Patient Access

Outdated scheduling systems, endless phone calls and clunky user digital interfaces cause friction – for both patients and staff. The result? Frustrated patients, no-shows, unused appointment time slots and a hit to bottom lines. Patients want to see their provider quickly, and they don't want to jump through hoops to make an appointment. Online patient scheduling software may be the solution. In Experian Health's 2024 State of Patient Access survey, nearly 8 in 10 patients who reported being unhappy with their provider experience blamed waiting for an appointment as a top frustration. And 89% of patients said they want to schedule their appointments online or using a mobile device. Unsurprisingly, 61% of patients would consider switching to a healthcare provider that offers a patient portal or a digital front door. Now, 63% of providers report offering self-scheduling tools and another 16% plan to implement online patient scheduling in the next six months. But getting patients to use them is still a challenge. With online patient scheduling software, patients get the 24/7 access they crave, and healthcare organizations benefit from increased patient volume, improved staff efficiencies and revenue growth. Understanding online patient scheduling software To enable online patient self-scheduling, organizations need a platform that translates a provider's scheduling rules into an intuitive experience, guiding patients to the appropriate provider and appointment while keeping the provider in control of their calendar. This is achieved with Experian Health's Patient Schedule solution, through decision support and automated business rules that uphold best practices, regardless of how the appointment is booked. The platform then digitizes the scheduling workflow, handles various scheduling scenarios, and includes necessary pre-registration information for the right appointment. It streamlines the process, ensuring patients can easily communicate their needs and be routed to the correct provider. Providers can automate their scheduling protocols, ensuring patients only see available options. Online patient scheduling software puts patients in charge of managing appointments—on their own time. Tools like Patient Schedule integrate with practice systems, making it easy to coordinate care seamlessly. The software is customizable to an organization's scheduling rules, so patients only see the calendars and appointment types providers want them to see. New and returning patients can access systems in real time and find the appointment slots and providers they need easily. Patients can book, reschedule and cancel appointments, making no-shows less likely. Physician time is used wisely, schedule gaps are lessened and staff no longer has to waste valuable time confirming appointments. Instead, text messages, with their 98% open rate, facilitate fast and direct patient communication. Benefits of patient schedule software to hospitals More than 62% of healthcare workers consider patient scheduling to be one of the areas hit hardest by staff shortages. However, when patients have convenient, 24/7 access to patient scheduling software, it eases the burden on overburdened call center staff, administrative resources and operational costs. Patient scheduling software boosts retention of existing patients and makes it easier to acquire new patients. On average, providers using Experian Health's scheduling solution see 32% more patients per month, reduce scheduling time by 50% and enjoy an 89% patient show rate. Key features to look for in online patient scheduling software Patient scheduling software features should facilitate convenient and flexible patient scheduling while increasing care access, streamlining staff productivity and boosting operational efficiency. Here's a breakdown of key features to consider in online patient scheduling software. 1. User-friendly interface Old habits are hard to break. Experian Health data reports that more than half of providers (55%) find getting patients to use digital services to be one of their greatest challenges. Why? Some research indicates that 89% of patients are reluctant to use an online scheduler because they're either not aware of the service or feel they don’t have the computer skills to use it. Easy-to-use online scheduling is common for everyday tasks like booking dinner reservations. However, in healthcare, that's not always the case. Patients struggle to use slow systems and hard-to-navigate interfaces. To encourage widespread adoption, online patient scheduling software needs to be simple to set up, deploy, and use—for providers and patients. Tools like Patient Schedule easily automate scheduling workflows, allowing providers to define appointment criteria and sync with existing calendars. A platform with no login required, unique patient identification and mobile access makes it easy—and secure—for patients to find providers and schedule appointments. 2. Appointment reminders Relying on appointment reminder phone calls can drain your staff and the bottom line. Patients might miss calls, forget to return messages, lose reminder cards or forget about their appointments entirely. This leads to no-shows, time wasted on rescheduling and juggling physician calendars, decreased patient outcomes and reduced revenue. Automating appointment reminders by text or IVR with Patient Schedule makes it simple to send patients updates, confirm appointments, and maximize staff and physician time. Patients can book, reschedule, or cancel appointments in real time—even after business hours. When patients are in charge of their own schedule, no-shows decrease, and revenue goes up, not to mention improved patient outcomes and satisfaction. 3. Integration capabilities Seamless integration is key. Online patient scheduling software works best when it dovetails with practice management systems, electronic medical record (EMR) platforms and other operational technology. This ensures efficient scheduling, fewer gaps in physician schedules and the ability for providers and practice management to communicate effectively with patients throughout the entire patient journey. With the appropriate integration, patients are in control of their scheduling. Status updates are communicated in real time over text when a patient books, reschedules or cancels online – keeping everyone in the know. Patient Schedule's template rules allow providers to optimize their calendars to ensure patients schedule into the right time slots. Practice managers benefit from coordinated workflows and a holistic view of the entire schedule, making it easier to identify gaps. 4. Customization options There's no one-size-fits-all approach to online patient scheduling software. Whether integrating self-schedule into an existing online system or starting from scratch, the software solution should be tailored to every organization's requirements, goals and budget. When selecting a partner, it's important to consider the organization's needs carefully. What's the scope of use? Is it a small practice or a large hospital network? What existing systems will the online patient scheduling software need to integrate with? Is the online patient scheduling software replacing a large call center or a small support staff? For best results, look for flexible solutions that allow room to scale while accommodating changing healthcare environments and privacy needs. Factors to consider when choosing a solution To ensure a successful implementation of an online patient scheduling software solution, consider these additional factors: Accessibility features Staff training and onboarding requirements HIPAA compliance Privacy protection features Time to launch Cost to implement Ongoing technical support Case studies: Successful implementation stories Curious how Experian Health's Patient Schedule solution benefits healthcare organizations? Here's what two clients had to say: In practice: When Indiana University (IU) Health implemented Patient Schedule, they found that “the platform is very new patient-focused with new patients accounting for over 59% of Self Scheduling bookings.” Of those bookings, they saw an 87% show rate and found “around 64% of our patients self-scheduled during non-business hours.” Watch the webinar: See how IU Health used self-scheduling to manage increasing patient volumes with less staff – and gain insights on using digital scheduling to scale operations. In practice: CareMount Medical, a patient-centered organization, implemented online patient scheduling as part of a 24/7 access initiative, enabling real-time scheduling access across all of their providers and specialties. Read the case study: See how CareMount Medical used Patient Schedule to make it easier for patients to get in to see their provider, improve patient satisfaction and boost financial visibility. By adopting online patient scheduling, healthcare providers can streamline operations, improve patient satisfaction and deliver high-quality care. This solution speeds up staff training, streamlines scheduling time, improves patient no-show rates and increases patient volumes and retention. Ready to make the move to online patient scheduling? Contact Experian Health to get started. Learn more Contact us

