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This is the fourth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. In this post, we address the fourth step – prior authorizations, and helping your patients get the approved care they need. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. To read the full white paper, download it here. Ask ten physicians how to improve healthcare administration, and they are likely to share dozens of conflicting answers. But if there’s one thing almost all of them can agree on, it’s the need to dramatically overhaul the processes around prior authorizations (PAs) for patient care. Prior authorizations for specific procedures, tests, and medications are designed to reduce financial surprises for patients and providers – while encouraging evidence-based care. The challenge is that criteria for authorizations changes frequently and can be complicated. Unfortunately, due to the COVID-19 pandemic, frequent change and complexity are difficult to manage. After months of avoiding in-person interactions, patients are now flooding back to their providers to catch up on deferred care. In many ways, the increase in volume is to be celebrated: providers are recouping lost revenue and patients are once again receiving necessary services. But with the return of patients comes the return of onerous paperwork, and providers are not entirely prepared to play catch up. In 2021, two-thirds of providers told Experian that they are finding it difficult to keep track of complicated criteria that keep changing during the pandemic. The same number expect to see ongoing challenges with securing authorizations for scheduled elective procedures, a marked increase from just over half of those surveyed last year. As providers, payers, and patients adjust to the new normal of COVID-19, it’s time for providers to streamline operations, increase efficiency, and improve revenue cycle predictability with automated prior authorizations. Coping with the multiplying burdens of prior authorizations Faxes and phone calls dominate the pre-authorization process. Practice staff – or even patients themselves – might spend hours working with multiple payer organizations trying to fill out forms, get more information, or appeal decisions. Without going through this tedious procedure, practices risk claim denials that can significantly impact their revenue cycles and patients may end up with unexpectedly large out-of-pocket bills. Over 80 percent of providers have seen an uptick in prior authorizations since 2020, building on a multi-year trend of increasingly complex PA requirements. In a recent survey from the American Medical Association (AMA), 85 percent of physicians confirmed that the burdens from prior authorizations are “high” or “extremely high,” and are affecting their practice operations. With an average of 40 prior authorizations per week per physician, some practices are spending more than two full working days each week on paperwork, the AMA says. Practices that want to get ahead of PAs will need to take a new approach to preapprovals and health plan relations. Fortunately, innovative automation technologies are available to help. Leveraging automation tools to streamline prior authorizations Prior authorization software can significantly decrease the cognitive burdens and person-power involved in completing PAs. With key features, such as an always-up-to-date knowledge base of current requirements for multiple health plans, staff members don’t have to search for obscure rule changes or the right payer portal to make sure their submissions are accepted the first time around. Exception-based workflows with dynamic work queues can easily guide staff members through convoluted requirements. Advanced status tracking, flags for manual review requirements, and procedure reconciliation tools also ensure that staff are always informed and prepared to take action. As a result, providers and physician groups gain the ability to complete more PAs in less time with a lower risk of errors, resubmissions, or claims denials. Meanwhile, patients can get the timely, evidence-based care they need and are less likely to find unpleasant surprises in their next medical bill. Integrating proactive preapprovals into the patient journey Providers can even take these newfound capabilities one step further to create a fully coordinated, cost-effective administrative experience for their patients. For example, automated Notice of Care tools are the perfect complement to digital prior authorization solutions. With these solutions, providers can send timely and accurate patient admission, observation, and discharge notifications while simultaneously gaining visibility into pending encounters. Uniting Notice of Care tools with data-driven PA strategies will make it simpler to proactively and holistically manage patient flow, anticipate resource allocation, and provide patients with timely and accurate information. As consumers begin to return to their pre-pandemic healthcare habits, it will be more important than ever for providers to get a handle on their administrative requirements and ensure they have the bandwidth to focus on reestablishing strong relationships with patients. With a combination of prior authorization tools and Notice of Care solutions, practices can complete necessary administrative tasks quickly and easily to support efficient, effective, and engaging patient journeys through the continuum of care. Learn more about how Experian Health can help your organization streamline patient access and improve revenue cycle predictability with automated prior authorizations. Download the white paper to learn more about how the prior authorizations process is changing post-pandemic.   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

