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
Imagine if every time you wanted to sign up to buy groceries online, book a vacation, or apply for a job, you had to fill out a paper registration form. For 21st century consumers who are accustomed to sleek digital and self-service experiences in industries such as retail, travel and banking, such an antiquated and cumbersome process seems unthinkable. Unfortunately, when it comes to healthcare services, we don’t have to use our imagination. Too often, we’re still required to fill out time-consuming, repetitive and tedious forms before accessing services. For providers who want to stay competitive, the long waits and wasted time that arise from paper-based registration system do nothing to win consumer loyalty. And on top of the disappointing patient experience, manual intake processes often lead to delays and errors that can disrupt the billing cycle, costing time and money further down the line. In fact, up to half of denied claims occur because of issues around the point of registration, such as identification errors, sub-standard data analytics and inefficient workflows. And at a time when patients and staff are trying to minimize face-to-face contact due to COVID-19, manual registration seems like an unnecessary extra touch point. Is it time to say goodbye to paper-based paper registration? Reimagining the patient intake experience for the digital age During registration, patients can be asked to provide personal details, submit their medical history, and confirm payer information. They may also need to schedule appointments, organize billing, or sign up for care management programs. It’s often a patient’s first glimpse of how a provider is going to look after them, so making the registration experience as stress-free as possible is a great way to build customer loyalty from the start. As the competition for consumer business heats up, providers should look for ways to give patients the virtual and mobile-friendly experience they desire, with as little time as possible spent in waiting rooms filling in forms. By letting patients tick off their registration to-do list online or via a mobile device – before even coming into hospital – providers can improve patient satisfaction, while using automated workflows to drive down costly errors and increase revenue. Here are two examples of how healthcare providers have embraced self-service registration and automated pre-registration workflows to benefit both their consumers and bottom line: 1. Schneck Medical Center used automated pre-registration to double their productivity For the patient access team at Schneck Medical Center, getting the correct patient information in a timely manner during registration was a challenge. By introducing eCare NEXT®, they were able to automate pre-registration workflows so the majority of manual, repetitive patient tasks could be completed automatically, freeing up staff to focus on patients who needed specific attention before being cleared. With Registration QA added to the mix, they could track and correct errors and spot opportunities to improve performance in real-time, for a better patient experience and more efficient operations. Skylar Earley, Director of Patient Access and Communication, said that by using Experian Health’s patient intake solutions, “we were able to make some fairly minor workflow changes, but double our pre-registration productivity on a daily basis and then repurpose some labor to different areas in patient access.” 2. Martin Luther King Jr. Community Hospital (MLKCH) used automated registration to reduce claim denials Seeing that a large portion of claim denials were originating during patient registration, MLKCH introduced an automated registration workflow to eliminate unnecessary manual tasks and increase the accuracy of the data being collected. For Patient Access Manager Lori Westman, the results have been impressive: “We get fewer denials because we’re getting true verification data, and our patient volumes continue to increase. So the fact that we can take off at least two to three minutes on half of our registrations is speeding up the work for the team, and the turnaround time is much better for the patients.” By reducing paper-based tasks and introducing automated pre-registration options, these providers were able to make life easier for patients while slimming down their workflows. Is it time for your organization to do the same? Download our free eBook to find out more about how automated patient intake workflows could help you create a seamless, more efficient patient registration experience.