Patients expect clear information about their insurance coverage when they visit their healthcare provider, but too many leave feeling confused and financially underprepared. Experian Health's State of Patient Access 2024 survey reveals that 56% of patients struggle to make sense of their insurance coverage without provider assistance, while 61% say improving coverage explanations is the most urgent challenge in patient access. For providers, the financial fallout from missed insurance eligibility checks is even more pressing, with 15% of providers citing eligibility issues as one of their top three reasons for denials. Accurate eligibility checks are crucial to keep the revenue cycle on track. This article highlights common challenges and current best practices for improving eligibility verification. Could automated insurance eligibility checks give patients and providers the financial clarity they're looking for? What are insurance eligibility checks? Insurance eligibility checks are carried out pre-service to confirm that a patient has active insurance that will cover their planned treatment and care. Verifying insurance status, coverage details and benefits in advance ensures that the proper claims and bills are sent to the right recipient. Patients and providers get early warnings of coverage limitations and potential out-of-pocket costs, which helps patients access care without any financial surprises. Without these checks, healthcare organizations may deliver services to patients without active coverage — and with no clear path to payment. Therefore, a reliable eligibility verification process is essential to minimize the claim denials, rework and billing errors that often stem from inaccurate insurance information. How do insurance eligibility checks impact revenue cycle management? In the healthcare revenue cycle—which revolves around who pays, when and how—insurance eligibility checks are a first line of defense against revenue leakage. They're a proactive step toward establishing smooth claims and collections processes so no dollar goes uncollected or is lost to avoidable admin overhead. Prioritizing robust eligibility verification systems, as patient survey respondents advocate, is not just an operational necessity; it's a strategic safeguard against slow payments, patient dissatisfaction and financial instability. The insurance eligibility check process The eligibility verification process typically begins by confirming the patient's contact information to match their insurance card and electronic health record details. Staff then initiate an eligibility request to confirm active coverage. Once confirmed, they check that the plan covers proposed services, including any pre-authorization requirements, and review coverage limits to ensure the patient hasn't exceeded annual or lifetime caps. If applicable, providers also cross-check for Medicare eligibility using the Medicare Beneficiary Identifier (MBI) to identify any additional coverage. Common challenges with insurance eligibility checks Findings from Experian Health's State of Patient Access and State of Claims surveys illustrate the extent of the eligibility challenge, pointing to three main areas for improvement: Outdated or incomplete insurance information Sometimes, the insurance details in the provider's system don't match the payer's record. Patients may change jobs, switch insurance plans, or have secondary coverage they didn't know about or forgot to mention. If these changes aren't caught up front, it can lead to claim rejections and billing delays. Besides the obvious problem of lost revenue, this challenge incurs extra work: 43% of providers report that incomplete checks add at least 10 minutes per eligibility check. Changing payer policies and pre-authorization requirements Keeping up with each insurance provider's prior authorization requirements is challenging, especially if the patient's treatment is urgent. Missing a necessary authorization can lead to a denial, delayed payment and extra work. More than three-quarters of providers say payer policy changes are increasing, but only 10% are using automated tracking as part of their denial management strategy. Is there an opportunity to automate prior authorizations and eligibility verification to tackle denials? Inadequate tools to verify eligibility More than 7 in 10 providers say their organization runs eligibility checks quickly and accurately, but significantly fewer think their revenue cycle management technology is as good as it could be. 59% of providers are using at least two different solutions to collect all the necessary patient info for a claim submission. Tool overload is a real problem, as staff must wrestle with different platforms, processes and logins to get the eligibility information they need. Best practices for effective insurance eligibility checks  To tackle these challenges, providers can use automation to streamline their verification workflows. Some key practices for more reliable and efficient insurance eligibility checks include: Automate real-time eligibility checks for faster, more precise verification: For example, Eligibility Verification automatically verifies insurance coverage and plan-specific benefits information before and at the time of service. This not only speeds up registration, but also catches any potential coverage gaps before services are provided. Automation also helps minimize manual work and reduces the risk of human errors that can lead to claim denials. Track payer policy changes automatically: Insurance verification software helps providers keep up with ever-changing payer requirements. Eligibility Verification connects to more than 900 payers with advanced search, to maximize the likelihood of matching patient information. This can be used alongside Experian Health's automated pre-authorization tool, which dynamically updates national payer prior authorization requirements and flags when something is missing. Give patients upfront, automated price estimates: More than 80% of patients say upfront pricing estimates help them prepare for costs. Automating eligibility checks and patient payment estimates help patients understand their coverage, co-pays and deductibles, so they know what to expect when their bill arrives. This improves transparency, boosts patient satisfaction and accelerates collections. Implementing these best practices helps ensure smooth claim submissions and reduces denials due to eligibility issues, ultimately supporting a healthier revenue cycle. Case study: How Providence Health found $30M in coverage and reduced denial rates with automated eligibility checks Within just five months of implementing Eligibility Verification, Providence Health had saved $18 million in potential denials. Read the case study to see how automated insurance eligibility checks reduced denials, increased staff productivity and boosted patient satisfaction. How Experian Health can help healthcare organizations improve eligibility checks While healthcare affordability remains a pressing concern for patients and providers, quickly and accurately verifying insurance eligibility will remain among the top priorities for both groups. Experian Health aims to simplify the process with automated Eligibility Verification. In addition to reducing payment delays and denials, its streamlined workflows support higher patient volumes, especially as patients have more complex insurance arrangements and take on greater financial responsibility. One significant advantage is the ability to provide extra support for the growing number of patients who may be eligible for Medicare. Medicare eligibility checks can be complicated, particularly if patients don't know which component they qualify for. Eligibility Verification includes an optional MBI lookup service to find and validate the patient's MBI number without requiring a manual search. Find out more about how automating insurance eligibility checks verifies coverage quickly and accurately — giving patients and providers early clarity about how the cost of care will be covered. Learn more Contact us