This is the third in a series of blog posts highlighting how the patient journey has evolved since the onset of COVID-19. Explore how digital patient intake solutions are transforming the registration process – presenting patients with self-service options and providers with an automated and more efficient process. To read the full white paper, download it here. Registration is a familiar pain point in the patient journey, but COVID-19 has pushed both patients and providers to embrace digital patient intake processes and solutions. These new solutions move registration out of the waiting room, reduce errors and inefficiencies, automate billing, payments and create an enterprise-wide approach to data. Digital patient registration, once considered a “nice to have,” is now a widespread priority. A reveals that 88% of providers plan to invest in patient intake capabilities as a result of the pandemic, up 15% over a year ago. Patients lead the way on post-pandemic digital experiences COVID-19 marked a tipping point in the digital patient experience. Contactless care in the form of telehealth, along with increased use of patient portals and self-service scheduling tools, helped patients access care from a distance. Now, even though 81% of patients say they believe their provider has made on-site facilities safe, many still prefer online and mobile registration options. The study also revealed that 64% of patients prefer an online or mobile-enabled registration experience. “There’s an ‘ick’ factor,” explains Spiro Kalapodis, Director of Product Management for Registration Accelerator and Patient Financial Advisor at Experian Health. Patients actively dislike filling out paper forms, using registration kiosks and handling iPads set out for public use. “I don’t blame them,” says Kalapodis. “Even though the initial wave of COVID-19 restrictions has passed, I would prefer completing the registration process from the comfort of my car, rather than fill out forms in a crowded waiting room.” Simplifying a difficult process with digital registration and digital patient intake solutions One reason automated registration can be such a relief is that manual processes are notoriously difficult for providers to manage. Manual patient registration has always been labor-intensive and subject to human error; COVID-19 magnified these limitations. Paper forms are inefficient – they require design, printing, paper, clipboards, pens, secure storage and disposal. So many things can go wrong: receiving illegible responses, inputting data incorrectly, misplacing forms, the list goes on—and each step consumes valuable staff hours, with questionable results. Meanwhile, patients moved, visited new providers, changed jobs and switched insurance companies which meant there was more information needing capture. At the same time, providers are struggling to recoup revenue that was lost when patients deferred care during the pandemic. Optimizing both human and digital resources is key to delivering on an improved patient experience and regaining consistent profitability. “Patient intake solutions automate everything so data can be used consistently across the patient journey,” says Kalapodis. “For example, when a patient scans their insurance card and submits it through Experian Health’s Registration Accelerator, we leverage technology behind the scenes that can automatically indicate the patient’s insurance provider, policy details, and correctly return the patient’s subscriber details —information that staff members otherwise have to figure out for themselves. By automating this process, we’re saving time and resources, reducing misunderstandings and preventing data entry errors, which can be costly for providers and confusing for patients.” With the right data, providers can also create accurate estimates and even invite patients to pay their bills as part of the registration process. The patient receives a text message with a link to their estimate, along with the opportunity to pay online or on their mobile device. “Not only does this streamline the billing and collection process for providers, it creates a frictionless experience and increases greater transparency for the patient,” says Kalapodis. Getting to a single view of the patient Maintaining accurate data records can help providers deliver smooth patient experiences, better care, simpler payment processes and allows for better communication. Unfortunately, COVID-19 created another challenge on this front. During the pandemic, many patients signed into patient portals to schedule vaccine appointments. In their hurry to secure a shot, many inadvertently created duplicate accounts—and now have duplicate records. Obviously, multiple vaccine logins are not the only source of duplicate, inaccurate and incomplete patient data. But thanks to COVID-19, providers have this additional problem to contend with. Automation can make fast work of data issues. A universal identity manager creates a single view of the patient using unique patient identifiers, which prevent duplicate data records. The result: fewer billing errors and reduced associated costs, better care and a more frictionless patient experience. Patient intake can be painless Digital patient registration was a good idea even before COVID-19. Paper forms, entry errors, fragmented data, duplicate records, slow billing, and a lack of transparency made the registration process costly and inefficient. But COVID-19 made the need for digital more acute. Providers that hope to re-engage patients and recover profitability in the post-COVID-19 era need the power of data and automation. Learn more about how Experian Health can help you deliver a patient registration experience that fits post-pandemic expectations while improving efficiency, reducing errors and leveraging patient data. Download the white paper to learn how digital patient intake solutions are revolutionizing healthcare.   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

