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

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Expert Q&A: how to optimize patient collections in 2022

A little over a year ago, Experian Health surveyed healthcare providers for a snapshot of their views on the digitalization of patient access, and the importance of healthcare collections. At the start of the COVID-19 pandemic, patient collections emerged as a top priority, the result of rising unemployment and competing consumer demands that impeded patients’ ability to pay. By June 2021, provider attitudes had changed. Our follow-up State of Patient Access 2.0 survey revealed that patient collections were no longer the number one concern for healthcare providers. Patient perceptions of the billing process have improved too. In our latest Interview with the Expert, Matt Baltzer, Senior Director of Product Management at Experian Health, explains why providers feel more confident about patient collections. He also discusses how automated healthcare solutions can help providers shore up these gains and optimize healthcare collections – especially as consumer behavior returns to pre-pandemic patterns. Watch the interview below:   Why are healthcare collections no longer the number one concern for providers? In the six months between the two surveys, the number of providers saying they were “concerned or very concerned” about collecting payments from patients dropped from 50% to 41%. Baltzer explains that during this time, collection rates were relatively steady (when adjusted for volume), and providers received fewer calls about patient balances. Currently, the bigger concern for both providers and patients is to determine patients’ coverage status quickly and accurately. There are three main reasons for this shift. Firstly, multiple rounds of stimulus payments issued by the government helped consumers pay down their debts, including medical bills. Secondly, the pandemic caused a drop in consumer spending on travel, entertainment and dining out, which meant credit card usage was lower than pre-pandemic levels. Consumers had more cash available to pay healthcare bills. And thirdly, employment rates have started to recover. Around the time of the first survey, providers were faced with a surge in patients who had suddenly lost employer-based coverage, but as unemployment levels improve again, this is less of an issue. Those still affected by job losses have been able to access expanded government support, such as Medicaid. How should providers prepare as consumer spending returns to pre-pandemic levels? As Americans start to return to previous consumer habits and routines, household spending is likely to increase, which could squeeze medical bills again. Baltzer explains that “as we see stimulus programs winding down, and discretionary spending options increase, we can expect to see an increase in the utilization of revolving credit lines. For most consumers, that will mean it’s more difficult to meet unplanned out-of-pocket obligations.” Prior to the pandemic, a survey by the U.S. Federal Reserve found that 40% of Americans struggle to find $400 to pay for an unexpected bill. This means providers may not be able to rely on the steady collection rates seen in recent months. While efforts to improve transparency will help patients prepare for possible financial obligations, many providers are going further, implementing the right data, tools, and strategies to understand and address each consumer’s unique situation, making it as easy as possible for patients to pay. Baltzer says: “Data can help drive attention to the accounts with a higher likelihood to pay. This means you can identify those who just need a little more time to pay, and then help those truly in need of charity support. Things can change quickly, and having fresh, accurate data will be essential. Now is not the time to take our eyes off the ball, as the game may shift quickly.” With access to reliable and comprehensive consumer data and automated patient collections solutions, providers can tailor the patient experience according to individual needs and preferences. They can create a more empathetic financial experience, with upfront pricing estimates, personalized payment plans and flexible payment options. Not only will this be more desirable for patients, but it will also optimize healthcare collections, improve operational efficiency and increase the chances of more bills being settled in full. How can optimizing patient collections offset recent staffing challenges? Staffing shortages remain a growing challenge for healthcare providers. According to Baltzer, technology and automation can help ease the pressure on collections teams. He says, “Automation is key. Providers are being challenged to make the most of limited staff resources, especially for patient collections. It’s important to focus staff attention on the accounts most likely to pay. That means filtering out accounts that might be bankrupt or deceased and using automation for manual tasks – such as checking for charity eligibility or cleaning up patient records. Best-in-class providers are increasingly leveraging automated dialing and texting solutions to communicate with patients and help short-staffed teams focus on the tasks that matter.” Collections Optimization Manager can help organizations deploy a targeted approach to patient collections, using data and analytics to segment, screen and monitor accounts. By optimizing on the back end with user-friendly interfaces and efficient workflows, staff can focus their efforts on the accounts that need the most attention. On the front end, Patient Outreach solutions can help patients take control of their own financial journey with timely bill reminders and self-pay options, and requires minimal staff intervention. Automated text and IVR messages that connect directly to billing software ensure that more accounts are settled without adding to the organization’s headcount. Watch the full conversation, and download the State of Patient Access Survey 2.0, to find out more about how Experian Health can help your organization spot new opportunities to optimize healthcare collections.