Flu season is rapidly approaching, which means healthcare providers must ramp up their preparedness efforts. What can they do to ensure they're ready to meet the seasonal surge in demand? Recent data from the southern hemisphere, often a forecast of what's to come in the US, suggests that this year's flu season will likely be similar to last year. The CDC warns that while “we cannot predict what will happen in the United States this upcoming season, we know that flu has the potential to cause significant illness, hospitalizations and deaths.” With hundreds of thousands of people hospitalized each year, providers must find ways to prepare for rising patient volumes and manage the risk of infection among patients and staff to keep services running smoothly. Making it as easy as possible for patients to book and attend vaccination appointments will be critical. Digital patient access will be the key to streamlining patient care. Using digital tools to prepare for flu season 2024-25 As services face increasing pressure, digital and automated tools can help healthcare providers prepare for flu season by easing staff burdens. More patients mean more appointments to schedule, more registration forms to fill out and more people in waiting rooms. Opening the digital front door helps manage high volumes by allowing patients to complete more access tasks online and prevent bottlenecks. Here are three strategies to implement to support staff and patients through a challenging season: 1. Manage infection risk with online self-scheduling An online patient scheduling platform has two clear benefits – it relieves pressure on staff during busy times and gives providers control over patient flow. Fewer calls need to be made by call center agents. No-shows are less likely because patients can book, reschedule and cancel appointments, and receive automated reminders, which makes the best use of physicians' time. Online scheduling also plays a part in infection control as providers can incorporate screening protocols to identify patients with symptoms of COVID-19 or flu, and manage their onward care pathway appropriately. Empowering consumers to take control of their healthcare with a patient scheduling system might encourage vaccine registrations, which could help reduce the burden on health services when staffing shortages remain stubbornly high. What's more, patients now expect the flexibility and convenience of scheduling appointments at a time and place that suits them. Experian Health's 2024 State of Patient Access survey found that six in ten patients want more digital tools to manage their healthcare. This indicates a growing demand for easy, simple and transparent processes. Watch the webinar: See how IU Health used self-scheduling to manage increasing patient volumes with less staff – and gain insights on using digital scheduling to scale operations beyond flu season. 2. Offer mobile registration to manage demand Should patient volumes increase, patient access staff will be under even more pressure than usual. Anything that can reduce the administrative burden will be a win. Experian Health's Registration Accelerator allows patients to complete intake forms and insurance checks through their mobile devices before stepping through the door. Their details can be pre-filled automatically, reducing the risk of error. This creates a quicker, more efficient patient registration experience that minimizes issues for staff to resolve. Mobile-enabled registration is also far more appealing for patients, who'd rather complete registration from the comfort of home than sit in a waiting room filling out lengthy forms. Plus, it reduces in-person interactions, thus minimizing exposure to infection among staff and patients. Given that 89% of patients say digital or paperless pre-registration is important to them, providers that offer online patient intake solutions will have a clear advantage in attracting potential new customers during times of high demand. In practice: See how West Tennessee Healthcare replaced clipboards with clicks with Registration Accelerator. 3. Reduce no-shows and increase engagement with automated patient outreach Providers must communicate proactively with patients to keep them in the loop as the situation evolves. With an open rate of 98%, text messages are a direct and convenient way to communicate quickly with patients. Automated patient outreach can increase vaccination rates by notifying patients about flu shot availability and offering a direct link to schedule an appointment. Automated reminders reduce no-show rates and help ensure no slot goes unused as patient volumes increase. Messages can also include tailored instructions for specific at-risk groups to emphasize the importance of timely vaccination and provide directions. This approach helps manage patient flow, increase patient satisfaction and ensure providers are prepared for the seasonal surge. Contact Experian Health today to learn how digital patient access solutions can help healthcare providers prepare for flu season in 2024. Learn more Contact us

According to a new report by the American Hospital Association, administrative costs now make up over 40% of total hospital expenses. Hospitals and health systems spend around $40 billion annually on billing and collections alone. For revenue cycle managers, the pressure is building as administrative tasks like insurance eligibility verification, claims management and payment processing overwhelm their teams and drain budgets. However, a sizeable chunk of these costs—perhaps as much as $18.3 billion—could remain in hospitals' hands if certain administrative tasks were automated. Automating key revenue cycle management (RCM) workflows improves efficiency, accuracy and cash flow, while easing staff stress and expediting patient care. Could it be the secret weapon to alleviating administrative burdens? This article looks at the issues in further detail, and explores 5 use cases that show how automation can reduce administrative costs in healthcare. Understanding administrative costs in healthcare Spending on healthcare administration in the U.S. has risen from $654 per person in 2013 to $925 in 2021. Administrative costs cover the resources needed to manage the non-clinical aspects of care. These resource requirements are immense in a complex system with multiple payers, fragmented data systems and growing regulatory demands. Add persistent staffing shortages and increasing patient volumes to the mix, and it's easy to see how costs spiral out of control – especially when relying on inefficient systems. The billions of dollars and hours of staff time consumed by administrative tasks make it clear that resources are not being used most effectively. This is where automation can make a difference. The role of automation in healthcare Automation reduces human errors, speeds up workflows and accelerates cash flow. It frees up time, money and headspace to optimize services and improve patient experiences. It's no wonder it's gaining traction in revenue cycle management. However, many providers are not fully capitalizing on automation's potential: Experian Health's latest State of Claims 2024 report shows that fewer healthcare administrators feel their organization's technology is sufficient to meet RCM demands compared to two years ago. How can they tap into the benefits of automation to reduce administrative costs? Benefits of automation and how it can reduce administrative costs in healthcare Automating healthcare administration is about doing more – and better – with less. Some of the benefits include: Fewer errors in billing, coding and claims management. Fewer mistakes mean fewer denials, which translates to faster payments and less rework. Reducing time to get paid, as automated processes speed up claim submissions, insurance verification and payment collections. Cash flow improves and staff spend less time chasing payments. Alleviating staffing shortages, as automation takes care of repetitive tasks like data entry, payment reminders and reporting. Management can reduce the burden on overworked staff and curb training costs, while teams can focus on “value-added” work. Improving efficiency in every corner of the revenue cycle. Automating routine tasks makes the entire billing and revenue cycle process more efficient, allowing teams to handle more work in less time without increasing headcount. Happier patients (and a better-looking bottom line). Automation makes it easier for patients to understand their bills, set up payment plans and pay their balances online. Satisfied patients are more likely to pay on time, reducing the cost of chasing overdue payments. Implementing automation in healthcare When it comes to reducing administrative costs, selecting the right parts of the workflow to automate is key. Here are five possible use cases to consider: 1. Streamline insurance eligibility checks “Checking if my insurance was accepted was a fast and friendly process. The staff even helped clarify which insurance was the right one for me since I had multiple cards.” This is what one patient at Providence Health said, after the health system switched to automated insurance eligibility verification. Insurance Eligibility Verification connects to over 900 payers and automatically checks patients' coverage and plan-specific benefits information in real-time. This reduces the manual effort required by staff and prevents the delays and denials that lead to additional administrative costs. As the patient notes, it means patients get early clarity about how their care will be funded, so there are no surprises later. Read the case study: How Providence Health found $30M in coverage and reduced denials with automated eligibility checks. 