Tag: self-pay

Consumers love the ability to research and compare prices of products on the fly so they know upfront what they’re signing up for. They’ve come to expect this level of empowerment in every transaction. Yet in healthcare, that expectation is now a demand as patients shoulder increasingly higher out-of-pocket costs.   Patients are also wary of being surprised by exorbitant hospital bills months after care. As a precaution, they want to know how much of the costs they’ll be responsible for before they receive treatment. Additionally, it would also be nice to make payments and schedule appointments online without being put on hold for hours or dealing with confusing call centers.   Until now, healthcare providers have been more or less behind the times when it comes to integrating technology into everyday workflows. With this in mind, organizations need to make price transparency and self-service vital aspects of the care they provide, and they need the right technology to do it. Fortunately, benefits of self-service portals not only include price transparency, but also appointment scheduling. Experian Health’s range of tools, such as the Patient Self-Service portal, makes it easy for any healthcare provider to catch up and equip patients with the tools they need to be confident in their care and payments.   Advantages of self-service portals   Patient engagement is the cornerstone of quality care and clinical outcomes. However, it can be difficult when patients are prematurely frustrated because they already know they’ll be hit with higher than expected costs for their visit, tests, and treatments. As a solution, moving patient billing to the front of the revenue cycle eliminates that worry, making it the first step to build trust and improve patient engagement.   The next step is making administration simple and convenient for patients. Scheduling appointments, changing insurance or address information, and asking questions about their treatment shouldn’t be arduous processes. When patients can accomplish these tasks quickly and conveniently, they feel more satisfied with their chosen healthcare provider.   Empowering patients through information and engagement helps them manage their ailments, illnesses, or simple doctor visits more efficiently, which translates to fewer readmissions. Providers can also improve their cash flow by delivering accurate estimates and immediate balance notifications, rather than making patients wait up to 30 days for paper statements. In turn, patients and providers can both benefit from using a self-service portal because it improves virtually every aspect of healthcare administration.   Key benefits of self-service technology in an all-in-one portal   Experian Health’s Patient Self-Service portal makes it easier to keep patients informed and empowered, which not only improves the quality of their care, but also aids an organization’s financial health. For instance, manual scheduling alone takes one person or a team of full-time employees, which can be costly. On the other hand, in a self-service portal, patients interact directly with technology without the need for full-time human assistance.   The easy-to-use portal isn’t just about scheduling, though. Through the portal, patients can also check whether they qualify for financial assistance, receive support for presurgery planning and postsurgical follow-ups, and email questions to their medical team. Another helpful portal feature notifies patients about their possible qualification for charity care. If eligible, patients can avoid medical bankruptcy by setting up a crowdfunding page to help pay their bills.   Furthermore, the portal is accessible 24 hours a day, seven days a week. It's where the head of a household can review and update the entire family’s billing, account, and insurance information conveniently in one place. In addition, patients can receive a consolidated bill that's easy to understand and set up automatic payments so they know how to budget for future healthcare costs.   Combined with upfront price transparency – which is now a legal requirement in many states – the Patient Self-Service portal provides vital benefits for streamlining healthcare administration and engaging with patients on the level that they need and expect.

