All posts by Experian Health

As most doctors will say, healthcare is about helping patients, not making money. However, these two goals aren't as separate as some would assume. In order to help their patients, healthcare providers need to buy equipment, pay salaries, and spend money to maintain an effective, efficient customer experience. Revenue is what makes healthcare work, so preserving revenue should be a main priority for healthcare administrators. That's how Stacy Calvaruso, assistant vice president of patient services and revenue cycle at Louisiana Children's Medical Center (LCMC) Health, approaches her job. "Revenue preservation is a term that we use in our organization to talk about how we're going to ensure that we're maintaining all the money that we can possibly collect for the services that we provide for our community," Calvaruso says. "Everyone is being asked to do more with less, and patient access or the revenue cycle is no different than the clinical areas. We have to ensure that we're able to collect all the money and all the income that we generate as an organization so that we can put more money back into the community to provide more services to more patients." For help with revenue preservation, Calvaruso's team uses Experian Health's revenue cycle management tools. The full suite of Experian Health's revenue management products help LCMC Health facilitate patient access, manage contracts, process and submit claims, and streamline collections. Here's a closer look at how Experian Health approaches each stage of the revenue preservation process. Patient Access With 86 percent of leading medical practices seeing an increase in payer prior authorization, having accurate and comprehensive patient data is crucial to getting patients the treatment they need with fewer denials from insurers. Experian Health can help by verifying patient information at the point of service. From there, automated software coordinates patient data across all connected facilities so customers, doctors, and insurers are better informed about possible treatment options and how much they're likely to cost, eliminating any surprises in the payment or collections process. According to Calvaruso, a transparent process helps to prevent repeated work, which is a major cause of revenue loss. "Instead of calling a patient after the fact about a denial or incorrect insurance information, we're able to call them on the front end to let them know that we've verified their benefits, we know what the estimate of their out-of-pocket payment is going to be, we've talked to their doctor, and we're ready for them to come and have these services," she says. Experian Health's Patient Access tools make it quick and easy to find the right information and avoid miscommunications and delays that affect revenue preservation. Hospital staff will be grateful for the lightened workflow and improved outcomes for both customers and administrators. Contract Management One of the most common clogs in revenue collection comes from unclear contract management. Without the right data to analyze contract compliance, hospitals will struggle to get accurate payments from insurers and customers. Calvaruso says that one of the cornerstones of her revenue preservation philosophy is reducing the avoidable denials; Experian Health's contract management tools can analyze and audit contracts to ensure payer compliance and clarify anything that could lead to such a denial. Experian Health's contract management tools also provide patients with more accurate estimates of treatment costs. One recent survey of 54 hospitals found that getting a price estimate is a frustrating process for patients; another poll found that 46 percent of younger patients aren't paying their full bill at the point of service because they didn't have an accurate cost estimate. Having accurate contract management data can make a big difference at both the point of service and in later payment collections. Experian Health's contract management tools can not only increase the revenue a hospital collects, but they can also improve the financial experience and build better relationships with customers and insurers. Claims Everybody makes mistakes, but given the amount of stress that healthcare providers are under, it's more likely that they'll make mistakes on routine paperwork like claims forms, which can lead to the kind of rework that hospitals loathe and that eats away at revenue. On top of that, without a streamlined system in place, it's often unclear where the initial problem occurred, which means administrators can't correct the problem for next time. "We make sure we've done all the work in the beginning to prevent the rework," Calvaruso says. "One way we can do that is by using that lean process that assists us with identifying where we can improve." Experian Health's solutions helped Calvaruso develop that type of process. ClaimSource helps organizations prioritize the claims that need immediate attention, which saves time and reduces the number of tardy claim submissions. To avoid errors in the claims themselves, Experian Health's Claims Scrubber® makes sure clean claims are submitted the first time, eliminating the dreaded rework. Collections Submitting new claims after denials is aggravating, but bad debt write-offs are even more harmful to revenue preservation — it's money that the organization will never see, no matter how much more work is put in. The only way to ensure accurate collections is to minimize the risk of denial in the first place. As Calvaruso says, a key component of preserving revenue is moving back-office work to the front end. For collections, this means accurately verifying patient identity and analyzing litigation risks. Of course, not every situation can be accounted for, and there will always be issues with collections, Experian Health's collections solutions make it easier for organizations to prioritize their past-due accounts and pursue them effectively. No healthcare organization will ever receive 100 percent of the revenue it's due, but taking the right steps to preserve revenue can mitigate much of the loss and keep things running smoothly. With healthy revenue management, healthcare providers can better help the people who need them most.

