At A Glance
Revenue cycle management automation and artificial intelligence (AI) can help healthcare organizations reduce manual work, catch errors earlier and prioritize claims that need attention. Learn how revenue cycle teams can use AI-powered tools like Patient Access Curator and AI Advantage to support more efficient workflows.Test PHP upgrade to 8.5.12
Healthcare organizations face ongoing pressure to identify every available source of insurance coverage and secure reimbursement for care already delivered. Coverage can change, become active or become discoverable after a patient receives care, creating the risk that eligible claims go unpaid. Providers need a stronger way to uncover missed coverage and protect revenue after the point of service.
Experian Health is helping address this challenge through its acquisition of eInsights, which serves more than 200 U.S. healthcare organizations and has helped clients recover more than $225 million in reimbursements. By expanding Experian Health’s insurance discovery capabilities beyond the front end of the revenue cycle, the acquisition helps healthcare organizations identify coverage that may otherwise be missed and recover reimbursements tied to care already delivered.
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Finding insurance coverage shouldn’t be a one-time event. A patient’s coverage can change or become discoverable after care is delivered, and when that happens, providers can miss reimbursement and patients can end up with bills they shouldn’t have received.
Experian North AmericaJason Considine, President of Experian Health

Key takeaways:
- Revenue cycle teams can use automation to reduce repetitive work and apply AI where data-driven prediction, matching or prioritization can improve a workflow.
- Experian Health’s2025 State of Claims surveyfound that 41% of providers now face denial rates of 10% or higher, while 68% say submitting clean claims is more challenging than a year ago.
- Patient Access Curator™ (PAC)uses AI to support front-end data validation and insurance discovery, whileAI Advantage™helps teams predict denial risk and prioritize denial follow-up.
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Take a look at at four opportunities that healthcare marketers and patient outreach teams can incorporate into their post-pandemic playbook.
Learn about COVID-19’s impact on the patient journey and see how digital transformation is helping the healthcare industry recover.
The pandemic opened the door to a whole new set of identity management challenges. How can providers solve for data standardization challenges?
The State of Patient Access surveys patients and providers to see how patient access has changed since COVID-19. See the results!
The future of patient access is digital, and providers that get their systems up and running effectively now will reap the benefits in the long run.
With more patients starting to come back through the door, there’s an opportunity for providers to smooth out the kinks in the registration experience.
Learn how ACS worked with Experian Health and our Universal Identity Manager (UIM) platform to deliver the Experian Single Best Record (ESBR).
Accurate and efficient workflows will be paramount as patient volumes rise. It’s time to rethink the manual processes that often result in delays, errors, and non-compliance.
More than 40% of patients surveyed skipped medical care in the early months of the pandemic, according to a recent study by researchers at the Johns Hopkins Bloomberg School of Public Health. Of those who needed care, 58% missed scheduled preventive care. Similar trends are observed in cancer screening, with appointments for breast, colorectal, and cervical cancers – in some cases dropping by around 80%-90% in March and April 2020, compared to 2019. Diagnostic testing for several cancers also plummeted, as did HPV vaccinations. These trends aren’t unexpected: COVID-19 forced medical facilities to cancel or scale back services, while fear of infection and financial worries kept many patients away. But with most services operating at near-normal capacity again, and the vaccine program tipping the balance in favor of rescheduling care, preventative services are still lagging. Many patients remain reluctant to attend screening and wellness visits, despite the health risks associated with delaying care for potentially serious conditions. Re-establishing a preventive care routine is essential. For patients, getting back on track with earlier diagnosis means more timely treatment