2. Automate claims submission More than half of healthcare administrators say that claims errors are increasing. A quick win would be to use automation to pre-fill patient data and avoid the inconsistencies and typos that occur with manual input. A more significant gain could come from combining multiple automations to populate, check and track claims submissions. Tools like ClaimSource® can automate the entire claims cycle in a single application. Indiana University Health (IU) utilized ClaimSource to process $632 million in claims transmissions in just one week, after a halt to their operations. Summit Medical Group paired Claim Scrubber with Enhanced Claims Status to improve claims submission. Claim Scrubber ensures all claims are complete and accurate before being sent to the payer, and generates alerts so staff can intervene quickly if an error pops up. Enhanced Claim Status automatically pings payers for status requests so staff can spend less time seeking updates and accelerate follow-up activities. With this approach, Summit boosted their first-time pass-through rate to 92% and reduced accounts receivable days by 15%. Experian Health was client-rated #1 by Black Book™ ’24 in Denial & Claims Management Outsourcing, Health Systems. Learn more 3. Improve denial management Denials remain one of the biggest pain points for providers. Payers are miles ahead in their use of automation and artificial intelligence (AI), using sophisticated machine learning tools to process and deny claims at scale. Experian Health's flagship AI-powered denial management solution, AI AdvantageTM, can help close the gap. This tool “learns” from an organization's historical claims data and trends in payer behavior to predict the probability of denial. It also identifies and segments denials so staff can prioritize those with the highest chance of being reimbursed, reducing the time and cost of manual appeals and rework. 4. Accelerate patient payments On the patient side, automation can be deployed to send patients reminders about outstanding balances, set up payment plans and process payments quickly and securely. Simplifying patient billing makes it easier for patients to pay, which increases collections rates while reducing the need for follow-up calls. Read more: 5 ways patient payment software improves patient satisfaction 5. Generate better financial reports Another smart use case for automation is generating real-time revenue cycle performance reports. With advanced data and analytics, staff no longer need to spend hours compiling information, while managers get faster, reliable information to inform strategic decisions. Experian Health's healthcare data analytics turns raw data into business-ready information to find potential sources of revenue leakage and boost financial performance. The future of healthcare automation Automation is already helping reduce administrative costs in healthcare by relieving staff of the tedious, time-consuming, repetitive tasks that drain time and money. However, many still rely on old data systems that don't work well together, leaving revenue opportunities slipping between the cracks. Choosing solutions that improve integration and interoperability will continue improving data-sharing between platforms and services, further reducing errors and delays. Looking ahead, automation and AI will play an increasingly major role in handling complex tasks in revenue cycle management. RCM leaders will find even more opportunities to minimize manual intervention and lower administrative overheads as these tools evolve. Learn more about how Experian Health's automated Revenue Cycle Management solutions help reduce administrative costs in healthcare and create more resilient revenue cycles. Learn more Contact us

Improving patient access is often a heavy lift for healthcare providers thanks to staffing shortages, lack of thorough staff training, inefficient processes and more. Experian Health's State of Patient Access 2024 survey found that curating accurate patient information also continues to be a challenge, which is the primary cause of denied claims for almost half (49%) of healthcare providers. Meanwhile, patients themselves are growing frustrated and are increasingly demanding better access. The same Experian Health survey revealed that patients want self-service, on-demand mobile scheduling, faster access to doctors and more digital channels for managing their healthcare. They also want more communication, faster service and easy-to-use digital platforms. After all, why shouldn't managing access to healthcare be as easy as booking a flight online? Here's a closer look at some of the key findings: 89% of patients want self-service scheduling 85% dislike manually filling out repetitive intake paperwork 96% want a cost estimate before their treatment Unfortunately, today's healthcare industry is often plagued by a highly complex interplay between people, processes, environment and technologies. Providers are hamstrung by outdated and siloed procedures. From laborious patient registration to by-hand claims processing, workarounds and manual tasks are inherent in their systems – making it challenging to fully meet patient needs. The new healthcare rally cry: Better patient access It's clear that an innovative response to revenue cycle management and patient access is needed, and needed soon. Providers have heard the message from patients - they want more self-serve access, like streamlined scheduling, on-demand service and user-friendly technology. That's where patient access software comes in. How patient access software benefits patients By leveraging modern digital tools, patient access software offers patients more speed, convenience and control over their healthcare experience. Patients now have 24/7 access to live online appointment scheduling, registration forms, test results, bill pay and more. Automated patient estimates provide clear, upfront information about the cost of medical services. Patients can also use this software to communicate with their providers. When patients feel more involved in their healthcare journey, outcomes tend to be better, too. Here's a closer look at how patient access software helps patients: Online patient scheduling offers self-service convenience and the flexibility to schedule from any digital device. Patients can reschedule or cancel appointments online. These tools eliminate the need for lengthy office phone calls and allow patients to book appointments at their convenience. Patient intake solutions create better registration experiences by allowing patients to complete registration forms anywhere and anytime. This makes check-in easier and faster. Better technology streamlines the patient experience by removing the frustration of repetitious, manual paperwork. An Experian Health study showed that patients spend an average of $675 a year on surprise medical bills, with nearly half spending more than they can afford, thanks to inaccurate estimates. Tools like Patient Financial Advisor can help patients get accurate out-of-pocket estimates, while providing them with personalized payment plans and the ability to pay bills online. What's in it for providers? Better patient access solutions offer healthcare providers countless benefits. In addition to fostering continuous engagement with patients, providers benefit from streamlined administrative processes, reduced appointment no-shows and optimized scheduling. Plus, facilitating better patient engagement and satisfaction tends to improve health outcomes and strengthen patient-provider relationships. Providers that leverage AI and automation also reduce the burden on overworked staff and enhance revenue cycle efficiency, eliminate error-prone manual entry and increase revenue. Here's how implementing patient access software helps healthcare providers: Automated insurance verification and eligibility tools eliminate the costly human errors that cause claim denials and payment delays. These platforms can verify a patient's insurance coverage and benefits in seconds, ensuring accurate reimbursements and lower bad debt. Electronic prior authorization solutions automate pre-authorization inquiries and lessen the volume of claim rejections. Pre-authorizations are one of the three most common reasons for reimbursement denials. Patient payment estimates provide clear, upfront information about the cost of medical services. These tools create a sense of accountability in patients who understand their financial responsibilities before receiving care. Automating this step at patient intake reduces the administrative burden on healthcare staff. It also increases the likelihood that providers get paid and sets the stage for more effective collections when needed. Improved patient access is a win-win, and better technology is at the heart of patient-centered healthcare. Patient access software is integral in enhancing the efficiency of healthcare delivery, improving patient satisfaction, and optimizing the revenue cycle for healthcare providers. These solutions encompass a variety of technologies and processes designed to facilitate better communication, streamline administrative tasks and ensure timely access to care. Experian Health offers a suite of patient access software that streamlines the entire patient journey from start to finish.  Contact us to learn how these solutions can help healthcare organizations reduce manual errors, decrease claim denials and improve patient experiences.  Patient Access Software Contact us

