Tag: claims

for our upcoming webinar with Banner Health, where attendees will gain insights into the organization's workflow and processes.  It is estimated that 30-50% of denied claims occur on the front end during the patient access process, namely during registration, authorization and eligibility. Unfortunately, manual patient intake processes contribute to these denials, and ultimately, the bottom line, staff productivity and the patient experience take the hit. Banner Health chose to automate its patient access processes with eCare NEXT from Experian Health. The solution, which integrates directly with Banner Health’s acute and ambulatory electronic health records (EHRs), automates the organization’s preregistration workflow, including medical necessity and financial clearance. This improves registration accuracy, provides more accurate patient estimates and reduces the number of denials on the front end. Banner Health has benefited by incorporating a mix of Experian Health products that integrate directly and collaborate with other technologies and workflows already in place: Decrease in eligibility errors. With eCare NEXT, initial denials due to eligibility errors have been reduced by $30M in the first quarter alone since going live with Experian Health. Significant cost savings. With more accurate estimates, Banner Health has seen significant cost savings on the front end from more efficient coverage discovery. The system is consistently finding 30+% unique or new coverage in the patient access workflow. Improved staff engagement and satisfaction. Automation has greatly reduced manual inputs, enabling staff to focus more on the patient rather than systems and logins required for patient intake. Our partnership with Experian Health helps Banner Health's revenue cycle team deliver on its mission of “getting it right, at the right time, every time."  — Becky Peters, Executive Director of Patient Access Services, Banner Health  

Claims denials put a big dent into the budgets of healthcare providers – something many organizations can’t afford today given the current pandemic. In an environment where everyone must do more with less, reducing claim denials could release vital revenue and staff time to create breathing space for quality improvement. The good news? About 90% of claims denials are preventable when healthcare providers automate revenue cycle functions. In fact, providers could gain an estimated $9.5 billion by automating the claims management processes. Here are 5 ways for providers to proactively reduce claim denials. Healthcare providers should shift from reactive to proactive claim denial management, looking at the whole RCM process. On the front-end, that includes streamlining the patient registration process. By achieving near-perfect levels of accuracy on the front-end, providers can prevent costly claims denials and unnecessary re-work on the back-end of the revenue cycle. On the back-end, ideally, providers will use technology to prevent denials in the first place, improve processes for managing denials when they do occur, and then use a robust analytics platform to understand what went wrong so it can be avoided in future.

