This week, Experian Health is a proud partner of National Health IT Week. U.S. National Health IT Week is a nationwide awareness week focused on catalyzing actionable change within the U.S. health system through the application of information and technology. Comprehensive healthcare reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers. Initiated in 2006 by the Healthcare Information and Management Systems Society (HIMSS), National Health IT Week has emerged as a landmark occasion for using health IT as part of the overall solution to improve America’s healthcare as a bipartisan, federally led, market driven initiative. While the healthcare industry has transformed in the last decade as health organizations have moved to electronic health records (EHRs), it brings us one step closer to the vision of comprehensive care coordination, but fully achieving care coordination across the vast health enterprise is still a long way ahead. While a recent American Hospital Association (AHA) survey showed that nearly all reported hospitals (96 percent) possessed certified EHR technology in 2015, the Office of the National Coordinator for Health Information Technology reports that there is very little coordination of patient data across the healthcare ecosystem. Much of this disconnect begins with the inability to transfer data in a secure manner that will match, manage and protect patient identities across enterprises. "As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies to managing patient information are no longer sufficient," says Karly Rowe, Vice President of New Product Development, Identity and Care Management Products for Experian Health. "Leveraging sophisticated matching technology and outside data sources, can improve patient identification and prevent duplicate or overlapping records which result in inappropriate care, redundant tests, and medical errors – as well as make data accuracy higher for clinical, administrative, and quality improvement decision purposes." To solve the industry problem of matching, matching and protecting patient identities across the healthcare ecosystem, we must start by creating a universal patient identifier (UPI) to make patient data truly interoperable. For example, one of the biggest challenges in managing patient data begins when patients move, change names, or switch doctors and their EHR doesn’t follow them. They have to start over, trying to recall events and dates in their medical history with a new doctor, who is tasked with providing care without the detailed insight into the patient’s medical record. But if that same patient had a universal identifier that allowed healthcare providers to communicate with another healthcare provider about a patient, the new provider would know all the ins and outs of that patient’s history, leading to a more holistic approach to care and higher patient satisfaction. Simply put, a UPI can be thought of as a mechanism to link all patient information and associate it with the right individual based on patient data. This is similar to how credit bureaus link an individual’s credit history to the right individual to ensure accurate reporting. Using a similar model, patient data — and supporting patient demographic data — can be used for the common good to improve patient safety, increase quality of care and reduce mistaken identity risks. The benefits of a UPI extend across the entire healthcare system as well, as it improves the quality of patient identities, which can have duplicate, overlapping and incomplete records. Additionally, a UPI can help eliminate incorrect medical treatments; deliver current and accurate patient data; and prevent identity fraud, HIPAA breaches and incidental disclosures of protected health information (PHI). Ultimately, this will build patient trust through increased visibility and record accuracy. Knowing that preventable medical errors, many of which are the result of incorrect patient identification, are the third leading cause of death in the United States. The creation of a UPI will allow the healthcare industry to facilitate accurate information exchange to stop problems before they start. For example, if a patient shows up to fill a prescription and is mistaken for another patient with the same name and given the wrong prescription, there could be fatal interactions with other medications that patient is taking. The National Council for Prescription Drug Programs (NCPDP) has already started using this technology to establish national patient safety identifiers. A national patient safety identifier, or UPI, is a vendor-neutral, cost-effective solution that will link patient data at scale efficiently and accurately to improve patient safety and care coordination. Identity management is a critical, underlying component to every interaction, and healthcare is no exception. To fully achieve the goal of comprehensive care coordination, creating a UPI to help match, manage and protect patient data is the first step in achieving the interoperability of patient data. Participate in National Health IT Week’s Virtual March and help catalyze actionable change within the U.S. health system through the effective use of health IT.