When was the last time you tried a new restaurant without reading at least one Yelp review beforehand? If you’re anything like the majority of American consumers, the answer is just about never. We live in an experience-driven world, after all, and whether you’re grabbing a bite to eat or trying out a new coffee shop, reviews are a great way to set expectations. But do patient reviews operate in the same way when it comes to hospitals? The answer is a resounding yes. Research shows that higher online ratings correlate with previously established metrics for evaluating hospitals, such as lower potentially preventable readmission rates. When it comes to overall satisfaction, patients are extremely perceptive, and they’re unafraid to share their opinions — good and bad. Yet Vanguard Communications found that about two-thirds of Yelp reviewers gave the top 20 hospitals rated by the U.S. News and World Report either a mediocre or poor rating. So where is the disconnect? One explanation might be that the areas assessed by U.S. News are too narrow. For instance, a hospital might rank highly for a certain specialty, bumping up its overall rating, but at the same time, its bill-pay system could be severely lacking, souring patients’ perception of the organization. Individual hospitals have the ability to assess all aspects of patient care — way beyond the scope of a top-20 list. The onus is on you to identify areas of improvement, and the best way to uncover hidden patient pain points is feedback.  And those pain points are more than just the bedside care received, but are often related on the financial experience. Creating a better experience At Experian Health, we don't focus on tackling every issue in healthcare; one of our specialties is helping healthcare organizations process and collect payment. However, that specific aspect of healthcare has a significant impact on overall patient satisfaction. In a recent study, Experian Health found the highest amount of opportunity for improvement is around the patient financial experience, which includes things like price transparency, understanding one’s ability for health payments, as well as options to pay for care. When it's easier for patients to pay their bills, they rate hospitals higher. Unfortunately, the first big obstacle in bill-pay is that patients often don’t understand what they’re paying for. Even if the quality of care was excellent, when a patient is unsure how much he or she owes, it’s all too easy to get frustrated and give a poor review. El Camino Hospital, a nonprofit hospital located in Mountain View, California, saw this problem play out with its own patients and, in response, made price transparency a major priority. Experian Health teamed up with El Camino to address this pain point. We debuted a self-service portal, allowing patients to access and manage a greater amount of data while still making account management, e-payment, eligibility, estimates, and billing information available. The most exciting element of the portal for patients and administrators alike was the addition of the patient price estimator, which gives instant estimates on a wide variety of procedures. The response to this tool was so positive that patients immediately began using it, even before El Camino promoted it. There was still room for improvement, though, so we worked to gather more patient feedback by incorporating a feedback survey into the portal. As surveys and comments rolled in, we discovered that patients were looking for a wider variety of services in the price estimator, so we’re now expanding the options. This consistent, patient-centered approach has shown tremendous benefits already. For instance, because availability to the portal is on demand, patients no longer need to directly contact the hospital for estimates, which typically results in a 24-hour waiting period. Because the call volume has greatly reduced, El Camino is now able to provide far more estimates in far less time. While El Camino Hospital's portal implementation is still in its early phases, other hospitals have seen impressive results with similar systems over a longer period of time. At Cincinnati Children's Hospital Medical Center, for example, they worked with Experian Health to revamp their online patient portal to make it more attractive and easier for patients to use. After the launch of their revised portal, online payments increased from $200,000 to $800,000, and patient billing satisfaction dramatically increased, as enrollment in their billing portal jumped from 900 to more than 45,000 families in a single year. The medical center’s patients now use the portal to ask questions of their healthcare providers, change on-file insurance information, and schedule or revise appointments. These features also reduce customer service phone calls and other related costs. The 3 steps of the patient feedback process When hospitals empower patients with access to their individual data and listen to their feedback, everyone wins. Patient feedback is essential at every level of implementing a new service to guarantee maximum efficiency. A successful patient feedback process includes these three steps: 1. Identify where feedback is needed. You don't need to harass patients for feedback on every single aspect of their hospital experience. Instead, look at which services would most benefit from patient insight; then, deploy surveys in those areas. Gathering feedback on high-volume services should be a priority simply because they affect the highest number of patients. Similarly, services that routinely trip patients up can only be clarified by directly asking patients what’s causing problems. At El Camino Hospital, creating the charge description master (CDM) was the first step in identifying where feedback was necessary. The list provided a convenient overview, so hospital administrators could easily pick out which services were high-volume or problematic and address them immediately. Whatever the method, pinpointing the services that are particularly troublesome for patients proves much more effective than trying to elevate the entire experience with no direction. 