With the ability to research products, compare price information, and conduct transactions all from their mobile devices, today's consumers are more savvy than ever. They expect an unprecedented level of transparency from companies. In fact, they demand it and will easily take their money elsewhere if a company doesn't follow through. Consumers expect the same high-level transparency from healthcare providers, and the demand is growing as patients are forced to bear more out-of-pocket costs for medical care. They want to avoid surprises, such as higher-than-expected cost estimates for services or insurance that may cover only a small portion of the expense. Price transparency initiatives are becoming increasingly more important in healthcare systems, and providers must embrace new capabilities to meet patients' expectations. The old model of billing patients weeks or months after they’ve received services is no longer viable. Billing needs to move to the front of the revenue cycle management process, and a number of Experian Health's solutions are designed to help do just that. 3 tools for greater price transparency in healthcare As patients are responsible for a higher percentage of their healthcare costs, healthcare providers' financial performance depends on an optimal collections strategy that focuses on patient engagement. The advantage of patients knowing and having confidence in healthcare cost estimates makes the collections process much easier and helps drive the future revenue cycle. Here are three Experian Health solutions that can help healthcare providers improve price transparency: 1. Patient Estimates: Patient trust is built on meeting expectations. With this in mind, Experian Health's Patient Estimates tool brings accurate, upfront price transparency before or at the point of service so patients know what to expect and can confidently make decisions about their healthcare. Cost estimates are derived from numerous types of data, including a patient’s benefits information, a healthcare provider's reimbursement agreements, and payer contract rates, among others. Much of the information can be automatically populated into the system, eliminating the need to constantly update price information lists and reducing the risks of inaccurate cost estimates resulting from error. With Patient Estimates, healthcare providers can also more effectively comply with state and federal price transparency requirements. 2. Patient Statements:Accurate price information is one thing, but even if the patient’s billing statement matches the cost estimates, collections can be a challenge if the statement is hard to read or understand. Patient Statements is a communications tool that simplifies and customizes patient billing statements, complete with important, easy-to-understand updates and messages. Making billing statements straightforward for patients to manage helps healthcare providers build a stronger level of trust when it comes to payments. Personalizing the statements with marketing and educational information turns them into valuable resources that create a better overall patient engagement experience. 3. Patient Self-Service:With accurate, upfront price estimates and simple, useful bill-paying systems and statements, healthcare providers can more successfully integrate our online self-service portal. Experian Health's Patient Self-Service tool digitally delivers cost estimates and statements to patients. It also allows patients to securely make payments and conveniently schedule future appointments from their desktop or mobile devices. Patient Self-Service brings the high level of price transparency to healthcare providers that consumers now expect. This makes it more likely for patients to meet their self-pay responsibilities and return for future healthcare services. Patient Self-Service also helps healthcare providers more efficiently comply with "meaningful use" Stage 2 program requirements. The capabilities for price transparency that these solutions provide is just a small sampling of what we offer today, and we’re continuing to research and develop even more useful tools. In addition, we’ve recently launched an extensive consumer research project to better understand patients’ wants and needs. We’re excited to use these insights to continue developing solutions that help healthcare providers improve engagement with patients.