Health payers created the prior authorization system as a cost and quality control strategy, ensuring patients receive only the most necessary, evidence-based, cost-effective and quality care. Nevertheless, real-life implementation has shown that prior authorizations often backfire on their original intents, increasing overall care costs beyond what is necessary. It also delays patient care, contributes to physician burnout and hinders operational efficiency.  Additionally, dealing with the administrative workload associated with prior authorizations can be overwhelming, time-consuming and exhausting for providers and billing teams. The sheer volume of paperwork required to navigate the traditional prior authorization system can be exhausting, particularly given the current climate of staff shortages and constantly changing payer policies.   Read on to learn why prior authorizations are crucial to reimbursements and how healthcare organizations can streamline the process using electronic prior authorizations.  What are prior authorizations?   Prior authorizations, also known as preauthorizations, is a process that involves healthcare providers obtaining approval from a health plan for a service or prescription to be delivered to a patient. This approval ensures that the plan reimburses the cost of the service or prescription.   Prior authorizations involve a series of steps. First, healthcare providers confirm the patients' qualifications for the proposed treatment. Next, they determine whether prior authorization is required. If an authorization is necessary, providers must submit information detailing the patient's medical history and other administrative information. They also have to submit supporting documents to justify the necessity and appropriateness of the proposed treatment. If the submission meets the prior authorization criteria, the plan approves the request and reimburses the cost of care.  Payers develop prior authorization criteria drawing from medical guidelines, cost considerations, utilization data and other relevant information. However, according to an American Medical Association (AMA) survey, more than one in three providers claim that these rules are rarely or never evidence-based.  Why are prior authorizations required?  Payers created prior authorizations to ensure that the specific service delivered to the patient is medically necessary, appropriate and in line with evidence-based guidelines. It is a cost-and-quality control mechanism. It is set in place so patients only receive the best and most cost-effective care option, optimizing quality while controlling costs.   Prior authorizations have been suggested to help manage the cost of care and reduce healthcare spending. Payers employ prior authorizations to prevent the arbitrary prescription of expensive treatments and medications to patients without appropriate justification. For instance, a healthcare provider might prescribe a costly brand-name medication for which a generic and more cost-effective alternative exists.  The prior authorization requirements regulations also ensure that healthcare providers administer evidence-based care and prescribe FDA-approved medications. In cases of off-label use, the requirements help encourage providers only to prescribe treatments supported by high-quality scientific literature. These medications must also meet indications endorsed by recognized sources such as the American Hospital Formulary Service Drug Information (AHFS-DI).  Challenges with traditional prior authorization methods  For many providers, dealing with prior authorization is an endless journey of starting, completing and revising paperwork. This process presents administrative challenges, leading to a significant waste of time and resources. An AMA survey found that 86% of physicians have reported that prior authorization increased healthcare resource usage.   Healthcare providers frequently allocate a large portion of their daily schedules to addressing prior authorizations. This practice takes staff time and effort that could otherwise be dedicated to providing high-quality patient care. According to an AMA prior authorization survey, healthcare providers spend about 12 hours working on 43 prior authorizations weekly. Not to mention that over one in four providers report that these prior authorization requests often or always end up being denied.   These experiences with traditional prior authorization methods have severe consequences for healthcare providers. They lead to increased physician workload, burnout, and lost time and productivity.  For patients, the time required to process manual paperwork can be a frustrating roadblock to accessing timely care. A convoluted prior authorization process also adds extra hurdles to working with different healthcare specialists for patients with multiple chronic conditions. Consequently, processing prior authorizations through traditional methods could lead to delays in care and even treatment abandonment.   The impact on patient outcomes is also quite significant. According to the AMA, more than nine out of 10 doctors report negative effects due to prior authorizations.   Additionally, payer policies are constantly changing, compounding this issue. It's hard for providers to stay up-to-date and ensure submissions are accurate. These new changes are often unannounced, making it more likely for healthcare providers to make prior authorization requests based on outdated rules. As a result, many of these submissions are instantly rejected.   Challenges with traditional prior methods point to one fact: the need for a more efficient prior authorization system is evident and urgent.  Why healthcare providers should use electronic prior authorizations  Electronic prior authorization entails systems or solutions that streamline the process of obtaining approval for proposed medical procedures, services and medications to be delivered. These systems enable healthcare providers to initiate authorization requests electronically, eliminating the need for manual paperwork processing. They are designed to improve operational efficiency, reduce healthcare providers' administrative burden and ensure patients receive care as early as prescribed.   Alicia Pickett, Senior Product Manager at Experian Health, says, "As healthcare providers face increasing administrative demands, automating prior authorizations is no longer just an efficiency measure—it's a necessity. By streamlining this process, we enable providers to focus on what matters most: delivering timely, high-quality care to their patients."  Overall, electronic prior authorizations connect payers' objective of only remunerating high-quality, appropriate and cost-effective care and providers' aspiration to bypass excessive procedural prerequisites for reimbursement. They also help ensure patients enjoy seamless and timely healthcare encounters that culminate in favorable clinical outcomes.  The benefits of electronic prior authorization solutions  The traditional prior authorization workflow can be tedious, time-consuming and error-prone. Enter electronic prior authorizations. Its unique capabilities offer many advantages for hospitals, healthcare providers and patients.  Neeraj Joshi, Product Director at Experian Health, says, "The true value of electronic prior authorizations lies in its ability to remove barriers to care. By reducing approval times and minimizing paperwork, patients receive faster access to the treatments they need, ultimately leading to better outcomes and fewer delays in critical care."   Here are some benefits of using electronic solutions to address prior authorization hurdles.  Reduced administrative burden  Prior authorization can be lengthy and frustrating when healthcare providers have to gather, review and complete hundreds of pieces of paperwork weekly. Electronic prior authorizations accurately and efficiently take care of these burdens in a way that human efforts cannot replicate.   