Healthcare providers are always balancing a million tasks at once. The most important of these tasks, obviously, is serving patients, which can sometimes crowd out the important but thankless business functions — like keeping tabs on the insurers you're processing. Payers are changing their policies and practices constantly, and those changes are easy to miss when you're focused on everything else you have to do to keep a healthcare organization running. But if a payer policy changes without you knowing, it’s going to cost you. If your denial rate ticks up because of an unknown change in payer policy, you could end up spending thousands of dollars per year to rework those extra claims. The good news, though, is that there’s a tool that can lighten the load. Experian Health’s Payer Alerts service keeps you in the loop about the payer policies and procedure changes you’re too busy to catch. That way, instead of poring over the mergers, acquisitions, and countless other details that affect the insurance industry, you can stay focused on what’s really important — without making sacrifices to your bottom line. How it works With Payer Alerts, every notification you receive is the result of extensive behind-the-scenes work by our software. The program monitors more than 50,000 web pages that payers visit and records any relevant policy changes before preparing an alert for you. The alert contains a detailed summary of those changes and a link to the affected policy. Once you receive the alert, you can just follow the link and make the necessary adjustments to your internal procedures. But given the variety of potential policy changes, those adjustments can be tough to pin down. That’s why every alert categorizes each change by healthcare specialty, allowing you to receive the alerts most related to your organization. And the customization goes further than that.Want an email that describes all relevant administrative changes? Done. Want a web-based portal where you can identify any reimbursement issues? Easy. Regardless of what you need, the alert will be waiting for you in the right platform. Finding ROI in new information Being privy to policy changes without having to sift through insurance jargon can mean a lot for a healthcare organization. “When things change and information is always current, that’s a huge benefit,” says the director of managed care at Rocky Mountain Cancer Centers, a longtime user of Experian Health’s services. When you’re in the loop about what’s covered and what's not, you’ll also be in better shape to increase your revenue and cash flow. RMCC, for instance, reduced its denial rate to 27 percent in its first year using the service and has reached a $1 million ROI on the investment year over year. Payer Alerts isn’t some app that bombards you with pointless notifications every five seconds. By giving you the necessary information to make timely, strategic decisions, the software can help you start running your practice more like a lucrative business. Building the perfect defense Payer Alerts helps healthcare organizations streamline their workflow and maximize revenue through more than just its immediate features; its compatibility with other Experian Health services can provide the perfect defense against the myriad payer issues that might arise. Combining Payer Alerts with our Contract Manager and Contract Analysis solutions not only keeps you up-to-date with policy and procedure changes, but it also helps you target those changes in ways that meet your unique needs. When RMCC realized that sending out individual forms for different information was wasting time, it used its Experian Health software package to aggregate all the data from those separate appeals into a single form. This helped the company reach its efficiency improvement objectives, satisfying both patients and staff. Ultimately, you can’t fix any issues with your insurance processing if you don’t know they exist, and you won’t even know there’s an issue if you aren’t aware of the constant policy changes in the industry. While you can’t stop these changes from occurring, you can invest in a system to adapt to them and avoid the agony of having to scrutinize it all yourself. If you're ready to learn more about Experian Health's Payer Alerts, get in touch with us today. To learn more about how RMCC used Payer Alerts to increase revenue and cash flow, download the case study.

Last year, the National Academy of Medicine estimated that excessive and unnecessary medical tests waste at least $200 billion a year in the United States. The same report estimated that, in addition to the monetary costs, the mistakes resulting from unnecessary tests and treatments can lead to 30,000 deaths annually. No healthcare organization wants to write wasteful and unnecessary medical orders — they're bad for patients and for business. Unfortunately, given the fact that so many providers might be submitting and fulfilling orders for one patient, finding a way to organize a patient's treatment schedule in the most effective and efficient way can be difficult. For many healthcare organizations, however, Experian Health can provide a solution: Order Manager, a web-based platform for tracking treatment orders. Order Manager in action Experian Health’s Order Manager is a component of its comprehensive eCare NEXT® suite of healthcare workflow solutions. Order Manager facilitates communication between every player in a patient’s course of care — hospitals and health systems, standalone clinics, community physicians, and even testing facilities can all verify or update a patient’s testing and treatment schedules when necessary. Order Manager integrates data into a patient's electronic medical record so all supplementing data or documents he or she accumulates are captured and organized within a centralized interface that has actionable suggestions. The all-in-one platform gives providers a GPS-like ability to track an order until it's completed, and every provider in the patient’s circle of care can see what tests have been ordered, what medications have been prescribed, and what the results have been. With Order Manager, staffers don’t have to manually place orders or call the patient’s original hospital or doctor to verify prior authorizations — no more duplication, no more conflicting and dangerous treatment plans, and no more confusion. When ordering systems aren't automated, it doesn’t just affect patient care; the labs that fulfill the orders are getting squeezed by inefficiencies, too. For Aegis Sciences Corporation, a leader in healthcare and forensic laboratory sciences, Experian Health’s Order Manager helped optimize order processes as efficiently as it has for hospitals. Aegis Sciences wanted to provide staff members with the tools they need to consistently provide a positive experience to patients and the physicians they work with, and Order Manager has been an important tool in helping the company do so. The web-based platform improved efficiency and reduced costs by transforming operations into fully paperless processes. Healthcare staff at Aegis Sciences said Order Manager was key in supporting the quality of the organization’s work, particularly the processes that require certain authorizations to be completed before tests can be ordered. With the help of Order Manger, Aegis Sciences was able to reduce the time spent on tasks such as accessioning — the arduous process of logging and sorting a sample in a larger data collection — to less than a minute. In fact, according to Aegis Sciences: "Experian Health's Order Manager teams were key in helping us realize our vision of a fully paperless process that could improve our workflows and processes to keep pace with our exceptional growth. We're now able to offer a fully paperless process to our clients and require that certain fields, such as demographics and diagnosis codes, be completed on the front end." Client satisfaction at Aegis Sciences has risen thanks to a 27 percent reduction in errors and necessary follow-ups, as well as a 76 percent drop in attestation statements during the verification process. To learn how Experian Health's Order Manager can help your organization improve the quality of care for your patients and consumers, feel free to contact us today. Our team can assess the role that Order Manager could play in your organization's workflow and help you implement it in the most efficient way. To read more about Ageis Sciences' experience, download this case study.