With COVID-19 leading to postponed and cancelled medical appointments, more consumers are turning to “contactless care”. Recent figures suggest telehealth adoption has shot up from just 11% in 2019 to 46% over the course of the pandemic, and some providers are seeing up to 175 times the number of telehealth patients than pre-COVID. As they grapple with the surge in patient volumes alongside regulatory change, many are playing catch-up. For patients, rushed implementation means the telehealth experience can fall short of expectations. Compared to the easy one-click services available with online retail and finance platforms, telehealth can feel clunky and frustrating. Technical issues, not knowing how to prepare for appointments, and a lack of awareness of available services can all taint the consumer experience. Providers looking to launch (or re-launch) a patient-friendly telehealth service ahead of a possible second wave should aim to check off these four considerations before rolling it out. 1. Prioritize easy online scheduling for virtual care Allowing patients to book telehealth appointments when it suits them will help to reduce no-shows and minimize delays. A telehealth platform that integrates with physician calendars and other patient management and record management systems will keep things running smoothly at the operational level, while creating a convenient and secure way for patients to schedule care. For example, when Benefis Health System implemented Patient Schedule, more than 50% of patients chose to book their appointments out of normal working hours. Sam Martin, digital developer and web specialist at Benefis, says: “If you’re not allowing your patients to schedule online, you’re behind the times. You can only benefit from it. We’re seeing the number of online bookings continue to grow every month, confirming that this solution is working for patients.” 2. Include quick and reliable coverage checks With the pandemic and resulting unemployment putting both provider and patient cashflow under strain, any available commercial or government coverage must be identified quickly. Providers should run automated coverage checks to find any missing coverage and select the right financial pathway for each patient as soon as possible. Not only will this create a more compassionate patient financial experience, it’ll allow the collections team to focus their attention on the right accounts and minimize the risk of write-offs. Automated Coverage Discovery screens for eligibility through Medicare, Medicaid or commercial plans, without any collections agency getting involved. With this tool, Essentia Health were able to find coverage for 16,990 accounts that were assumed to be self-pay or uninsured. Kathryn Wrazidlo, Patient Access Director, says: “This has helped patients because we’re actually billing their insurance versus billing them for self-pay. It’s helping staff because they’re billing the insurance company much quicker. There’s less rework.” 3. Get telehealth claims right first time Given that the pandemic may cost hospitals an estimated $200 billion between March and June 2020, there’s no room for the added financial burden of claim denials. But as telemedicine expands, so does its regulatory framework. Providers must keep track of changing payer updates and coding rules so that claims are submitted right first time. An automated, data-driven claims management tool can help providers analyze claims with greater confidence and spot any errors well in advance of submission. Telehealth alerts can be included as customized edits, to confirm whether the patient’s current plan includes virtual care. To help providers manage this process, Experian Health is offering free access to telehealth payer policy alerts through our COVID-19 resource center. 4. Protect patient data As with any part of the digital patient experience, a multi-layered approach to protecting sensitive information is a must. Ideally, this will include two-factor patient identity authentication, device recognition and out-of-wallet checks whenever a log-in attempt looks suspicious. Automating this process with a tool such as Precise ID allows providers to integrate multiple data points to check that a patient is who they say they are, in a way that’s HIPAA-compliant. This makes it harder for thieves to access patient data, without burdening the patient with extra checks as they manage their information. Retaining patient volume and rebuilding revenue through “contactless” care won’t be possible unless the entire telehealth journey is as seamless as possible. From scheduling to payment, Experian Health can help you create a virtual patient experience that’s convenient, secure and reliable. To learn more about how to build a better digital patient journey, download our free eBook.

  Recently I had the opportunity to present at a regional chapter of the National Association of Healthcare Access Management about the growing need for business intelligence to improve patient access functions, as well as revenue. In speaking with attendees, it became clear that automating the patient access workflow with real-time data can create a more efficient and accurate process. Here’s how. As the responsibility for paying healthcare bills increasingly falls to patients themselves, patient access can make or break the revenue cycle. From registration and verifying insurance details, to scheduling appointments and collecting cash payments—this is the front line for the financial side of the patient experience. When you consider that half of denied claims occur earlier in the revenue cycle at the point of registration, improving those early-stage patient access processes is the obvious place for providers to look when seeking to minimize lost revenue. Revenue loss in patient access is mostly due to errors in patient identification, inadequate data analytics and inefficient workflows. If front and back office teams were better connected and able to work together quickly to communicate and resolve issues, many of these errors could be prevented. Without reliable tools and workflows to support this, those teams often must resort to manual fixes for any errors that arise. Unfortunately, this takes time and effort, blocking opportunities to find new ways to improve decision making and business performance. Healthcare is becoming more competitive. Providers must work to leverage the right data in the right way to safeguard profits and offer a better patient experience. That said, where should you start? Doing more with less requires the right data insights There are two sides to the solution: first, you need to be sure your data is accurate from the start. Around a third of denied claims are caused by inaccurate patient identification, while 12% of patient records are duplicates. Cleaning up your data with high-quality demographic data can help eliminate preventable denials. Secondly, you need to be able to draw insights from your data to help make smarter decisions in the future. Let’s say you notice a spike in late payments from a certain population. Why is that? Looking at historical data on patient and payer behavior can point to emerging trends and help you figure out where to focus your efforts in response. Or perhaps you’ve recently added a new function to your patient portal. Analytics can help you see if and how patients are using it and evaluate its overall performance. Once you have your data and analytics in place, you can start to use it to make improvements. Automating the patient access workflow with real-time data can create a more efficient and accurate process. It will also help link front and back office staff with shared systems that minimize errors and wasted staff time. 3 ways to use data analytics to streamline patient access For providers looking to streamline their early revenue cycle processes using the power of data, three areas to focus on are: Creating a better patient experience Increasing numbers of self-pay patients means patient loyalty is a growing priority for providers. Creating a positive, straightforward patient financial experience is essential for hospitals and health systems looking to reduce the stress and anxiety many patients feel when dealing with healthcare bills. Using data insights to identify the sticky parts in your patient access processes can help you spot opportunities to improve the consumer experience. For example, are patients receiving duplicate communications because the system is failing to update demographic information? Are there bottlenecks or backlogs that are creating stressful delays for patients? A business intelligence tool such as Revenue Cycle Analytics can help you pinpoint the root cause of delays and errors so you can work to fix them—and level-up your patient experience. When Martin Luther King Jr. Community Hospital (MLKCH) realized patient registration in their busy Emergency Room was a bottleneck and source for claim denials, they implemented an automated platform to streamline their registration process and improve the data being captured at the point of registration. Lori Westman, patient access manager at MLKCH says: “We get fewer denials because we’re getting true verification data, and our patient volumes continue to increase. So the fact that we can take off two to three minutes, at least, on half of our registrations is speeding up the work for the team, and the turnaround time is much better for the patients.” Uncovering potential revenue loss Analytics can show you exactly where your revenue cycle is losing money. Using appropriate benchmarks and custom KPIs, you can analyze accounts across the entire cycle to make sure your existing revenue cycle solutions are performing optimally and identify new opportunities for improvement. By gathering together multiple data streams into a single dashboard, you’ll get an at-a-glance view of your revenue cycle performance, so you can drill down to the root cause of denials. This also helps link up your front and back office staff. Rather than working retrospectively to address issues as they happen, your back office team can use insights from whole system data reporting and analytics to give front office staff immediate feedback on where denials are occurring. Monitoring payer rules and performance With American hospitals footing the bill for more than $620 billion in uncompensated care over the last two decades, it’s vital to verify a patient’s insurance options as soon as they set foot in the hospital. With up to date information on payer rules and a robust process for finding missing coverage, you can avoid protracted negotiations with payers and focus on denials, rejections and exceptions. A payer dashboard can also help you assess how payers are performing against one another, so your discussions around timely payments will be based in fact. By analyzing performance around pre-service, point of service and post-service, you’ll be better placed to work more closely with payers to minimize the risk of both late payments and denied claims. Learn more about how data analytics and an automated patient access workflow can help eliminate costly denied claims, boost revenue cycle performance and improve the patient financial experience. Steven Thiltgen is Director of Analytics Consulting for Experian Health