Improved operational efficiency  Electronic solutions for prior authorizations are a partner tool that helps hospital management allocate resources appropriately. They can also help reduce staff workload and workflow, even amidst staff shortages. By freeing healthcare providers and staff from the time-consuming task of handling prior authorization paperwork, they can focus more on enhancing patient experience, care and satisfaction. As a result, hospitals have a more productive, less stressed and efficient workforce.  Reduced claim denials  Errors in the prior authorization process are a leading cause of claim denials, particularly when hospitals use traditional methods. Electronic authorizations help reduce the risk of claim denials by ensuring accuracy and completeness at every step of the submission process.   Improved patient experience and outcomes  Traditional prior authorization methods lead to costly care delays and frustrating patient encounters with the healthcare system. On the other hand, electronic accelerates time to care delivery, reducing the likelihood of patients experiencing adverse effects.  Increased hospital financial resources  By automating the prior authorization stage, healthcare organizations can speed up the entire claims and revenue management process. This accelerated system also helps reduce claim denial rates and boosts reimbursement rates. As a result, cash flow improves, ultimately strengthening their financial standing.  Key features of prior authorization software  Experian Health's prior authorization software, Authorizations, is an integrated online service that automates the inquiry and facilitates the submission processes for prior authorizations. The system automatically fills in payer information, and users are only infrequently prompted to make inputs.  Key features of the prior authorization software include:  Knowledgebase: Authorizations can access real-time and up-to-date prior authorization requirements and criteria in the National Payer Rulesets.   Submissions support: The software guides users to the appropriate website and presents patient data in an efficient format so that users can create clean submissions.  Enhanced workflow: It works with dynamic work queues, which provide an instant view of the prior authorization status and guide users through any pending tasks.  Postback: Users can send information about authorization status to the health information system (HIS) and practice management systems (PMS).  Image storage: Images of payer responses can be received and stored securely in the software's integrated document imaging system.  Reconciliation: The software offers insights into and helps resolve authorization variances, allowing staff to take proactive steps to prevent denials and appeals.   Electronic prior authorization solutions are a valuable time- and resource-saving investment for stakeholders in hospital revenue management. According to the Council for Affordable Quality Healthcare (CAQH), the healthcare industry could save around $494 million annually by using them. In addition, providers can save 11 minutes per prior authorization transaction with electronic solutions.  Additionally, electronic prior authorization software creates a win-win situation for healthcare providers and payers: Payers only release payments when necessary and hospitals get steady, adequate cash flow to meet the operational expenses of delivering quality care.   Find out how Experian Health's electronic prior authorization software, Authorizations, helps healthcare organizations achieve faster reimbursement rates.  Learn more Contact us

As economists offer up their best guesses for the US economy over the coming year, healthcare leaders know one thing for sure: no matter what happens, they need solid revenue cycle management (RCM) processes to remain financially sound and deliver high-quality care. Revenue cycle management connects the financial and clinical aspects of care by ensuring that providers are properly reimbursed for their services, through accurate and efficient billing and claims management processes. Keeping the financial scales tipped in the right direction is a growing challenge: data from the American Hospital Association shows that payer delays and denials are driving up operational costs while slowing revenue. Many providers are turning to artificial intelligence (AI), automation and data analytics to eliminate inefficiencies and maximize reimbursement. Factors that affect healthcare revenue cycle management While revenue cycle math is pretty simple – money in versus money out – the reality is more complex. A tight grip on delivery costs is just one part of the equation. Most RCM efforts center around determining who owes what and collating the necessary documentation to secure prompt payment from each party. A few factors to consider include: Are there reliable processes for capturing accurate patient information? How quickly can coverage and pre-authorizations be verified? Are claims and denials managed efficiently? How easy is it for patients to understand and pay their bills? Can RCM leaders monitor and analyze staff and agency performance? Changing payer policies, patients' financial status and data management demands add to the challenge. The goal of revenue cycle management To achieve the primary aim of getting reimbursed in full and on time, organizations must reduce billing errors, submit clean claims and refine operational efficiency so staff can stay laser-focused on high-value tasks. But it's important to look beyond the spreadsheets: selecting the right tools to deliver a transparent and compassionate patient experience will boost the bottom line, too. History and evolution of RCM RCM has shifted from largely paper-based processes to sophisticated software-based systems in just a few decades. Few could have imagined how those early healthcare information systems of the 1970s would evolve as electronic health records, standardized coding frameworks and digital data processing came to the fore. Changes in regulation and reimbursement models furthered the need for advanced analytics. And now, the rise of healthcare consumerism drives demand for the industry to open its digital front door. Organizations that commit to digital transformation will be in a stronger position to navigate today's RCM challenges and meet the needs of digitally native consumers. Relationship between patient experience and RCM Experian Health's recently published State of Patient Access Survey 2024 reveals the extent to which the patient experience affects revenue. Integrating patient-centered principles into RCM processes improves patient satisfaction, makes it easier for patients to understand and pay their bills, and leads to better financial performance overall. Steps in the healthcare revenue cycle A typical revenue cycle management workflow in healthcare follows the patient’s journey. Each touchpoint in the patient's journey is an opportunity to check that patients, payers and back-off teams have the information they need to expedite payment: Scheduling – When the patient books an appointment, administrative staff verify the patient's insurance eligibility. This is a chance to make sure pricing is transparent and give the patient an estimate for the cost of care. Registration – Next, the provider captures the patients' medical history, insurance coverage and other demographics. Correct patient information on the front end reduces the errors that cause rework in the back office. Prior authorization – Front-end staff check whether the patient's insurance provider requires prior authorization for the procedure or service they need. Skipping this step can lead to costly denials and rework. Treatment and follow-up – After treatment, the back office collates billable charges and assigns a medical billing code to the claim. Accuracy is paramount, as reworking claim rejections can drain resources. Claim submission – Then, the claim must be submitted to the payer. Accurate and timely submissions prevent rejections and reimbursement delays. If a claim is denied, it must be resubmitted as quickly as possible to avoid lost revenue. Collections – Once the payer approves the claim, the patient's out-of-pocket costs are calculated and billed. Providing a range of convenient payment methods will increase the likelihood of prompt payment. Regulatory and compliance considerations At each stage in the process, staff must stay mindful of the regulatory and compliance frameworks governing revenue cycle management. These are primarily patient-centered. For example, the Health Insurance Portability and Accountability Act (HIPAA) safeguards patient privacy and sensitive health information, while the No Surprises Act seeks to make pricing more transparent. Failure to adhere brings severe reputational and financial risks, as made painfully clear by recent headlines about the cost of cyberattacks within the industry. Common challenges in healthcare RCM For most providers, avoiding the cycle of claim denials and rework is the biggest challenge. A survey of 1300 hospitals