Yale New Haven Health is an award-winning academic healthcare system, and a big part of why its people achieve success is because they continually ask, “How can we do better?” For two years, the financial preservice team used focus groups and other feedback to learn about the financial concerns of patients and their loved ones. Then, they pursued a rigorous, tech-driven transformation to better develop estimates, identify patient payment solutions, explain billing and collections, and engage with patients. Yale New Haven Health employees and executives view patients’ financial care as an important facet of healthcare. By pairing their own dedication and know-how with Experian Health products, they’ve improved the patient experience and increased staff satisfaction. Here’s how: Create transparent, plain-language patient estimates The preservice team wanted to give patients cost estimates that were easier to understand and more accurate. Now that they’re using Eligibility, team members know exactly what procedure a patient is having and are better equipped to verify eligibility and explain the patient’s deductibles, co-insurance, and out-of-pocket expenses. For example, the team has standardized the varying (and sometimes cryptic) eligibility responses returned by hundreds of different insurance companies and other payers. Team members give patients the same clear answer — no matter how many ways payers use to describe what their plans will and won’t pay for. Find alternative payment solutions Another challenge confronting Yale New Haven Health was helping patients find ways to pay for procedures. The preservice team deployed Coverage Discovery, which can find and verify insurance coverage that patients didn’t even know they had. As patients register for their procedures, the tool searches for previously overlooked Medicare, Medicaid, and commercial insurances. Patients can sometimes avoid costly self-pay situations, and Yale New Haven Health avoids write-offs and unwarranted charity designations. Also, the preservice team is watching trends in what Coverage Discovery finds so they can spot potential problems earlier and identify payment alternatives sooner. Make it less painful to receive a bill It’s nearly impossible to achieve pain-free billing, but the confusing terms and codes found on most healthcare statements shouldn’t add to the pain. As part of its financial care transformation, Yale New Haven Health started using Patient Statements to combine hospital and physician billing into one easy-to-understand document. It even added customized messages to further explain the procedures and costs. Patients have said that they’re happy with the new design. Give patients a way to be self-sufficient Patients want an easy, digital way to evaluate options and understand what products and services cost. Healthcare is no exception. Yale New Haven Health uses Patient Self-Service to serve up a self-service portal that gives patients a greater say in their healthcare and connects them to their providers. For example, patients can set up their own payment plans (within parameters set by Yale New Haven Health). It saves time for the patients and the preservice team, which enjoys a reduced volume of customer service calls. Yale New Haven Health already had a relationship with Experian Health. It was already using Payer Alerts and Collections Optimization Manager to improve back-end revenue cycle operations. This time around, it focused on preservice processes and added Eligibility, Coverage Discovery, Patient Statements, and Patient Self-Service to its financial care system. These tools have garnered more satisfied patients, to be sure. They’ve also served as physical expressions of Yale New Haven Health’s commitment to excellence. Staff members can take greater pride in their jobs knowing they have the tools to better fulfill their patient-centered mission. A lot is said about treating the whole person instead of just the disease. By approaching financial care as an important companion to clinical care, Yale New Haven Health has discovered countless ways to answer the question “How can we do better?” Learn more about Yale New Haven Health’s patient financial care transformation. Read the case study.

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.

In the “good old days,” U.S. healthcare was basically free – at least that’s what patients with a good insurance plan believed. You may have had a small co-pay, but if you were employed, chances were that you and your family received comprehensive health insurance that took a barely noticeable bite out of your paycheck. Fast forward to 2014, and that rosy picture is long gone. Changing reimbursement models are compounding the financial risk for healthcare providers by placing a greater payment burden on patients. For example, a growing number of employers are adopting high-deductible health plans (HDHP) and/or health savings accounts. The number of people with HDHPs has risen from 19.2 percent in 2008 to 33.4 percent in 2014, as reported by the Centers for Disease Control and Prevention. Out of necessity, providers are finding themselves in the collections business if they are to protect the bottom line. One of the best tools at their disposal to increase full and fair payment for healthcare services, and which has long been employed by collections agencies? Data and analytics. Real-time information and advanced data and analytics can help identify the most effective and customized collections approach based upon each patient’s financial situation. This data gives healthcare organizations the full picture of a patient, providing continuous monitoring of unpaid accounts for changes in a patient’s ability to pay. Obtaining and effectively leveraging that information is just one best practice for healthcare organizations seeking to enhance their collections methodologies. Additional must-have strategies include: Management of internal collections and agency performance with real-time dashboards and reports, and support evaluation and performance improvement.  Use of full-time revenue cycle consultants and data analysts, who work with each account to recommend “best practice” collections and outsourcing strategies, evaluate reports for opportunities and oversee champion/challenger scenarios.  Tools that help detect hidden or additional insurance coverage from Medicaid, Medicare and commercial accounts.  Creation of customized patient statements that go beyond traditional statements by facilitating financial counseling, education and greater patient engagement.  Simplified and streamlined payment processes by collecting patient open balances anywhere and at any time through eChecking, signature debit, credit, recurring billing, cash, check or money orders.  Times may be changing, but employing a well-coordinated, proactive approach to addressing the self-pay patient and capturing the balance after insurance has paid doesn’t have to be challenging. Learn how Experian Health and Passport’s patient collections tools work together to help you obtain payment certainty even with today’s new reimbursement models, by combining unmatched insight, real-time data and innovative collections solutions.