Tag: Coverage Discovery

for our upcoming webinar with Banner Health, where attendees will gain insights into the organization's workflow and processes.  It is estimated that 30-50% of denied claims occur on the front end during the patient access process, namely during registration, authorization and eligibility. Unfortunately, manual patient intake processes contribute to these denials, and ultimately, the bottom line, staff productivity and the patient experience take the hit. Banner Health chose to automate its patient access processes with eCare NEXT from Experian Health. The solution, which integrates directly with Banner Health’s acute and ambulatory electronic health records (EHRs), automates the organization’s preregistration workflow, including medical necessity and financial clearance. This improves registration accuracy, provides more accurate patient estimates and reduces the number of denials on the front end. Banner Health has benefited by incorporating a mix of Experian Health products that integrate directly and collaborate with other technologies and workflows already in place: Decrease in eligibility errors. With eCare NEXT, initial denials due to eligibility errors have been reduced by $30M in the first quarter alone since going live with Experian Health. Significant cost savings. With more accurate estimates, Banner Health has seen significant cost savings on the front end from more efficient coverage discovery. The system is consistently finding 30+% unique or new coverage in the patient access workflow. Improved staff engagement and satisfaction. Automation has greatly reduced manual inputs, enabling staff to focus more on the patient rather than systems and logins required for patient intake. Our partnership with Experian Health helps Banner Health's revenue cycle team deliver on its mission of “getting it right, at the right time, every time."  — Becky Peters, Executive Director of Patient Access Services, Banner Health  

Despite the majority of elective procedures being up and running again, patients are still keeping their distance. Nearly half of Americans say they or a family member have delayed care since the beginning of the pandemic, while visits to the emergency room and calls to 911 have dropped significantly. Patients are avoiding care, but it’s not for the reason you’d expect. Beyond obvious worries about catching and spreading the virus, a second concern is becoming apparent: patients are fearful of the potential cost of medical care. With so many furloughed, laid off or losing their insurance coverage, medical care has become unaffordable for millions of Americans. It’s especially tough for those who fall into the coverage gap, where their income is too high to grant access to Medicaid coverage, but too low to be caught by the ACA safety net. If patients continue to delay care, it’s only a matter of time before their symptoms worsen, leading to more complex and expensive treatment or even risking their lives. For the hospitals and health systems with revenue levels at a record low, encouraging patients to return for routine care is a matter for their own financial survival too. The answer lies in making sure patients feel safe and comfortable both when they come in for care, and when they look at their financial responsibilities. 5 ways to ease the return to routine care 1. Reassure patients about safety measures before and during their visit Patients are understandably anxious about what their visit is going to be like. Will they have their temperature taken? What should they do if they have symptoms of the virus? Will seating areas be spaced out and sanitized? Pre-visit communications and proactive information on arrival will help them feel comfortable and eliminate the shock factor of seeing more stringent infection control measures. 2. Minimize unnecessary contact by shifting patient intake online From online scheduling and pre-registration to telehealth and contactless payment, there are many ways to keep face-to-face interactions to a minimum. Not only will this help reduce the spread of the virus, it’ll make the whole patient experience more convenient for patients. Exploring a virtual and automated patient intake experience can also free up staff to work on other tasks, thus also protecting the organization’s bottom line through efficiency savings. 3. Encourage patients back to care with automated outreach campaigns With so much uncertainty at the moment, patients may be unsure if it’s even appropriate to come in for routine care. Use automated outreach to prompt them to book appointments and schedule follow up care. A digital scheduling platform can help you set up text-based outreach campaigns, to reassure patients that it’s safe (and essential!) to come in for any overdue care – without placing any undue burden on your call center. 4. Provide price transparency before and at the point of service With healthcare experts pointing to financial worries as a major barrier to care, anything providers can do to improve the patient financial experience is an advantage. Price transparency is the first step. When patients have clear and accessible payment estimates upfront, they can plan accordingly and/or seek financial assistance as quickly as possible, reducing the risk of non-payment. 5. Screen for charity care eligibility with faster automated checks Once those payment estimates have been generated, the next step is to confirm whether the patient is eligible for financial support, in the event that they’re unable to cover their bill. Checking eligibility for charity assistance is a time-suck for patient collections teams, but with access to the right datasets, it’s a perfect candidate for automation. These steps become even more urgent as providers face the prospect of a ‘twindemic’ – or a surge in COVID-19 cases colliding with flu season. By avoiding delays to care, patients can avoid the need for more serious and expensive treatment further down the line, when hospitals are likely to be under even greater pressures. Contact us to find out more about how our data-driven, automated patient intake solutions can help make your patients feel as safe and comfortable as possible, both physically and financially.

From the moment a patient is admitted, automation strategies can help devise payment plans, find missing coverage, or screen for financial assistance and charity eligibility.

With many hospitals already operating at slim margins amidst the COVID-19 pandemic, the consequences of a rise in uncompensated care could be significant.

Finding missing coverage is a challenge for most healthcare providers, but with the right discovery strategy, it’s possible reduce bad debt.

An automated coverage discovery solution can reduce instances of uncompensated care by identifying patient accounts without sufficient insurance coverage.

Why is missing coverage so detrimental? When patients are unable to pay, providers see an increase in self-pay receivables - 97% of hospitals reported an increase in self-pay receivables compared with the prior fiscal year. When providers can’t collect, the result is uncompensated care $35.7 billion – The amount of uncompensated care hospitals provided in 2015 (AHA, Dec 2016, http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf) Registration errors and frequently changing insurance coverage contribute to an increase in self-pay receivables and bad debt: 20% error rate: Wastes an estimated $15.5B in claims that are never corrected and re-processed. Find previously unidentified coverage to reduce bad debt Experian Health’s Coverage Discovery® solution provides an efficient and trusted means for healthcare providers to reduce misclassified self-pay accounts. Our advanced self-pay engine maximizes the actionable coverage found for our customers across government and commercial payers, previously missed due to frequently changing insurances, data entry mistakes or patient misrepresentation to avoid high deductible health plans. The benefits to you: Make coverage identification more efficient Reduce number of accounts sent to collections & charity Maximize insurance reimbursement revenue Identify primary, secondary, & tertiary coverage Automate the self-pay scrubbing process What are our clients are saying about Coverage Discovery: [Video] Murry Ford, Grady Health System: “Coverage Discovery has brought in quite a bit of revenue for us—revenue that we would not have identified otherwise.” [Video] Mike Simms, Cone Health: “Since we’ve been using Coverage Discovery, we’ve received over $3 million in payments—more than a 300% ROI. It’s well worth every dollar spent.” Here’s why Coverage Discovery is different: Flexibility: Multiple delivery options easily fit Coverage Discovery into your revenue cycle Time matters: Find coverage on-demand Powered by Experian: Billions of data assets improve account specific intelligence and maximize found coverage Relevant: Confidence Scoring reduces data noise and removes potential false-positives to ensure staff time is focused on actionable accounts Uncover previously unidentified coverage with Coverage Discovery.