found that denials by commercial payers had increased by 20.2%, while Medicare Advantage denials had increased by 55.7% between January 2022 and July 2023. Reliance on inefficient manual processes to track and monitor claims does little to help. A 2023 CAQH report shows that switching from manual to electronic claim status inquiries could reduce the time spent on each transaction by 17 minutes, saving the medical industry more than $3.2 billion overall. Providers are also collecting increasing sums from self-pay patients. Financial pressures and uncertainty around coverage mean many patients cannot fully cover their medical expenses. Improving their financial journey with accurate upfront estimates, clear and compassionate communications, and convenient payment methods will accelerate payments. Unfortunately, there's still some way to go: the State of Patient Access Survey 2024 found that 64% of patients had not received a cost estimate before care, and of those that did, 14% reported final costs that were much higher than expected. Financial impact analysis To track the financial effects of these challenges, healthcare organizations should identify key performance indicators (KPIs) aligned to their specific priorities. Conducting real-time monitoring and analysis of patient access, collections, claims and contract management metrics can flag up opportunities to prevent revenue leakage and maximize income. Read more about how to identify the right KPIs for your revenue cycle dashboard. 4 ways to improve revenue cycle management in healthcare When it comes to implementing specific revenue cycle management solutions, the following four tactics are likely to yield the greatest return on investment: Automate AccessA healthy revenue cycle begins with quick, accurate and efficient patient access systems. Automated, data-driven workflows reduce the errors that lead to denials and rework. Online scheduling allows patients to easily book appointments, while solutions like Patient Access Curator use AI to capture all patient data at registration with a single click. Increase collectionsMaximizing patient collections while fostering a positive patient experience can be a delicate balance. Patient access staff must be the patient's advocate, while ensuring the organization collects what’s owed. Giving patients upfront estimates of their financial responsibility and offering appropriate financial plans makes it as easy as possible for them to pay. Collections Optimization Manager allows providers to focus their efforts on the right accounts, through highly predictive patient segmentation. Streamline claimsAutomating claims management is another way to use technology to accelerate reimbursement. Claims management software verifies that each claim is coded properly before being submitted. Encounters can be processed in real-time with automatic alerts to flag any issues before the claim is submitted. Experian Health's flagship AI Advantage™ solution helps predict and prevent denials by checking claims before they are submitted and calculating the probability of denial. It evaluates and segments denials that occur based on the likelihood of reimbursement following resubmission, and prioritizes the work queue so staff make the best use of time. Increase reimbursementHealthcare organizations that don't stay current on payer policy and procedure changes risk payment delays and lost revenue. Providers and payers must be on the same page to quickly resolve mismatches between expected and actual reimbursement amounts. Automated payer policy and procedure change notifications help providers strengthen relationships with payers and avoid payment delays. How healthy is your revenue cycle? Our revenue cycle management checklist helps healthcare organizations catch inefficiencies and find opportunities to boost cash flow. Case studies See how automated revenue cycle solutions helped Stanford Health optimize their patient collections strategy. See how Schneck Medical Center prevents claim denials with AI AdvantageTM Hear how UC San Diego Health used automation to improve patient billing and drive collections. Getting the most out of revenue cycle management software These case studies demonstrate that a successful revenue management strategy has three essential ingredients: data, software and training. Experian Health's “Best in KLAS” revenue cycle management solutions are built on proven technology and proprietary databases, to help staff find new opportunities to bring in revenue. Experienced consultants are on hand to guide staff and ensure workflows are set up for the best results. The future of RCM Whatever the economic outlook, technology’s defining role in the future of revenue cycle management is undisputed. Payers are already leveraging AI to their advantage, and patients have come to expect convenient digital transactions—any providers that fail to embrace AI and automation-based RCM solutions will fall behind the competition. Learn more about how Experian Health's revenue cycle management solutions generate more revenue for healthcare organizations.

Could healthcare organizations be doing more to open their digital front door? According to a 2024 study by HIMSS researchers, hospitals that embrace digital technology see stronger patient experience outcomes. This aligns with Experian Health's most recent State of Patient Access (SOPA) survey, in which patients and providers agreed that patient access had improved thanks to digital technology. Adoption of digital health technology accelerated in response to COVID-19, as healthcare organizations sought to manage demand and facilitate “contactless” access to care. Telehealth, mobile apps and patient portals gave patients more control over their health while allowing providers to deliver more personalized and efficient care. With over half of healthcare providers and nearly a third of patients acknowledging improvements in access since before the pandemic, it's clear that offering more digital options is a powerful strategy to improve patient engagement and streamline access. Progress is encouraging, but there are always opportunities to do more. What is healthcare's digital front door? Healthcare's “digital front door” includes all the digital channels through which patients access care, such as websites, patient portals, mobile registration and payment apps, telehealth platforms and online scheduling tools. The goals are to create convenient and user-friendly entry points for patients to engage with their providers, use online tools to expand access, improve patient satisfaction, and increase operational efficiency. Why a digital front door is crucial for healthcare providers When asked why they believe patient access has improved since before the pandemic, the top four reasons given by patients all relate to scheduling and registration processes: Being able to see a doctor quickly (72% agreed) Checking in and registration (61% agreed) Scheduling appointments (58% agreed) Finding appointments that work with their schedule (57% agreed). In other words, patient access improves when providers open the digital front door. Alex Harwitz, VP, Digital Front Door, at Experian Health, explains that for providers, this equates to two major benefits: 1. Improves patient engagement Harwitz says that putting access in the hands of patients gives patients more flexibility and choice about how and when they book appointments, fill out registration forms and pay for care. “There's a growing demand for easy, accessible healthcare, and opening the digital front door is how we meet it. Digital tools use automation and data analytics to create a more personalized and convenient patient experience, making it easier for patients to remember appointments, adhere to treatment plans and manage their financial obligations,” he says. “That's huge for busy households. The to-do list just got a lot shorter, so it's easier for them to engage.” 