The world of healthcare, as everyone knows, can be complex. And in such a complicated system, solutions that simplify, automate, and reduce busywork can make a real difference in both patient satisfaction and workplace efficiency. Although healthcare is, by its nature, a high-touch field, there are several opportunities to allow automated software solutions to handle the basic processing tasks associated with patient management. When routine interactions with patients are automated, medical and administrative staff members can devote more of their time to the cases that need the most attention. Automated workflow solutions also simplify and reduce busywork to make a noticeable difference in patient satisfaction and workplace efficiency. Obviously, that outcome is desirable for all parties involved. It reduces costs, improves morale, and results in satisfied patients. In an ideal workflow environment, employees can personally attend to problem cases and resolve certain issues manually while an automated system handles the run-of-the-mill cases that cause administrative backlogs. Experian Health has worked hard to develop just such a system. We call it eCare NEXT®. Introducing eCare NEXT The eCare NEXT platform, using an approach called Touchless Processing™, is able to offload a number of key patient processes, including scheduling, preregistration, registration, and admissions. Touchless Processing is an exception-based system, meaning that it automatically flags patients who require manual follow-up with staffers. The system updates data in real time, and users can interact with it through either a work queue system or by responding to triggered alerts. Healthcare organizations using the system can automate up to 80 percent of human intervention in the patient management process — allowing healthcare staff to focus on larger, more important initiatives to improve the patient experience. And Touchless Processing doesn't just free up staff time; patients see immediate benefits as well. One of the biggest frustrations in a patient's experience is the inability to get a reliable estimate for how much a service will cost. The eCare NEXT system sorts through all the complex factors that affect healthcare pricing — which are often too complex for hospital billing departments to accurately estimate on their own — and quickly determines accurate cost estimates for both the patient and insurance. Efficiency results in lowered costs — and happier patients The eCare NEXT system cuts costs in other ways, too: by reducing staff training needs, by ensuring compliance, by enforcing transparency, and so on. The benefits of an automated patient management system can manifest themselves in all sorts of ways. Blessing Health System, based in Quincy, Illinois, implemented eCare NEXT and found that it reliably increased efficiency and accuracy in patient management: "Experian Health provided our staff with a reliable, real-time registration error-alerting process. Our overall registration accuracy rate has improved significantly since implementing eCare NEXT. We now have the tools we need to be successful in one user-friendly application." Blessing's employees found that eCare NEXT improved dashboard capabilities and made it easier to view critical data, including missed estimates and copays. It was a clear upgrade over Blessing's previous system, in which employees manually calculated patient estimates. After adopting eCare NEXT, Blessing's point of sale collections increased by over 80 percent, its clean claim rate increased from 63 percent to 90 percent, and denials went down by 27 percent. And because the process had become so much more accurate and efficient, the average number of days an account spent in accounts receivable decreased by 28 percent. There’s no need to labor under an outdated administrative system that's certain to cause backlogs, errors, and intense frustration for patients and staffers. By offloading patient management work to the eCare NEXT system, healthcare providers can do what they do best: help people. For more information, contact Experian Health or check out our Touchless Processing whitepaper.