For many of the 36 million Americans who have registered for unemployment benefits during the coronavirus outbreak, losing their job means losing their health insurance. Options for the newly-unemployed are limited yet complicated: while the federal government has declined to reopen enrollment under the Affordable Care Act, several states are supporting those without coverage by opening emergency enrollment periods for state-based health exchanges. Those that can afford it may extend their existing employer plan through COBRA, while those that can’t may apply for Medicaid. But unfortunately, millions will be left without coverage. Now, with these changes happening in both large quantities and at rapid speed, the process for checking a patient’s coverage status is more complex, time-consuming and susceptible to errors than in normal circumstances. Further errors may appear as patients are forced to switch care teams, leading to disjointed care and incomplete, inaccurate or duplicate health records. It’s a huge administrative and financial burden for providers, who must keep pace with changes to the health insurance landscape or risk a surge in denied claims as a result of patient misidentification. How should they guard against patient identity errors and minimize revenue loss in the wake of COVID-19? How to prevent mismatched patient records and avoidable claims denials A 2018 survey found a third of denied healthcare claims were caused by patient identity errors, costing hospitals an average of $1.5 million. We may see this figure creep up following COVID-19, unless providers move quickly to implement robust identity proofing and patient matching processes. Providers looking to do this should consider prioritizing the following three areas: Eliminate errors during patient registration Up to half of denied claims occur earlier in the revenue cycle, which is also when most duplicate medical records are created. Improving identity proofing during patient scheduling and registration is a logical place to focus, to ensure records are accurate from the start. This should include proactively checking for active coverage as early as possible. Using a Coverage Discovery tool that automatically finds available coverage will help avoid bad debt write-offs and give patients peace of mind. Essentia Health’s Patient Access team were able to find 67% coverage pre-service, for patient accounts that were previously considered self-pay or uninsured. Automate identity matching throughout the revenue cycle When patient records are incomplete, duplicated or overlaid with part of someone else’s record, denied claims become an accepted cost – but they’re often avoidable. Instead of time-consuming and error-prone manual checks, providers should consider using automated identity management software to ensure patient records are accurate and complete. Data-driven matching technology supported by a Universal Patient Identifier allows a single view of each patient to be shared safely and securely across multiple healthcare services. There’s no need for tedious reconciliation work and providers can be confident they’re submitting clean claims each time. Improve identity management protocols for telehealth and mobile services More patients turning to telehealth services and patient portals to minimize face-to-face contact, putting pressure on providers to solve the patient matching problem. And with payers expanding coding for reimbursements for telehealth and remote services, there’s an added imperative to make sure patient information is accurate in order to minimize the risk of claims denials. Victoria Dames, Senior Product Director at Experian Health, says portal access has increased by roughly 40% since the start of the coronavirus outbreak, and explains that the rise in telehealth and mobile services means identity proofing must be a priority: “If you don’t already have identity proofing and automated solutions for patient matching in place, you’ll have duplicate records. We don’t want that – it’s important to have one view of the patient. But we need to move quickly. Automating for identity proofing eliminates the risk of human error and it’s faster too, which is crucial right now. We know many providers want to get their identity management and claims management systems optimized quickly, so we have a team set up to help.” Using the right technology to verify patient identities and analyze claims, avoidable denials resulting from missing or incorrect information can be caught sooner. Contact us to find out how we can help your organization manage patient identities to eliminate costly claims denials during and after COVID-19.
Flu season came early to Australia this year, with more influenza hospitalizations compared to last. And 93% of reported cases were the more dangerous Influenza A strain. If you’re wondering what this has to do with your healthcare organization, the answer is that generally speaking, flu season in the U.S. often mirrors what’s just happened in the southern hemisphere. In short, get ready. The number of cases in Australia has U.S. health officials gearing up for a challenging flu season over the next few months. Although flu activity is currently low in the US, the Centers for Disease Control and Prevention (CDC) expect this to increase in the coming weeks, particularly as Australia experienced an unusually severe early flu season this year. For healthcare organizations, this will likely translate into extra demands on staff and services, crowded emergency rooms and higher rates of admission. Your organization most likely already has a robust winter health contingency plan in place. Still, there may be new ways to use data analytics and technology to increase efficiency, so you’re as prepared as possible. Are you ready? Three ways technology can help providers prepare for flu season Create a flu-preparedness patient engagement strategy At this time of year, patients can be exposed to many misconceptions about flu and how to prevent it. A helpful way to make sure your patients are informed about how to protect themselves against illness is to communicate the risks, encourage vaccinations and promote preventative behavior. Consumer data can help you to deliver personalized messages to patients in a time and format that suits them best, segmenting your patient groups according to risk status. Whether you’re contacting them through their patient portal, email or in-person touchpoints, a tailored approach will create a more reassuring patient experience, while allowing you to target your information campaign to the right people at the right time. Promote telehealth services More hospitals and pharmacies are turning to telehealth systems to help manage flu season. Patients can log on to watch information videos and have virtual consultations with physicians without being exposed to germs in the doctor’s office. Reducing the number of patients showing up to access services in-person can help relieve pressure on services, while minimizing the risk of infection spreading. Check in with your telehealth provider to make sure everything is in place to provide your patients with the virtual care and advice they need. Streamline patient registration With more patients likely to be coming through the doors, the last thing you need is a time-consuming registration process hindered by lengthy and often unnecessary eligibility checks. Automating registration, financial clearance and other patient access processes can eliminate many manual tasks, save time and reduce errors so there are fewer denied claims. At such a busy time of year, your patients, staff and bottom line will thank you! How one Los Angeles hospital streamlined patient registration to manage flu season Martin Luther King, Jr. Community Hospital in Los Angeles worked with Experian Health to streamline patient registration and insurance verification. With a high-traffic emergency department and limited front-line staff, manual quality assurance and multiple payer website checks were creating bottlenecks and inaccuracies that took up more time to fix. Using Coverage Discovery, the hospital was able to improve efficiency in insurance verification, while Registration QA saved time in validating patient and payment information. In addition, eCare NEXT® helped automate workflows and generate data insights for further improvements—integrating seamlessly into the hospital’s existing Cerner® system. Speaking about the improvement made ahead of last year’s flu season, Lori Westman, patient access manager at MLKCH, said: “We have a lot of returning patients to our emergency room, so once we check that patient in, their eligibility automatically runs in the background and our staff doesn’t have to go into another website to check their eligibility. This has saved us two to three minutes of our registration time.” “We average about 300 patients every 24 hours. Heading into flu season, they’re expecting to hit a 400-per-day volume, so the fact that we can take off two to three minutes at least on half of our registrations is going to speed up the work for the team that much faster, to have a turnaround time that much better for more patients to come through.” Find out more about how we can help you streamline your Patient Access processes, so your organization is fighting fit for this year’s flu season.