Nov 03,2021 by Experian Health

Getting a holistic picture of patients with social determinants of health

This is the fifth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. In this post, explore the fifth step—treatment, and how social determinants of health can help your organization get a more holistic picture of your patients. To read the full white paper, download it here. How does a virus that does not discriminate produce such different healthcare outcomes across population groups? COVID-19 exposed population care challenges within the healthcare system. For example, data from the Centers for Disease Control and Prevention (CDC) consistently shows that American Indian and Alaska Native (AIAN), Black, and Hispanic people have a higher risk of COVID-19 infection, hospitalization, and death than their white counterparts. The AIAN community is 3.4 times more likely to be hospitalized due to the virus. An analysis shows that health disparities like these result in approximately $93 billion in excess medical costs and $42 billion in lost productivity per year. These differences in the health status of various population groups are socially influenced, unequal in distribution, and, most crucially, often avoidable. Arming clinicians with patient-level “Social determinants of health” insights can help When it comes to health outcomes and patient engagement, health providers can look beyond the immediate medical needs of a patient to understand non-medical factors that commonly act as barriers to accessing good healthcare and inhibit successful treatment. These can be things that influence a patient's social networks, socioeconomic situation, cultural and environmental conditions, as well as how they live from a health perspective. They are collectively known as social determinates of health (SDOH), and they account for up to 80 percent of health outcomes. Examples of social determinants of health include: Access to nutritious foods and opportunities for physical activity Access to transportation Education, job opportunities, and income Housing stability Language barriers and poor literacy skills Pollution and [lack of] access to clean water Racism, discrimination, and violence For example, a patient that suffers from a language barrier may have problems booking an appointment and understanding the steps for proper care. This can result in inconsistent treatment and poor treatment outcomes. A patient’s income can also play a part. Some patients may lose their jobs, move homes, lose access to cars, and more – resulting in food insecurity, housing instability loss of access to care and medication. According to a Gallup survey, 25% of patients defer treatment because it’s perceived to be unaffordable. It’s vital for healthcare providers to create a plan that includes touchpoints that screen for SDOH updates. Providers will need to actively educate their patients about alternative payment plans and other financial aid programs, to show their patients that care is accessible through a variety of resources. The benefits of addressing SDOH using digital solutions: to reduce health inequity and improve patient engagement Research found that integrating SDOH data into patients’ electronic health records and care plan considerations offered the potential for improved care and health. Adding this useful data allowed for a better understanding of patients’ social influences, as well as better collaboration between healthcare providers and community services – enabling patients to be treated and engaged from a holistic standpoint. When providers take SDOH into account and adjust patient engagement in care planning  accordingly, can alleviate: Readmissions Unnecessary emergency department visits Poor care quality ratings When employing an SDOH solution, providers can use data to develop new strategies that can target vulnerable populations. For example, SDOH research during the pandemic, conducted by the National Center for Biotechnology Information, revealed that school closures increased food insecurity for children, which led to greater rates of malnutrition. This led to lower immune system responses and increased the risk of infectious disease transmissions When trying to increase COVID-19 vaccination rates among populations living in low-income areas, healthcare providers can utilize SDOH data to develop ways to make care more accessible. Social determinants of health insights on access to care, medication, housing, and food barriers can also proactively identify patients with health inequity. Understanding differentiating drivers of individual SDOH profiles can help healthcare programs meet patients’ unique needs – ones that are hindering an equal playing field for their own health. Social determinants of health can help providers discover new opportunities Healthcare providers can also use this data to devise strategies to communicate more effectively with their patients, especially via the patient’s preferred channels. Technology and communication barriers that are typically overlooked should be examined as a part of SDOH. For example, a patient that prefers direct mail over email may ignore communications that they’re not receptive to. Meeting a patient where they are and through the channels they prefer is crucial to making a connection. Once they understand a patient's SDOH, providers can connect patients to relevant outreach or community programs that assist in removing some of the barriers to a patient's optimum care.  For example, if a hospital learns that their patient base has higher food insecurity, as opposed to access to care risk, they can work to prioritize partnerships with a local food bank or meal delivery programs. This allows providers to proactively help their patients make it easier to comply with their care plans when otherwise, a meal on the table would’ve taken priority over a wellness check. combining SDOH solutions with patient scheduling software, providers can automate proactive outreach for more and frequent follow-ups to encourage patient engagement. By utilizing social determinants of health (SDOH) insights, every patient visit becomes an opportunity to verify and address the non-medical factors that may be affecting the patient’s health and make better use of your organization’s community network. SDOH can help providers build robust patient profiles to display information that wouldn’t be visible in the clinical data. With Experian Health’s SDOH solution, providers can create robust profiles that can determine a patient’s readmission SDOH risk, and provide factors that are driving these risks. This solution can also provide recommended strategies that care team members can use to align appropriate resources and be proactive about their health outcomes. The healthcare system is designed to help patients during illness or injury.  However, delivering care equity is best achieved by also accounting for the non-clinical conditions that influence health. By looking at a patient holistically and combining clinical data with SDOH, providers can identify the unique challenges patients face and then tailor care to a patients’ individual needs. As providers adapt to life in the shadow of COVID-19 and move beyond crisis mode, it’s more crucial than ever to enrich patient identity management with SDOH, and close the gaps in care when the virus subsides. Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience COVID-19 highlights an acute need for digital patient intake solutions Automated prior authorization: getting patients the approved care they need