2. Make it multichannel. Feedback is often subject to selection bias, meaning a customer is more likely to write a Yelp review when he or she is either extremely pleased or extremely angry. Offering people several options for providing feedback increases the chances that you'll get a good sample size. You can gather patient feedback via polls using various methods, including text message, email, phone, and paper mail. El Camino Hospital chose to add an SMS feature, building a feedback function on its desktop interface while continuing to field phone calls regarding more complex issues. Its choice proved rewarding, and patient feedback rolled in. Limiting your feedback channels limits the amount and type of feedback you receive, so the more options that are available to patients, the more likely they will be to share their opinions and suggestions. 3. Identify patients who need help and offer it. Patient feedback is only valuable if you act on it. Once you’ve identified specific problems, reach out and offer a solution to patients who expressed concerns. In conjunction with increasing transparency, El Camino Hospital set a goal to identify and assist at-risk patient accounts. After gathering feedback and information on these accounts, El Camino integrated a medical billing fundraiser to lend a helping hand. From there, it created alerts for other at-risk accounts to spread the impact of the fundraiser. By responding to feedback, hospitals can respond to concerns before they become more serious problems, as well as anticipate patients’. If one patient encounters a problem, it's likely that several more will encounter the same issue — if they haven’t already. If hospitals aren't listening to their patients, they’re missing valuable insight into their problems and limiting their scope of improvement.

In an ideal healthcare world, third-party payers would always make payments accurately and on time. Unfortunately, human error is unavoidable, so missed payments and underpayments happen. Identifying and correcting these inaccurate payments often falls to healthcare providers, and without a strategy to make sure payers are complying with your contract terms, these errors are bound to cause stress and volatility to your revenue cycle. There are, of course, external causes of underpayment that a provider can't necessarily control, such as payers misinterpreting contract terms or incorrectly calculating a payment. Providers, however, can counteract this by limiting internal mistakes like incorrect billing or failure to provide appropriate documentation. Still, it’s easy to let incorrect or late payments slip through the cracks, especially without a robust contract management system. Experian Health's Contract Manager and Contract Analysis tools can help providers make sure they're reimbursed quickly and accurately. How Contract Manager and Contract Analysis eliminate payment problems Experian Health's Contract Manager for Hospitals and Health Systems verifies the amounts owed for all applicable claims, monitors payer compliance, and models the financial implications of proposed contracts. And because Contract Manager’s data processing and storage is completely remote, providers get 24/7 web-based access with no capital investments required and no added cost for software or data updates. Contract Manager helped Timothy Daye, director of managed care contracting and reimbursement at Duke Private Diagnostic Clinic, part of the Duke University School of Medicine, identify underpayments and discover ways to avoid them in the future. “In addition to identifying underpayments,” Daye said, “there’s tremendous value in identifying billing issues that may result in underpayments and also identifying process improvements that can be implemented to eliminate the underpayments in the first place.” Contract Manager alone can identify and prevent late payments and underpayments, but when providers pair it with its companion solution, Experian Health's Contract Analysis, they can find added data and negotiating power to set contract terms that optimize third-party reimbursement. Because you don’t have a crystal ball to predict how all of the hundreds of variables in third-party contracts will affect payment, you need a contingency plan. That's where Contract Analysis comes in. By spotting unfavorable contract terms and offering real-world “what if” scenarios, Contract Analysis tells you exactly how proposed contracts with payers might affect your revenue cycle. You’ll know before signing on the dotted line how each part of the contract will play out. The Contract Manager and Contract Analysis combination allows you to audit payer contract performance to ensure