The United States’ health system has become the most expensive in the developed world, and high administrative costs are a big factor. They account for more than 25 percent of spending on hospital care, making American healthcare administrative costs higher than any other country. Much of the problem comes from the complexities of payment. With public health programs, private insurers, and patients themselves all splitting the bill, it’s difficult for hospital administrators to determine who pays what in each situation. Especially during patient registration, they are bogged down by the time-consuming process of verifying patients’ eligibility for insurance and other programs. For these reasons, Martin Luther King, Jr. Community Hospital decided to focus on improving its patient registration process. The private nonprofit safety net hospital in South Los Angeles serves a high-need community and sees about 300 patients per day. Manually checking in all those people meant that MLKCH’s administrative team had an overwhelming workload. The hospital needed an integrated solution. Automation simplifies hospital patient registration The hospital’s staff was spending a significant amount of time checking different payer websites and making phone calls to determine each patient’s eligibility for insurance and various programs. Then, the benefits information had to be copied and pasted into the hospital’s non-integrated platform, which was another slow process that often resulted in inaccuracies. Quality assurance to find and correct those errors was a manual process, too, taking up more of the administrative team’s bandwidth. To free up resources and reduce errors, the hospital wanted to automate its verification processes, streamlining its registration, quality review, and more. MLKCH also needed its hospital patient registration software to work well with the Cerner system it already used. It decided to implement Experian Health’s eCare NEXT® platform. “We decided to use Experian Health’s software within Cerner versus a couple of the products we were looking at, at the same time, because it truly integrated within Cerner,” said Lori Westman, patient access manager at MLKCH. “When we presented this to our CFO, he liked the fact that it was integrated within Cerner; he didn't want us to have to go out to another third-party payer to pull information back. It's all about time and the time we can save on our registrations. That was the biggest selling point — the integration within Cerner and its seamless registrar on the back end. To the team, it's just another program they're working with in Cerner.” The software from Experian Health automates registration and financial clearance, among other patient access processes, which account for up to 80 percent of manual preregistration tasks. The system assesses patients quickly, replacing the information-gathering that staff has traditionally done. For MLKCH, which sees many returning patients, if a patient is already in the system at check-in, eCare NEXT pulls up his or her eligibility automatically when an administrator accesses the account. This saves several minutes, making it a notable patient registration process improvement. The system also eliminates a large portion of redundant tasks. When using the platform to check eligibility with one plan, eCare NEXT also searches for other applicable plans. For example, MLKCH treats a large Medicaid and managed care population, so checking a patient’s eligibility required visits to both the state’s and the health plan’s websites. But eCare NEXT will verify both automatically. Additionally, the fact that eCare NEXT integrated seamlessly with Cerner has improved the hospital’s patient registration process. Because the two platforms work together, patient data has become more accurate and the quality assurance process is less cumbersome. MLKCH was able to implement new QA standards after staff became familiar with the automation tool. The team also found that the enhanced data from eCare NEXT can shape user education and pinpoint areas for further improvements. And while there were some concerns that a new platform would take a long time to adopt, the rollout of the patient registration system was smoother than expected. The administrative team got a robust solution with exceptional support to ensure users have every resource they need. Ultimately, implementing an automation tool eliminated MLKCH’s most time-consuming registration tasks, allowing staff members to focus only on the tasks that needed their attention. This made their jobs easier and more efficient while also reducing training needs and improving compliance. The registration process became much faster. Automating preregistration tasks and eligibility verifications has also ensured MLKCH’s administrators have more accurate eligibility information. This integrates with Cerner to increase the quality of patient records. But the most important benefit of improving the patient registration process has been how it affects patients. These time savings get passed on to them in the form of quicker registration and less hassle proving eligibility. Using eCare NEXT has not only helped the hospital's administrators, but it has also allowed MLKCH to enhance patient service. Westman adds: “We get fewer denials because we're getting true verification data, and our patient volumes continue to increase. So the fact that we can take off two to three minutes, at least, on half of our registrations is speeding up the work for the team, and the turnaround time is much better for the patients.” Need to streamline your patient access department? Learn more or schedule a demo with us today.