and a better chance of recovery. It promises a better financial outlook for patients, payers, and providers alike, who all suffer higher costs when medical conditions escalate. And providers want to get their day-to-day business back on track to smooth out what has been a heavily disrupted workflow and revenue cycle over the last year. Providers must reassure patients that returning to care is safe and necessary. Compassionate and personalized support will be key to making sure patients get the right care at the right time. Automated patient outreach strategies built on comprehensive patient data can help reverse the trends in forgone care. How can data and automation support personalized patient outreach? Kelly E. Anderson, one of the authors of the John Hopkins study, suggests that “physicians can mitigate some of the long-term harmful effects of this forgone care by proactively reaching out to patients who missed care, to try and reschedule the care either in-person or through telehealth.” Automated outreach combined with easy patient scheduling platforms can help providers identify and invite healthcare consumers to get much-needed preventive care appointments back on track. For example: Automation makes scheduling easy for patients and efficient for providers Online scheduling platforms allow patients to reschedule missed appointments at a time and place that suits them. A targeted outreach list of those patients most likely to need screening (for example, based on age, lifestyle, or health risk factors) can be used to send automated booking prompts and reminders by text message or interactive voice response (IVR). It’s simple and convenient for patients and reduces pressure on call center staff. Plus, it generates a wealth of useful real-time data on response rates to pinpoint areas for improvement. With the right data, providers can direct patients to appropriate services For patients that can’t or prefer not to attend their usual healthcare facilities, directing them to telehealth services or alternative venues might be a good option. Similarly, patients with a medical or family history that suggests a higher risk of cancer ought to be prioritized for screening. But you can only do this when you know who those patients are, and what exactly they need. Social determinants of health can be a powerful tool to help providers determine a holistic view of patients’ clinical and non-clinical needs. ConsumerView collates consumer data from over 300 million individuals, across multiple demographic, psychographic and behavioral attributes, so providers know more about the lifestyles and interests to be able to effectively resonate and engage. Data helps create a better patient financial experience Since many patients are worried about the loss of health insurance, outreach efforts might also involve pointing patients towards appropriate financial support. When socio-economic data reveals that a patient is struggling financially, providers can quickly check for missing coverage, offer tailored payment plans, and help obtain charity care if required. Automated outreach can also deliver the upfront information about healthcare pricing that so many patients demand, and help staff collect faster patient payments by providing easy payment links through text and IVR campaigns. Consumer data can inform compassionate patient communications With the majority of patients opting out of scheduled appointments because of concerns about COVID-19 exposure, any invitation to reschedule care should offer plenty of reassurance about hygiene protocols. Some patients may need a gentle nudge to reschedule appointments, so if you can help them feel comfortable visiting facilities and tell them what to expect, they’ll be more likely to return. Offering additional reassurance and support to communities who are traditionally underserved by healthcare services, or who have been harder hit by COVID-19, will be even more important. Best contact information, social determinants of health insight and ethnicity insight can support efforts to promote screening to groups who may face additional barriers to care. With the right data, you can go beyond compassionate messages and choose an appropriate communications channel that’s the right fit for the consumer, too. One thing that hasn’t been hindered by COVID-19 is the trend toward healthcare consumerism. Patients have a choice about which provider they use. Proactively supporting patients to catch up on missed care is a surefire way for providers to stand out as the easy choice.