compliance and maximize revenue. You could, for example, use it to check the accuracy of a reimbursement by comparing the expected payment to the actual payment, or you could recover from underpayments by finding lost revenue with data-driven insight. Contract Manager and Contract Analysis can also help you identify unusual causes of underpayments. For instance, when Daye and his team were working on a recent anesthesia project, they had to correct a non-standard billing situation. “The payer was taking a reduction by billing the QS modifier, which is outside of the norm of standard billing protocol,” Daye says. “We changed that process through the appeal with the payer by showing documentation that the QS modifier was informational only and doesn't warrant a reduction in payment." Had Daye and his team not been able to identify this system issue, they’d still be scrambling to determine why the payment was lower than they were expecting. However, by using Contract Manager and Contract Analysis, Daye was able to pinpoint an outside-the-norm situation and correct the payment discrepancy as quickly as possible. What makes the combo unique The Contract Manager and Contract Analysis combination is essential for any healthcare provider wanting to ensure it receives payments that are accurate and on time. By using proprietary valuation logic, these tools will give you more precise insight into your contracts, giving you a solid foundation to protect against any payment problems. Experian Health reimbursement specialists even offer complete contract maintenance to make things easier. Whether it's a coding typo or a misinterpreted contract item, there will always be some factor that could cause a payment error. And while you can’t control some of these unforeseen hiccups, you can use Experian Health's Contract Manager and Contract Analysis solutions to correct them in the most reliable, efficient way possible.

Providers can improve the customer experience and bottom line with the power of data and analytics. Introduction In an increasingly competitive and consumer-driven healthcare marketplace, it’s no surprise that providers are working harder to acquire and retain customers. Higher out-of-pocket expenses combined with more choice and control in when and where consumers receive care are driving more retail-like shopping behavior. As a result, healthcare organizations are looking for ways to slow or stop customer churn, drive audience engagement, and redefine how they interact with their customers instead of seeing them through a clinical transactional lens. Providers understand that they must deliver a positive overall experience to maintain a favorable brand in the community and earn customer loyalty, key factors in maintaining their financial solvency. While there are many facets to consider in providing customers a great experience during their healthcare journey, there hasn’t been much attention paid to the intersection between the clinical and financial sides of this experience. According to findings from an Experian Health study among 1,000 consumers and select providers, the greatest pain points and opportunities for improvement around the complete customer healthcare journey center on the financial aspects, from shopping for health insurance to understanding medical bills. This means organizations that want to meet the new demands of consumerism in healthcare and improve the holistic customer experience must address the end-to-end revenue cycle. Typical consumer healthcare journey* *Consumers revealed 137 “jobs” or “needs” associated with their healthcare experience, with varied levels of importance, difficulty and satisfaction. Money matters give consumers high levels of discomfort Using a “jobs to be done” methodology, qualitative insights were gleaned as to the jobs, or microtasks and decisions, consumers associate with a healthcare journey. Despite the staggering number and complexity of different “jobs” consumers must undertake just to access the care they need, patients’ biggest dissatisfaction centers on the process of paying for their care. Of all the activities included in a consumer’s healthcare experience — from acquiring health insurance to making appointments with providers to receiving treatment — the top “pain points” relate to money matters. Specific issues for patients surveyed include: Understanding how much is owed for services and if the amount is a fair market price Making sure they have money available to pay for services Determining what financial support is available (e.g., a payment plan) Ensuring that what is owed to the provider is accurate Understanding the amount covered by their health insurance [click on image to enlarge]   Providers also feeling the sting from unpaid collections, lack of customer service   The most glaring opportunity for improvement in the patient experience comes early in the journey — price transparency. Patients are understandably confused about what their health insurance covers. They can’t always understand medical bills, and they have difficulty finding out how much their out-of-pocket charges will be and what payment options are available to them. Providers are also suffering — from unpaid collections, low customer satisfaction levels and an inability to address issues holistically. Here’s what providers had to say: We’re addressing the patient experience in one-off initiatives. Help us holistically improve