2. Streamlines patient access A second key benefit is reducing friction and bloat in patient access workflows. Harwitz says, “By expanding their online offerings, providers not only make it easier for patients to see their doctor sooner, but they also reduce demand on front office staff. Self-service options, performance reporting and data insights allow providers to allocate resources more effectively. It’s about making sure everyone gets the right support at the right time, whether that's online or in the office.” Getting the patient journey off on a strong footing also pays dividends throughout the rest of the revenue cycle: with fewer errors and faster throughput, collections and claims management improve, too. Read more: How patient access technology is transforming the healthcare revenue cycle Key components of a digital front door As more providers offer online patient access, competition for the digital front door is increasing. With 60% of patients looking for more digital and mobile options to meet with providers, schedule appointments, and manage bills and payments, these would be smart areas to prioritize for a competitive advantage. Here's what that might look like: 1. Cut paperwork and calls with self-service scheduling and mobile registration It should come as no surprise that a vast majority of patients say they do not like repetitive paperwork. Online and mobile-enabled scheduling and registration reduce form-filling and lengthy calls. For example, Patient Schedule gives patients a platform to book, cancel and reschedule appointments with ease, anytime and anywhere. Appointments are matched to patients' needs so no slots are wasted and patients see their doctor sooner. Mobile registration increases bookings further. With Registration Accelerator, patients receive a text that prompts them to scan their identity and insurance cards, so they don't need to wait in line to fill out forms. Validating their data from the start also improves billing accuracy and reduces the risk of downstream denials. 2. Make it easier to pay for care Simplifying the financial experience is a major component in opening the digital front door. Patients are worried about the cost of care and say that having accurate price estimates before treatment helps them plan for bills. With Patient Payment Estimates, providers can give patients accurate, upfront estimates of their out-of-pocket costs, while tools like Patient Financial Clearance can help direct them to appropriate payment plans. It's also important to make the actual payment process as straightforward as possible. Accepting payments 24/7 from any device allows patients to pay promptly and helps providers avoid bad debt. Checklist: 5 patient-friendly billing practices to accelerate collections 3. Communicate clearly for a great first impression At its core, opening the digital front door is about creating a welcoming first impression for patients. Patients don't want confusing instructions or radio silence when they have questions. They want proactive, helpful and clear communications. One of the benefits of digital tools is having the data and automation capabilities to send patients timely and personalized messages and reminders using their preferred channels. They can also drive targeted outreach campaigns using text messages and interactive voice responses to encourage patients to book appointments and make payments. The future of healthcare's digital front door These are just a few examples of how providers can expand their digital offerings to make it easier for patients to access care. But what will the digital welcome mat look like in the future? Advances in artificial intelligence, digital apps and wearable tech will transform the way patients interact with their providers. Hockey-stick growth in data generation will make data security and interoperability non-negotiable. It's a big ask of providers. Partnering with an expert third-party vendor will help digitally forward organizations remain responsive and adaptable. Find out more about how Experian Health helps providers open their digital front door with mobile scheduling, registration and payments.

Surprise tends to magnify human emotion. If the surprise is positive, a person's reaction to it will be intensely positive. If it's negative, it will be extremely negative. Such is the case with unexpected medical bills, and that's one reason why the No Surprises Act was passed in 2021. It aims to protect consumers from unexpected bills for out-of-network care in both emergency and non-emergency settings. Thanks to the Act, U.S. healthcare organizations must now provide transparent details of the estimated costs of their services – otherwise known as patient estimates. And, so far, it's working. One 2023 survey by Blue Cross Blue Shield and AHIP shows that "The No Surprises Act (NSA) prevented more than 10 million surprise bills in the first nine months of 2023 — continuing to protect millions of Americans from crippling medical bills each year." And as insurance deductibles and out-of-pocket expenses continue to rise, patient estimates are becoming even more critical. Experian Health's State of Patient Access Survey 2024 shows that both patients and providers would like to see improvement in the accuracy of patient estimates. Surveys show that 4 in 10 patients say they spent more on their healthcare than anticipated, and nearly one-quarter received surprise bills after treatment. Creating service transparency takes an effort, but there are also hidden benefits for providers. With medical debt skyrocketing past the $220 billion mark and the cost of care increasing, patient estimates apply much-needed rigor to healthcare billing and collections practices. Why are patient estimates important? Pricing estimates enhance the healthcare experience by making the financial responsibilities of treatment more transparent and more manageable. The benefits for patients include: Understanding potential treatment costs, allowing them to plan and avoid unexpected expenses Making informed decisions about their healthcare options by comparing the costs and benefits of different treatment plans Fostering transparency and trust between healthcare providers and patients Better coordination with insurance providers so they know what will be covered and what will be an out-of-pocket expense Reduced financial anxiety, allowing patients to focus more on their recovery and less on potential financial stress Increased cost awareness and acceptance, prompting them to comply more readily with treatment plans and not cancel appointments Providing a price quote empowers patients while creating a more efficient healthcare system of services rendered and payments received. Why are patient estimates useful prior to treatment? It's better for patients, and the healthcare system as a whole, if patients are more focused on healing and self-care than the stress and anxiety of an unexpected medical bill. If they know what's coming, patients can take control and make plans to alleviate any financial turbulence. In the case of planned care and procedures, pre-treatment cost estimates also allow patients to shop around for the best balance between service and price. In addition to helping patients make smarter treatment choices and financial decisions, patient estimates also help people understand, navigate and coordinate their insurance benefits. That also helps them avoid medical billing surprises that can later lead to collections and damage to their credit scores. How do patient estimates help providers? In today's healthcare landscape, where value and patient experience are key factors in reimbursement, transparency has become crucial in four ways: More satisfied patients: Estimates build trust and patient and provider relationships. This trust is essential for effective communication and patient satisfaction and can help reduce patient churn. Better adherence to treatment plans: Patients aware of the financial implications are more likely to stick to their treatment plans and follow through with necessary procedures and lifestyle changes. Adherence leads to better health outcomes and a more efficient treatment process. Better resource management: Knowing each patient's expected costs and required resources allows providers to allocate and schedule resources more effectively. Improved revenue flow: Pricing estimates at the front end of the medical journey establish upfront financial accountability, which can lead to providers being paid more quickly. As healthcare costs rise, improving price transparency is a win-win for both patients and providers. Patients want clear, upfront information about treatment costs, insurance coverage and payment options so they can plan ahead with confidence. When providers make this process smoother, it benefits everyone—saving time, reducing stress, and making things more efficient. Plus, it can help avoid those tough conversations when patients are caught off guard by unexpected bills. Providing the right information from the start creates a more positive experience for everyone involved. Technology can help create accurate patient estimates Experian Health's Patient Estimates tool makes price transparency and providing accurate estimates easier. This solution leverages real-time data, including insurance coverage, payer contract terms and provider pricing, so that everyone knows exactly where they stand before the service is rendered. Patients can focus on getting well while providers create the accountability they need to get paid promptly. With the right technology, patients and providers can come together in a mutually beneficial and less stressful encounter that leads to better relationships and better health. Contact us to learn how Experian Health can help your healthcare organization empower patients with clear, accurate cost estimates to enhance transparency, build trust and improve overall care satisfaction. Patient Estimates Contact us