In the healthcare industry, transparency is everything — you want your patients to be as informed as possible every step of the way. Unfortunately, that doesn’t always happen with pricing, leaving both patients and providers unsure what the final bill is going to be. That’s where Experian Health’s Patient Estimates tool comes in. With this solution, you can provide your patients with timely, accurate projections of the costs of their care either before or at the point of service. By better preparing patients for their bill, Patient Estimates helps you avoid the underpayment problems you’re likely all too familiar with, leaving you more time to focus on providing the care that really matters. The power of accuracy The pricing process in healthcare is complicated. Constantly translating the shifting policies of insurers, suppliers, and partner organizations requires a level of attention that healthcare providers are rarely able to spare. But unless you thoroughly understand all the details that go into a pricing estimate, the only thing you can really offer is speculation. And patients are stressed enough as it is; the last thing they want to worry about is whether their costs are going to unexpectedly skyrocket once the bill comes. Each projection that comes from the Patient Estimates tool undergoes several data-gathering stages before delivering any results. Patient Estimates collects information from the patient’s insurance provider, including claims history and payer contract terms, as well as the hospital's chargemaster price. This data is automatically posted to a centralized work list, which can be customized by a healthcare provider depending on its needs. Imagine you need a price estimate for a patient who needs a common procedure or you’re trying to pinpoint the costs of a very specific procedure. You can narrow your search in the Patient Estimates platform to match your patient’s unique situation, and then you can easily pull that pricing information back up at any time. Most importantly, this data is equally accessible for your patients — you can print estimates in a variety of languages or customize scripts for your staff to read. As altruistic as this all sounds, Patient Estimates isn’t just a way to fulfill an ever-increasing obligation of state mandates for price transparency. Getting accurate pricing estimates slashes the time you’d spend manually updating pricing lists and scrambling to create an audit trail for a patient. By automating this grunt work and providing accurate upfront information, Patient Estimates can make your collections process easy and efficient — not two words you typically associate with collections. “The tool is really behind a lot of our success with billing and quick client payments,” says the Baylor University College of Medicine’s director of patient access. “Partnering with Experian Health has allowed us to be an advocate for our patients while also protecting our bottom line.” Patient Estimates isn't just a useful resource for patients; it's also an efficient tool providers can use to avoid age-old payment problems. After all, your organization runs on payments, and you’d hate to miss out on essential revenue because you didn’t give your patients accurate information in the first place. Bundle up Combining Patient Estimates with other Experian Health services can extend the benefits across a wider range of services. Patient Estimates connects with Eligibility, for example, to generate up-to-date benefits information that can inform a patient's treatment plan. It also works in lockstep with our Contract Manager solution to price estimates based on a provider’s payer contract, no matter how complicated it is. The College of Medicine at Baylor University is among the providers that use Contract Manager to analyze contracts throughout clinical practice departments. After adopting Experian Health's product suite, the school overhauled its internal collections strategy and generated more than 18,000 patient estimates while collecting $4.2 million in contractual underpayments it would have previously missed. Baylor has used its package of Experian Health products not only to streamline its workflow, but also to improve its patient collections rate and negotiate stronger contracts. You don’t have to draw a hard line between helping your patients and making a profit. In fact, the two go hand in hand when you take the right steps. With Patient Estimates, everybody can get on the same page. Contact our team today to find out how to boost transparency in your organization. To learn more about Baylor University College of Medicine’s experience with price transparency, please download this case study.

Patient responsibility for their cost of care is rising dramatically. By 2025, it’s estimated that 20 percent of all consumer earnings will go to healthcare costs. As such, consumers are increasingly wrestling with how to navigate the healthcare journey, and providers are seeking ways to provide more transparency around costs. To dig deeper into these shifts, Experian Health conducted a study to assess the patient healthcare journey. A summary of findings were released in an all-new paper, Embracing consumerism: Driving customer engagement in the healthcare financial journey. We interviewed Kristen Simmons, Experian Health senior vice president of strategy and innovation, to learn more about the study. What prompted you to conduct this study on the “jobs” associated with the consumer health journey? In speaking with our clients and top thought leaders in the healthcare space, we are naturally aware that our industry is ripe for change. Consumers expect a more seamless, transparent healthcare journey – from start to finish – but we wanted to dig in and understand more specifically how they view each dimension of the process. What “jobs” must they tackle on their quest to getting the healthcare they need? What’s working, and where are they experiencing pain in the process? We wanted to hear directly from consumers to understand their current situation and motivations, and simultaneously assess how providers are feeling about the state of healthcare. Tell me more about the “jobs-to-be-done” methodology. Why did you take this approach to conduct your research? Consumers purchase and use products