the end-to-end patient journey. Providers said key impediments to progress include lack of clear and consistent prioritization, significant interoperability issues, and complicated organizational structures. They are frustrated by how hard it is to execute holistic changes efficiently. We need to measure our customer experience better. We want to standardize an approach that will drive progress and impactful change. Providers don’t have a clear path to move from customer experience as a concept to a measurable discipline. It’s a priority for them, but few are using a measurement system they feel is helping them understand and improve their patient experience. Patients are suffering, in part due to a lack of understanding of their charges. We want to set better expectations and make the charges and the value of our services easier to understand. Rising patient responsibility and the proliferation of high-deductible health plans drive the desire for full transparency in costs. Managing expectations at each step is crucial to providing the most accurate information to the patient. We’re not equipped to address customer acquisition and loyalty. Help us efficiently attract more consumers and keep them with us long-term. The focus has always been on healing people, with less attention to the business and marketing aspects of providing care. Providers need to focus efforts on acquisition and loyalty, but they’re generally understaffed and lack the skills to do so. There’s no doubt that healthcare organizations want to evolve and are thinking differently about how they deliver services and the value associated with those services. Ultimately, those that see driving customer engagement and redefining how they interact with their customers as a necessity, rather than a luxury, will succeed. Revenue cycle solutions for today’s consumerism environment    Where to start? Key areas that can be addressed in the healthcare financial journey include: Comprehensive data – One of the core components of a patient-centric revenue cycle begins with the ability to use reference data to address duplicate medical records, understand a patient’s propensity to pay and identify social determinants of health. Incorporating this type of outside data into the revenue cycle won’t just create better patient experiences from the moment patients begin interfacing with staff, it will also optimize revenue for health systems while enabling a revenue cycle that puts the patient at the center of care. Patient identification – As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies for managing patient information are no longer sufficient. Using sophisticated matching technology and outside data sources can improve patient identification and prevent duplicate or overlapping records that result in inappropriate care, redundant tests and medical errors — as well as improving data accuracy for clinical, administrative and quality improvement decision purposes. Insurance reconciliation – Organizations can use automated technology to monitor claims data, real-time eligibility and benefits information, payer contracts, and charge description master (CDM) information to ensure that payers are meeting their obligations fully and achieve accuracy and transparency in healthcare costs. Closing the gap in payer contracts and reimbursement allows organizations to focus on providing transparent cost estimates throughout every patient’s continuum of care and helps patients know their costs so they are better prepared to pay them. Price estimates – Providing accurate patient estimates is quickly becoming the norm for health organizations. But to ensure patient satisfaction rates are being met, health organizations need to empower patients with a frictionless financial experience. By incorporating credit data into the patient billing process, health organizations can enable a people-first product design to price transparency and collections that extends benefits to more people by understanding the unique financial needs of each patient. Self-service portals – One way to engage patients is with an online and mobile-optimized experience that’s proactive, smooth and compassionate to empower patients to set up payment plans, apply for financial assistance, estimate the cost of care and review insurance benefits. Conclusion   With so much to consider when addressing the evolving patient/customer journey, providers are well-served to start by improving their customers’ financial experience. As the link between customer satisfaction and a health organization’s revenue continues to grow, efforts to create a better financial experience are crucial. Using comprehensive data and analytics to power the revenue cycle and customer relationship management initiatives will allow health systems to encompass the end-to-end customer journey to ensure streamlined operations, measure and improve performance with payers, and provide accurate insights into each unique customer and their needs. The key to establishing this customer-centric mindset is embracing the power of data and analytics. From offering access to automated, personalized tools to providing price estimates to informing about charity aid options and offering payment plans — all these innovations help customers feel they can make better decisions about their care and how to pay for it. The result is more satisfied customers and an improved bottom line for providers.