The delta variant is still surging – and flu season is about to begin. How can healthcare providers leverage innovative technologies to streamline care and prepare for a potential “twindemic?” The summer of 2021 has not been kind to healthcare professionals.  After a brief period of hope that the worst of the COVID-19 epidemic was over, the delta variant started its march across America, flooding hospitals and physician practices with a new wave of seriously ill patients. Autumn and winter look like they might be trouble, too, as delta joins forces with the seasonal flu to form a potential “twindemic.” After a mild season in 2020, many experts are predicting that the flu will reemerge with a vengeance this year as people return to in-person work and school. The combination of the two illnesses could easily overwhelm providers who aren’t prepared with technologies and workflows that allow them to serve patients efficiently and remain responsive to fluctuating demands. As providers look to navigate the coming months, they will need to make sure that they have self-service tools in place to keep patients safe and relieve strain on staff.  With a few key digital solutions, resources can be maximized, unpredictable patient volume can be managed effectively, and difficult circumstances won’t slow down operations. Online self-scheduling can improve experiences for patients and staff Online self-scheduling is in high demand because it provides flexibility. patients want to move on with their busy lives without having to sit on hold with a representative. In Experian Health’s recent survey, the State of Patient Access 2.0, more than seven out of ten patients wanted to take the appointment-making process into their own hands, citing the speed and convenience of choosing their own appointments. Providers and physician groups appear eager to oblige.  More than 70 percent of providers responding to the survey stated they are planning to offer online appointment tools to improve experiences and manage complex operations as the pandemic continues. The benefits for providers are significant.  Online self-scheduling can measurably reduce administrative burdens on staff, allowing practices to reallocate their people power to other high-priority tasks. Giving patients the tools to make appointments may also help to reduce patient no-show rates, which can drain billions of dollars each year from provider organizations. Using self-scheduling tools, patients with transportation issues or concerns about exposure risks may be able to opt for telehealth visits, as opposed to unplanned visits to urgent care centers or the emergency department. This can help protect other consumers and staff from illness while allowing them to manage their own calendars. Mobile patient registration keeps patients safe from exposure during a "twindemic" Shifting patient registration from the clinic to the home can also be beneficial for patients and providers.  When patients fill out new forms or update existing information in person, they increase their exposure risk by staying in the waiting room longer than necessary. In contrast, a digital registration accelerator solution offers a quick, touchless, and convenient intake experience on the patient’s own mobile phone.  Patients can complete the process in their homes (where they are more likely to have all their personal information at hand), or in the parking lot while waiting for clearance to enter the building. On the provider’s side, automating patient intake improves operational efficiency and avoids errors that come from illegible handwriting and verbal information communicated through masks and plexiglass.  Data integrity algorithms and real-time feedback for patients can correct mistakes quickly to ensure high accuracy of patient data – a crucial competency for treatment and reimbursement. Patient portals boost convenience, communication, and security As providers prepare to battle two illnesses instead of just one, practices shouldn’t forget to leverage one of the most important parts of the digital arsenal: the patient portal. Portals are instrumental for staying connected with patients, particularly with the 40% of patients who skipped medical care in the early months of the pandemic. As a complement to necessary in-person care, patient portals offer a convenient way to communicate with providers, complete administrative tasks, and access personal health information at their leisure. Providers must be certain, however, that their portals don’t become avenues for medical identity theft.  Healthcare organizations must maintain tight security policies that simultaneously deliver an optimized patient experience. A patient identify-proofing and authentication solution that automates patient portal enrollment while adhering to the high standards of HIPAA and other industry requirements is key.  Solid security can reassure patients that sharing digital health information with their trusted providers is safe – fostering more open relationships and leading to better care. Hopefully, fears of a “twindemic” will fizzle as communities continue to take sensible precautions against the spread of COVID-19.  However, if the flu does roar back into life, providers must be prepared. Self-service technologies and robust security measures can safeguard practices against the strain of higher-than-expected patient volumes and supporting the continued delivery of high-quality patient care. Learn more about how Experian can help your organization incorporate these new technologies and prepare for a potential "twindemic."