This time last year, the Centers for Disease Control and Prevention and hospitals across the country weren’t quite ready for the flu season, which turned out to be the deadliest in 40 years. The flu and complications arising from it resulted in the deaths of more than 80,000 people. Hospitals felt the brunt of the 2017-2018 epidemic early. Hospital and medical center staffs were forced to work overtime, setting up triage tents and treating flu patients in recovery rooms. Alabama declared a state of emergency, and doctors in California had to treat patients in hallways. Experts predict a milder flu season this year, partly due to an updated flu vaccine that protects against H3N2, which was the severe strain that dominated last year’s flu season. While it's hopeful that this year’s flu season will be better, it's always a busy time for hospitals and providers, so they should be sure they're using the most efficient healthcare IT solutions to streamline their workflow. Greater efficiency is key When it comes to efficiency, hospitals should take a cue from Martin Luther King Jr. Community Hospital in Los Angeles, which collaborated with Experian Health to streamline patient registration and insurance verification. Before the collaboration, MLKCH had to consult websites and make phone calls to confirm a patient's insurance eligibility, which was time-consuming. The hospital has a large Medicaid and managed care population, which means employees had to consult both a state website and a health plan website. The hospital also had a high-traffic emergency department and limited front-line staff to handle the incoming flow of patients. Additionally, employees performed manual quality assurance, which is a time-consuming task. Understanding its challenges, Experian Health was able to help the hospital streamline its system to improve efficiency in insurance verification through Coverage Discovery. It also helped the hospital improve patient registration with Registration QA, which has improved data quality and patient registration accuracy. Since MLKCH integrated Coverage Discovery and Registration QA into Cerner, it has saved precious time when it comes to validating patient and payment information. “We have a lot of returning patients to our emergency room, so once we check that patient in, their eligibility automatically runs in the background and our staff doesn’t have to go into another website to check their eligibility," said Lori Westman, patient access manager at MLKCH. “This has saved us two to three minutes of our registration time.” “We average about 300 patients every 24 hours,” she continued. “Heading into flu season, they're expecting to hit a 400-per-day volume, so the fact that we can take off two to three minutes at least on half of our registrations is going to speed up the work for the team that much faster, to have a turnaround time that much better for more patients to come through.” Managing the season Only 42 percent of Americans got a flu vaccine last year — painfully shy of the CDC’s 70 percent target. Misconceptions and fears about the vaccination and its effectiveness can keep people from getting it, which only increases the spread of the flu. Flu season is always going to be a busy time for healthcare providers. But finding ways to manage staff and resources and work more efficiently is going to help hospitals and other facilities better manage the busy season. Learn more about Experian Health’s Patient Access solutions.
Meet Joe—a patient who is walking into a healthcare office, terrified of the news he might hear. He is confused and overwhelmed, not sure of where to turn for help. Joe isn’t entering a doctor’s exam room – he is actually walking into a hospital’s patient registration area, waiting to receive information about how much his procedure is going to cost. Although anxious about the procedure, Joe is even more concerned about its impact on the family budget, unsure of his insurance co-payment or what will be covered. He’s worried that he can’t afford to pay a large bill in one payment. His interactions with the registration staff over the next few minutes will set the stage for the remainder of his experience with the hospital. Now, let’s say the hospital realizes the value of having caring and compassionate financial conversations with patients at the start of the patient visit. Patient access staff quickly become the patient’s advocate while also improving the organization’s ability to collect from the patient and payer. In this instance, leveraging a data-driven approach allows staff to verify Joe’s identity and insurance coverage as well as provide an accurate estimate of his payment responsibility. The staff even can review data to assess his ability to pay and evaluate various payment plan and/or financial assistance options. Even after Joe is discharged, the hospital continues to employ a patient-centered approach to collections, using patient financial data to segment accounts that share demographic and financial profiles, rather than simply looking at balance amounts and number of days open. Joe’s financial data places his in the “most likely to pay” segment, indicating that he would not receive a payment follow up call until (for example) day 75 instead of the traditional call on day 45. This not only saves staff time and increases successful collections, it also preserves Joe’s satisfaction by eliminating unnecessary phone calls when he is likely to pay. Joe expected the hospital’s clinical staff to be responsive to his medical needs. When he found that the revenue cycle team was equally attentive to his financial needs, his satisfaction with the entire experience grew exponentially. It was fueled by a positive encounter that eased his mind about payment and allowed his to focus on his health. Using this proactive, personalized approach, the revenue cycle team had a major impact on both Joe’s experience and the bottom line. What is your healthcare organization doing to enhance the patient experience? Comment below to share some of your best practices.