Experian Health received full accreditation with the Healthcare Network Accreditation Program (HNAP) as a clearinghouse from the Electronic Healthcare Network Accreditation Commission (EHNAC). EHNAC’s HNAP accreditation recognizes Experian Health’s excellence in health data processing and transactions, and ensures compliance with industry-established standards and HIPAA regulations. Through EHNAC’s comprehensive third-party review, Experian Health was evaluated in areas of privacy measures, systems availability and security infrastructure. In addition, EHNAC reviewed the organization’s process of managing and transferring protected health information and determined that the organization meets or exceeds all EHNAC criteria and industry standards. Through completion of the rigorous accreditation process, the organization demonstrates to its constituents, adherence to strict standards and participation in the comprehensive, objective evaluation of its business. “At a time when regulatory concerns are keeping healthcare leadership awake at night, a company’s decision to take the necessary steps to ensure trust within its stakeholders and customers that they’re adhering to the latest standards in privacy, security and confidentiality is an important accomplishment,” said Lee Barrett, executive director of EHNAC. “Attaining EHNAC HNAP accreditation requires companies demonstrate full commitment to ensuring the security and privacy of health data processing and transactions for their customers and provides a ‘seal of approval’ indicating Experian Health exceeds industry-established standards and complies with HIPAA regulations.” Please click here to learn more about Experian Health’s industry leading solutions.

Experian Health, the healthcare industry leader for automating, integrating and transforming the front and back end revenue cycle management process, is committed to securely managing patient data and other healthcare transactions. To that end, Experian Health today announced that its applications* have earned HITRUST CSF® Certified status for information security to manage risk, improve security posture and meet compliance requirements. HITRUST CSF Certified status demonstrates that Experian Health has met key regulations and industry-defined requirements and is appropriately managing risk. This achievement places Experian Health in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards and frameworks, and incorporating a risk-based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls. “The HITRUST CSF has become the information protection framework for the health care industry, and the CSF Assurance program is bringing a new level of effectiveness and efficiency to third-party assurance,” said Ken Vander Wal, Chief Compliance Officer, HITRUST. “The HITRUST CSF Certification is now the benchmark that organizations required to safeguard PHI are measured against with regards to information protection.” Please click here to learn more about Experian Health’s industry leading solutions. *The following Experian Health applications have earned Certified status for information security by HITRUST: Eligibility Clearinghouse (NOA, TN and MPV), Claims, Coverage Discovery, Coordination Of Benefits (COB), Clinical Data Clearinghouse, Premium EDI, eCareNext, OneSource, ClaimSource, Patient Self-Service, BatchSource, Care Coordination, Search America, MPV portal (mediconnect.com)  

Not long ago, Excel spreadsheets were cutting-edge technology. Compared to stacks of paper and rows of filing cabinets, they seemed like an efficient, cost-effective way to organize and access data. But times have changed. Now, healthcare leaders are looking at their sea of spreadsheets wanting a simpler solution. According to KaufmanHall's "2018 CFO Outlook" report, 94 percent of the senior financial officers surveyed said that their healthcare organizations supplement their main data systems with spreadsheets. In the same report, more than half of them noted the need for better data visualization and easier report creation. This scenario could not be truer for Cody Torgler, physician revenue integrity coordinator with the University of Iowa Hospitals and Clinics. He realized that using spreadsheets was a waste of time and resources. "It really took our follow-up staff away from what they do well," Torgler said. "It was causing them to touch claims multiple times. Every time you touch a claim [that needs more