Oct 29,2021 by Experian Health

Q&A: healthcare price transparency in 2022

As payers and providers count down the days until the implementation of the No Surprises Act in January 2022, healthcare price transparency and billing remain trending topics in the healthcare world. The Act is the latest in a series of federal and state commitments to help healthcare consumers feel more prepared and informed about their medical costs. Consumers have come to expect a payment experience that matches the way they shop around for other household budget-eaters, such as cars and laptops. But healthcare isn’t like other purchases – it’s complex, high stakes, and often incredibly opaque. Lists of shoppable services are often difficult to navigate, information on quality can be hard to come by, and the reality is that patients don’t always have the power to choose how they access care. The CMS final rule on price transparency and the new regulations for balance billing signal a high-level desire to improve the healthcare experience with patient-friendly pricing. It seems to be working. Experian Health’s State of Patient Access 2.0 survey, fielded in June 2021, reveals that price transparency remains important to both patients and providers. It’s also improved substantially in the six months since the first survey. Back in November 2020, more than half of survey participants had final costs that differed significantly from their billing estimates. By June, this figure had dropped to just 14%, which means more patients are able to plan for their final bill with confidence. Given these improvements, what’s on the horizon for price transparency? In the latest of our expert interview series, Greg Young, Senior Director of Marketing, talked to Dan Wiens, Product Director for Patient Estimates at Experian Health, about the future of patient estimates and price transparency. Watch the interview below: What’s driving the change in patient perception when it comes to healthcare price transparency? According to Wiens, two major factors are improving patient attitudes to pricing estimates: “At the height of the pandemic, hospitals were seeing fewer patients and many elective procedures were canceled, so there weren’t a lot of estimates going out. Secondly, there has been a massive push for price transparency from governments and providers. In January 2021, federal regulations came out specifically to give patients a better view of their out-of-pocket expenses. Many more facilities are launching price transparency tools, as opposed to using databases that guess what a patient’s obligation will be.” As those regulatory requirements come into force, fewer patients are surprised by their final bill. By providing accurate estimates ahead of time, supporting patients to manage their financial journey, and providing personalized patient statements, hospitals are pushing forward with transparent pricing strategies that help patients feel in control of their medical bills. Is the problem of price transparency solved if patients, providers and politicians are in favor of these new regulations? Providers recognize the benefits of transparent pricing: 9 out of 10 providers told us they agree that providing accurate estimates helps patients to pay their bills. With everyone seemingly supportive of this approach, some might see the challenge as resolved. The problem then becomes a question of implementation. Wiens says the job isn’t quite finished yet: “Healthcare price transparency will continue to evolve and grow. Now that patients can see their out-of-pocket expenses for very specific procedures, they’ll want it for the rest. Hospitals are very quickly learning that when a patient knows what they owe, they can accommodate larger expenses and take care of smaller bills immediately. And the government is clear that they don’t want patients to be in the dark about what they owe, so we’ll see more and more transparency requirements.” Hospitals looking to step up their pricing estimates now have a variety of tools at their disposal. Offering patients personalized information in a convenient and easy-to-understand format should be top of the list. Patient Payment Estimates help patients understand their financial responsibility before even coming in for care. Patients get a cost breakdown straight to their mobile device and can immediately pay then and there if they want. This can also be integrated with Patient Financial Advisor, which provides real-time benefits information, and directs patients to appropriate payment plans and charity options. It makes the process less stressful and reduces the risk of uncompensated care for providers. Is there more healthcare price transparency regulation on the horizon? Regulations will continue to be a major driver of evolving healthcare pricing policy in the next few years. In addition to the federal government’s price transparency mandate in 2021 and the No Surprises Act, which takes effect in January of 2022, at least 22 states have followed suit in implementing price transparency and balance billing requirements. Wiens says, “price transparency and balance billing regulations will continue to evolve. A lot of hospitals want to make changes on their own, but some will need a little bit of extra motivation, which will come from regulations.” As focus shifts into more complex areas of healthcare finance, regulatory requirements will continue to ramp up. While the price transparency rule focused simply on helping patients understand their out-of-pocket expenses, the No Surprises Act is much more comprehensive and complex. This new regulation covers patient benefits, insurance claim processes, and determines whether patients are in or out of network. Further regulations are likely to dig deeper, to make sure patients understand what they’re paying. Providers that embrace a transparent approach to patient payments will be ahead of the game when those changes come into play. Download the  State of Patient Access Survey 2.0, to find out more about the future of patient-friendly pricing.

Oct 21,2021 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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