and services because they satisfy one or more important jobs they are trying to accomplish. In healthcare, this largely centers around the goal of getting better: Cure the ailment, fix the broken bone, complete the annual well-check visit. Qualitative insight into the “jobs” consumers need to get done ensures that we start with a “needs” mentality when we innovate products and solutions, rather than an “ideas-first” mentality. In our work, consumer interviews revealed 137 jobs associated with a typical healthcare experience. We then conducted a quantitative survey to measure the level of importance associated with each of these jobs, as well as the consumer’s current level of satisfaction with their ability to get each job done. These responses helped us develop a heat map illustrating the greatest pain points and opportunities for improvement. And let me tell you, there is a lot of work to be done to improve the customer experience in health! Are you surprised to see that the financial “jobs” associated with the consumer’s healthcare journey to be the most painful for consumers? I think we all knew the financial aspects of the journey would be a pain point, but it was surprising to see just how dominant this pain was ranked across absolutely every financial element of the journey from start to finish. Ninety-four percent of consumers ranked financial experiences as a major pain point in their overall healthcare journey. Additionally, 98 percent of consumers ranked worrying about paying their medical bills as a “very” to “extremely important” pain point. We need to build solutions and processes that offer consumers more transparency around the financial aspects of the healthcare journey—and importantly, help them know what to expect at each step along the way. This will alleviate some of the stresses of the unknown and allow healthcare consumers to focus on what matter most – getting the care they need. Beyond the consumer survey, you also interviewed 22 providers about their priorities for creating a better patient experience. What did you learn in these discovery calls and face-to-face interviews? Healthcare providers want to see change as well. They are obviously focused on healing people, but they recognize the need to give focus to the marketing and business aspects of providing care. They told us they want to find ways to provide more clarity around charges, and education around how charges can change along the way depending on health discoveries. They additionally cited desires to measure the customer experience, improve their IT infrastructures, build customer loyalty and even link customers with charitable organizations who can help with healthcare costs and payment. They fundamentally understand that all aspects of the consumer or patient experience is important, and some are beginning  to recognize that the financial and clinical aspects of healthcare may be more interrelated than once thought. The theme of “consumerism” bubbled up in both the consumer and provider responses. Can you expand on what “consumerism” means in the healthcare space? With the rise of digital technology, consumers have unprecedented power. They expect to be provided with a turnkey, individual experience that is fast and seamless. Think Amazon. Think Apple. Think about review sites like Yelp. While other businesses have been shifting their focus toward delivering meaningful and valuable consumer experiences, healthcare has largely stayed the same. But, costs are rising for governments and employers, and this is placing pressure on healthcare organizations to think differently about how they deliver value. Those rising costs are also directly impacting consumers, driving more shopping behavior and greater adoption of new online tools and resources (think WebMD) that give them more control. These shifts mean that driving consumer engagement and redefining how healthcare organizations interact with people is no longer a luxury, but a necessity. Providers need to make the customer experience a priority. Our survey results validate that, and I’m certain the expectations will only increase in the years to come as the next generations enter the healthcare arena. To learn more about the survey findings, visit Experian.com/consumerhealthstudy.  

As they do with everything else they purchase, consumers demand more personalized experiences with their healthcare providers. To meet that demand, healthcare organizations have shifted how they think about customer engagement. It's no longer enough to bring patients in, take them through a treatment plan, and send them on their way; providers are now focused on empowering patients, treating them like customers, and using data to improve outcomes and quality of care. This shift is partly due to the fact that rising medical costs have forced health consumers to be choosier about their providers, which means those providers have to be more competitive. While this shift is relatively recent in healthcare, consumers are used to comparing companies and products before making a purchase. With that in mind, healthcare providers should take a cue from the successful marketing techniques used in other competitive industries: collecting data, using that data, and connecting with consumers to get more data. With marketing solutions from Experian Health, healthcare organizations have an easy way to leverage data and more effectively reach their current and future customers. Finding your audience The people you want to market to aren’t just patients; they’re consumers — and hopefully future customers. And these consumers have specific lifestyles and habits. The best way to learn about those habits is through a comprehensive database of consumer information. Experian Health's ConsumerViewSM lets you tap into more than 30 years of historical data on more than 300 million consumers. Learn exactly who your audience is by pooling data points on core demographics including age, gender, marital and parental status, and more. ConsumerView pulls from a variety of sources and is constantly being updated, which means marketers can trust that they're getting accurate, actionable information. After you identify your target market, you can combine the data from ConsumerView with Mosaic® USA and TrueTouchSM to segment, identify, and