to 86% among younger patients. This finding echoes Experian Health’s research from our State of Patient Access 2.0 survey. In this survey, we found that the pandemic had cemented consumer expectations around convenient access to care. Providers that wait too long to open their digital front door risk losing consumers to competitors. The “digital front door” describes how a patient can find and access care through online and digital channels. This can include everything from booking appointments and virtual waiting rooms to contactless payments and telehealth. It’s more than just patient access: digital technology can create convenient and connected patient experiences throughout the entire patient journey. The goal is a patient experience that flows seamlessly between in-person interactions and virtual touchpoints, from finding care to post-visit follow-up. Experian Health’s clients revealed that many have embraced digital tools to deliver a patient experience that matches consumer expectations, driven in large part by the pandemic.* Some are planning to invest in their digital front door within the next year, while resource constraints are hampering others in moving forward. Healthcare providers in the early stages of digital transformation may be wondering where to start. Where should they focus limited resources for the biggest gains? The four opportunities that could offer the greatest return on investment are online scheduling, omnichannel communications, contactless payments and productivity-boosting automation. Help patients find and book appointments with easy online scheduling Last year’s State of Patient Access 2.0 survey found that nearly eight in ten consumers prefer to schedule their own appointments at any time, from any device. This trend is set to continue in 2022 and beyond. Many patients have been using online scheduling platforms to book COVID-19 vaccinations and tests, as well as to reschedule care that was delayed during the earlier months of the pandemic. Opening the digital front door with online scheduling offers patients the control, convenience and choice they desire. No-shows are less likely, which leads to higher physician productivity and satisfaction, greater efficiency, lower costs and better patient outcomes in the longer term. Communicate through patients’ preferred channels to boost engagement With the pandemic necessitating so many rules around daily activities, limits on how and when consumers communicate with their providers can feel even more restrictive. Many don’t want to be forced into phone calls at inconvenient times, especially when a simple text reminder or a quick check of their patient portal would do the job. Providers that allow consumers to customize their patient access experience and engage through their preferred channels will be rewarded with increased patient loyalty. Omnichannel solutions also help to build a consistent care experience. A digital process that looks and feels the same every time, regardless of which platform the patient uses, will make navigating the care process much easier. Additionally, patients will be more likely to schedule appointments and fill out forms in a timely manner on their own, which can alleviate staffing resource constraints. A digital front door can help with contactless payments One part of the healthcare experience that can be notoriously tricky to navigate is paying for care. PYMNTS found that 63% of patients would consider switching healthcare providers over a bad payment experience. Providers can make it easier for patients to pay by offering upfront estimates of what the patient’s portion of the bill is likely to be, running automated coverage checks to make sure no insurance is missed, and sending automated reminders with links to contactless payment methods. According to PYMNTS, less than 20% of patients pay for care before or during their visit. However, if providers made it easier to pay, this percentage would likely shoot up. By offering patients their own mobile financial advisor, they can pay bills and access appropriate payment plans right from their phones. It’s convenient for patients and could help reduce delayed payments. A digital front door can improve patient access and relieve pressure on staff A digital front door doesn’t just open up opportunities for patients; it can increase efficiency and improve staff workflows. Healthcare staffing shortages have put immense pressure on providers to find new ways to automate repetitive tasks and relieve staff burnout while maintaining high-quality patient care. For example, automated scheduling algorithms can optimize patient flow and anticipate bottlenecks, so staff can allocate resources more efficiently. Registration forms that are pre-filled with a patient’s information are less prone to errors, compared to manual processes. Automation helps link the digital front door to the front and back offices, which can speed up workflows, support better care coordination, and create a more consistent patient experience. A high-quality digital patient experience should be built on consumer choice, control and convenience. A digital front door is more than just adding a few online tools or sending some well-timed automated texts; it should be at the heart of the entire patient engagement strategy. By investing in digital solutions that leverage the technology already used by patients and staff, providers can offer a stand-out patient experience and improve collections performance. Contact Experian Health today to find out how digital health solutions can help your organization deliver the best patient experience possible. *Survey of Experian Health clients, October 2021 Are you an Experian Health client? Then we invite you to join our Innovation Studio research community. Your ongoing input is key to driving improvements to our tools and products! Sign up here!

Jan 31,2022 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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