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COVID-19 provided an unexpected use case for patient portals. In a matter of weeks, the benefits of remote patient access were undeniable. Patient portals allowed patients to schedule, register and pay for care from the comfort and safety of home. Now, as the latest omicron sub-variant triggers another surge in case numbers, providers are again reminded of the value in making digital channels available to minimize face-to-face interaction. With staffing shortages continuing and patient numbers rising, it’s worth recapping the benefits of patient portals. Why should healthcare providers prioritize patient portals? Here are 7 reasons: 1. Patient portals can be used to communicate safely with patients as Covid-19 cases rise Health officials may be cautious about reinstating extreme measures in response to the latest wave of infections. However, they can’t afford to be complacent about an uptick in hospital admissions. Patient portals can mitigate the risks associated with increasing foot traffic by allowing patients to schedule and register for care without attending in person. Completing paperwork from home eliminates the need for patients to share clipboards or sit in stuffy waiting rooms, while online scheduling platforms enable staff to manage the flow of patients safely and efficiently. Remote patient monitoring, secure messaging and online prescription refill requests can also be managed via portals, further reducing the need for in-person visits. 2. They can ease pressure on understaffed teams Providers need to find efficient ways to handle the administrative workload that comes with higher patient volumes. It’s even tougher given increasing retirement and resignation figures. More nurses are embracing the occupational benefits of remote and virtual care and are opting to switch from high-stress facilities to telehealth positions. While this speaks to the growth and impact of remote healthcare, it leaves a gap to be filled in hospitals. Patient portals can alleviate some of the burdens by reducing the need for staff input at various points in the patient journey. For example, online scheduling reduces the number of calls to call centers. Pre-filled data and automated registration can reduce the risk of errors during patient intake, which are time-consuming to fix. Portals can also be used to help patients navigate the payments process, speeding up collections and reducing the time staff spend chasing payments. 3. Patient portals can address inefficient patient access workflows Because patient portals are tethered to the patient’s electronic health record (EHR), they provide a hub for every piece of data relating to the patient. Patients can access that golden record at any time. They get an engaging and transparent experience, and are less likely to call up to ask questions – they already have the answers. They can also check data to make sure that it’s accurate, which helps avoid the delays and misunderstandings that cause friction for patient access teams. It’s important to ensure that the portal itself doesn’t introduce friction. Patients need to be able to enroll in the portal without too much trouble. Automating the patient enrollment process and implementing a multi-layered identity-proofing solution can create a secure and efficient way for patients to get the most out of their portal, without compromising safety or efficiency. 4. To improve patient engagement and meet consumer expectations One of the biggest reasons to invest in patient portals is because patients say they want them. Research from Experian Health and PYMNTS found that 44.1% of patients have obtained test results through patient portals, while 18% used patient portals to fill out forms for their most recent healthcare visit. Overall, two-thirds said they use patient portals. Beyond offering a convenient patient experience, this is also a matter of patient loyalty and retention: 61% of patients say they’d consider switching providers to one that offered a patient portal, which could have a significant impact on revenue. 5. They can boost revenue by offering easy ways to pay Experian and PYMNTS research shows that around a fifth of patients uses their portal to make payments. Unfortunately, 16% of those patients said they’d faced difficulty viewing invoices, setting up payment plans and making payments through their portal, which suggests some room for improvement. Experian Health’s Patient Payment Solutions solves these challenges. A range of self-service, mobile-optimized tools simplify the patient financial journey by giving patients upfront pricing estimates, personalized payment plans and easy ways to pay. 6. Using patient portals can improve health outcomes (especially for “frequent flyers”) Patient portals also play an important role in promoting better health outcomes for patients. Research shows that when patients have access to their medical information, they feel empowered and prepared to speak to their doctor and adhere to care strategies. Multiple providers can engage with the patient through the same platform, and see what other treatments are being prescribed. This helps improve communication between the patient and provider and helps improve care management. It’s especially useful for older patients and those with chronic conditions. In this way, portals support effective care coordination, helping value-based care providers achieve their goals of reducing healthcare costs, promoting population health and closing the gaps in care that have widened over the last few years. 7. Patient portals can support compliance with price transparency regulations Finally, portals offer a route to ensuring compliance with new regulatory requirements around price transparency. The No Surprises Act and hospital price transparency rule call on providers to give patients accurate, upfront cost estimates so they can plan for their financial responsibility more easily. Patient Payment Estimates can be delivered in several ways, including through patient portals. And as noted, once the patient has their estimate, they can also be directed to easy and convenient payment methods, including through their portal. Whether it’s a surge in COVID-19 cases, rising inflation, or labor shortages, providers must find ways to build resilience, stay competitive, and continue to offer patients the flexible and transparent healthcare experience they desire. Patient portals should be part of the plan to open the digital front door. Contact us to find out how Experian Health helps healthcare organizations deliver a reliable and secure patient portal experience.
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Artificial intelligence (AI) and automation can support administrative work in healthcare. In the revenue cycle, teams depend on accurate information, timely decisions and efficient follow-up to keep claims moving.
Artificial intelligence (AI) and automation can support administrative work in healthcare. In the revenue cycle, teams depend on accurate information, timely decisions and efficient follow-up to keep claims moving.
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