successfully reach your target audience with the most appropriate message. Consumer segmenting made easy While ConsumerView is the source for your audience’s data, Mosaic USA is how you make sense of it all. Think of it like an automatic filing cabinet, sorting your data into relevant groups and presenting it to you for easy accessibility. The segmentation system separates consumer audiences into 71 unique types within 19 overarching groups; more than 300 ConsumerView data points detail consumers' preferences, choices, and habits. This segmentation helps you zero in on your audience and tailor your messages to each group you're targeting. Using Mosaic USA, you could identify which segments of your audience would benefit from preventative medicine or which ones are currently living with certain health conditions. Then, you could send those audience segments messages and materials about your relevant services. With the TrueTouch platform, you can ensure each message is also delivered to your audience through the channels they prefer for optimal engagement. Getting on their level Knowing who your audience members are and what they value most is an important marketing step, but you still have to deliver your message in a way that resonates with them. That might be through personalized emails, ads on their favorite social media channels, or even direct mail advertisements. TrueTouch gives you the power to personalize your marketing campaign for each unique segment of your audience according to their preferred methods of engagement. Reaching out to customers before they need to come in for a visit will make that visit more personal and productive. Your personalized marketing campaign can leverage emails, social media interaction, website retargeting, and more, depending on what's most effective. As your marketing campaign draws in more customers, you can continually improve your TrueTouch usage by capturing data on which channels were most effective for which customer segments. Ultimately, healthcare providers should be the most focused on providing excellent care and making customers healthy. That's why Experian Health's marketing tools are designed to make healthcare marketing as easy and as effective as possible. Today's consumers are savvy and choose their care providers carefully, but gaining valuable insights into their behavior is simpler than you might think.

Between 2015 and 2017, patients’ direct responsibility for their healthcare payments grew by 29.4 percent, according to a study by Black Book. On average, that left each patient with more than $6,200 in deductible and out-of-pocket expenses for the year. But patients aren't the only ones who have had to grapple with these changes; the shift has changed hospitals' revenue models as well. In the same Black Book study, 92 percent of hospitals reported having trouble with collections using traditional solutions. The choice that many hospitals face is to either write off losses on late payments or pay exorbitant fees for collections agencies to pursue them all. Neither option is ideal, and for some healthcare providers, neither one is possible. Fortunately, there’s a third option that doesn’t involve pursuing all delinquent accounts — just the ones that are worth the effort. How Experian Health optimizes collections for you Experian Health’s Collections Optimization Manager is designed to help your organization sort out which patients are able and willing to pay from the ones who can’t or won’t pay. That helps you streamline the collections process and stabilize your revenue cycle. Experian Health's collections software does this in three important ways: 1. Segmenting patients by likelihood of recovery The first step in streamlining your collections process is to identify which patients will actually pay their bills. Experian Health's Collections Optimization Manager segments your patient population according to each patient's ability to pay, taking into account his or her unique financial situation and health coverage information. 2. Directing patients to the appropriate personnel Some accounts can be outsourced to a collections agency, while others should be directed to a financial assistance program. Using the Collections Optimization Manager to analyze your patient population helps reduce the cost of collections by showing you which type of personnel can best help each patient. 3. Keeping updated data on payment benchmarks The Collections OptimizationManager isn't a one-time solution; it's a dynamic system that continuously monitors each patient’s successful or missed payments. This data is immediately aggregated in the collections manager and kept up-to-date, ensuring healthcare providers have a real-time picture of a patient's financial situation. Optimized collections in action Healthcare’s patient-dependent revenue cycle is forcing hospitals and other healthcare providers to change their collections strategies. By using Experian Health's collections software in tandem with our other revenue cycle management solutions, you can reinvent your entire billing and collections process. It not only boosts your revenue, but also helps you provide patients with more personalized, compassionate financial options. For example, after Altru Health Systems, a healthcare provider in North Dakota, implemented Experian Health's Collections Optimization Manager, it identified 4,000 accounts that were eligible for nearly $2.7 million in assistance. This helped customers in need and boosted Altru's successful rate of collections by 114 percent by identifying accounts with a high propensity to pay. "Partnering with Experian Health has allowed us to be an advocate for our patients while also protecting our bottom line," says Stan Salwei, Altru's patient financial services manager. "Within 10 months of implementing, we were able to completely revamp our internal collections strategy to more effectively provide financial solutions for our patients in an ethical and compassionate manner." Experian Health does more than just provide the tools; we'll consult with you and your team personally to find the most effective ways to use them. If you have not yet implemented a streamlined collections strategy, contact us today.

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.