attention], that's taking money away from a claim that you might be able to get reconciled." How did Torgler's team solve its spreadsheet struggles? They saved time, money, and headaches by implementing a contract management system that monitors payer compliance with contract terms, value claims, and audit remittances based on the latest payment rules and adjudication logic. The hospital's new system provides regular updates to staff on claims and offers visualization and more easily searchable data. Staff members can navigate their database by grouping attributes, filtering, or generating reports. "The sky's really the limit with being able to find these variances, get these variances to the payer, and get them reconciled on time," Torgler said. The University of Iowa Hospitals and Clinics realized something other providers are coming around to as well: With better systems available, it's time to say sayonara to spreadsheets. Shake off spreadsheets and experience Experian For healthcare organizations that are ready to move past spredsheets, Experian Health offers a series of seamless data management solutions: 1. Claim Scrubber Spreadsheets get messy quickly. They're often maintained by multiple users, with different people entering data according to their own preferences. A less than immaculate spreadsheet might not seem like a big deal — until it comes time to fill out claims forms. That's when problems tend to snowball. Incomplete or inaccurate claims forms lead to undercharges and denials, wasting your team's time and effort. Experian Health's Claim Scrubber ensures every claim is clean. Even better, it's automated. Instead of wading through piles of spreadsheets, your staff can spend more time helping your healthcare customer. 2. Contract Manager and Contract Analysis Excel works in a pinch for records storage, but it's not great at keeping track of all the details of a patient's contract. Small fields with overflowing text can leave out important information and make it tougher for providers to see opportunities for negotiation. Experian Health's Contract Manager and Contract Analysis is like an automated contract lawyer. It helps healthcare organizations validate the accuracy of reimbursements, recover underpayments, negotiate better payment terms, and even evaluate potential lines of business. The bottom line? These tools leverage the best data to provide peak contract performance. Torgler's team at the University of Iowa Hospitals and Clinics uses the Contract Manager to stay on top of the hectic process of claims verification. "With the claim count that we have at the university and the volume that we have, Contract Manager has made the transition from the Excel documents to check expected amounts seamless," Torgler said. "The success of Contract Manager has allowed us to really grow at the university." 3. Patient Estimates Whether they're in for an annual checkup or open-heart surgery, patients like to know how much they're going to pay. But poor estimates are frustrating for everyone involved, and estimates based on a few rows of spreadsheet data are bound to be inaccurate. Only when patients are armed with the right estimates can they make informed decisions about what services they can afford. To provide accurate estimates, Experian Health's Patient Estimates tool relies on robust and continuously updated data. A spreadsheet might be able to hold information about a patient's claims history, contract terms, and insurance benefits, but why bother? Experian Health's tool gathers all that data automatically to issue top-notch estimates without unnecessary hassle. 4. Payer Alerts Once you close Excel, the information on a spreadsheet can't help you; it just sits there. Wouldn't it be nice to receive notifications whenever an insurance provider's payment policies or procedures change? That's why Experian Health's Payer Alerts keeps you current with an enormous range of payers. Information from more than 50,000 webpages run by more than 725 payers continuously feeds into the system, which then issues updates and distributes them via email and an online portal. With Payer Alerts, your organization will never be left out of the loop. The healthcare landscape is complicated and constantly changing. Spreadsheets just can't keep up any longer. Experian Health's data-driven solutions can ensure your organization doesn't get left behind. Schedule a demo with Experian Health today.

Experian Health will be at HFMA ANI again this year–booth 1025–at the Venetian-Palazzo Sands Expo in Las Vegas, Nevada. Kristen Simmons, Senior Vice President, Strategy, Innovation, Consumer Experience, and Marketing, with Experian Health, chatted with Joe Lavelle of IntrepidNOW to provide her insights on this year’s HFMA ANI conference, consumerism in healthcare and much more! Excerpt below: Experian Health booth activities  "[In our booth this year at HFMA ANI, we want to focus] around peer to peer learning and exchanges, so we are doing less selling and more engaging and more understanding. Understanding folks problems and helping to collectively arrive at solutions. We are doing a lot this year in terms of hands on demos of our solutions. We'll be showing some of our patient engagement products which include, self-service portals and mobile options for getting price estimates for applying for charity care, and setting up payment plans. Likewise, on the revenue cycle management side to automate orders with patient access functionality, contract management claims and collections, all those types of things that we do to improve efficiency and increase reimbursement for our clients. We'll also be showing off some of our identity management capabilities to match, manage, and protect patient identities so we can safe guard medical information and reduce risks for our clients. And on the care management side, our early support and sharing of post acute patient care information to help providers succeed as we all move forward into a value based paradigm." How Experian Health is addressing the need for consumerism in healthcare  "When it comes to consumerism, it's interesting when you're a company that has a lot of data and a lot of capabilities to say, 'Hey what can we do for people?' One of the things we really wanted to look at for our consumer approach, was to say, 'What is it that needs to be done?' We had some great hypotheses coming in and a lot of those were borne out but we actually undertook a big national study to take a look at what consumers biggest pain points were. It has a qualitative and a quantitative component. But, we basically looked at the entire healthcare journey so we weren't just asking them about the administrative and financial aspects of care, but also the clinical aspects. As we walked through the journey and were able to get a lot of quantitative data about all these different aspects of their healthcare journey, what actually turned out to be the most painful for the most people, were all the things around the financial equation. And, so clearly there can be pain in a clinical side, especially if you're unhealthy, you've got something chronic, you've got something terminal. There's all kinds of awful situations there but, really affecting almost everyone is a lot of the pain around the financial aspect of healthcare. So, we were able to look closely at some of those pain points and decide on some of the biggest ones that we wanted to tackle." How Experian Health is helping providers address financial pain points for patients and providers "Some of the big pain points for people is just the fact that you don't know what you're going to owe and as the patient portion of responsibility increases, understanding what you're going to be paying becomes more and more important to a consumer. So, understanding what I owe earlier, being transparent, and then helping me pay, those are some of the areas. And there are others but those are some of the absolute biggest pain points. And as you pointed out with some of our propensity to pay analytics, and some of the other capabilities that we have, we're able to help providers understand the financial situation patients are in much earlier in the process so they can get them to the right kind of funding sources. They can give them peace of mind so that they know what they're paying upfront, which may impact when they choose to go in for a major procedure or how they might want to save up for it or how they might want to access different funding sources." Listen to the full podcast

There's no question that portals increase patient engagement. According to the Office of the National Coordinator for Health IT, almost eight in 10 patients appreciate the improved access to healthcare information afforded to them by self-service systems. Unfortunately, portal systems also offer an obvious target for healthcare hackers. Within a patient portal, criminals can steal medical identity data, which is worth somewhere between 20 and 50 times as much as financial data, such as credit card numbers. They then use the stolen information to submit fraudulent claims, fill prescriptions, and resell medical equipment. What's more, because many healthcare organizations lack proper detection tools and some patients neglect to check their explanation of benefits (EOB) statements, health data breaches tend to go undetected longer than those in other sectors. No wonder healthcare data security incidents rose 211 percent in 2017, according to the 2018 "McAfee Labs Threats Report." Protecting patients' data with technology Patient portals engender patient engagement and loyalty, but if a data breach occurs, that loyalty is quickly lost. Besides losing patients’ trust, healthcare organizations that experience a data breach face potentially severe HIPAA penalties. Healthcare firms can learn a great deal from how other industries have met similar security challenges without overburdening consumers. Providers can use best-in-class technologies, data and analytics systems, and their deep understanding of patient needs to manage risks and protect patient identities. To arm providers against breaches, Experian Health offers Precise ID® with Digital Risk Score to protect portal users’ identities from their first sign-in to their last. By automating the portal signup process, it stops false enrollments at the source. Then, using multilayer verification, it provides access protection for future sessions. Because Precise ID takes less than a second to evaluate access risks, patients don't need to sit through loading screens. On the provider side, Precise ID satisfies the Centers of Medicare and Medicaid Services' Promoting Interoperability standards, minimizing compliance risks. At a time when one in five patients withhold information from physicians because of data breach concerns, Precise ID builds trust between patients and providers by protecting patients' data from unauthorized access. Giving patients the power to access their medical information through portal technology has been one of the past decade's biggest steps forward in improving patient-provider relationships. But with that reward comes responsibility: Providers must protect portals from unauthorized access and theft of medical records. With Precise ID with Digital Risk Score, providers get the security they need, and patients get the seamless access they've come to expect.