Managing the revenue cycle draws in considerable resources for healthcare organizations, even when it’s working as planned. The American Medical Association puts direct transaction costs and inefficiencies associated with the “claims management revenue cycle” at around 25-30% of overall healthcare spending. But when errors are made and claims end up being denied, providers could end up missing out on as much as   The total revenue leakage is probably higher, when you consider the opportunity cost of staff time spent sorting out denials. Among the most common reasons for denials are missing or incorrect billing information, non-covered charges for care, and absent authorizations. Thankfully, these are all issues that can be minimized with the right strategies and tools. By optimizing your revenue cycle from the outset so that claims are right first time, you can save hassle and expense later on. Here are 7 ways to proactively reduce claim denials in your health system. Figure out why claims are denied First things first. You need to understand where denials are occurring in your revenue cycle and why. You can determine the root cause of denials by analyzing data that’s already available to you alongside information on industry trends. A business intelligence tool can help you use advanced data analytics to find opportunities for improvement, and generate actionable insights that are focused on your specific KPIs. Once you know where the weak points are, you can get the ball rolling with solutions. Prioritize the big-impact fixes In all likelihood, most providers will have the opportunity to improve the claims process at several points in the revenue cycle. You can’t do everything at once, so identify the areas with the greatest potential impact on your hospital’s bottom line. Can denials be traced to a particular department, service line or physician? Has a certain payer changed their approach? Compare the cost of implementing processes to tighten up the weak points in the cycle with the amount of revenue likely to be recovered to ensure you get the biggest ROI for your efforts. Automate patient access for more accurate claims Up to half of denied claims occur early in the revenue cycle, during patient access and registration. Automating the patient access workflow with real-time data can create a more efficient and accurate process, linking front and back office staff with shared systems that minimize errors and staff time. Martin Luther King Community Hospital experienced these efficiencies first-hand, when they integrated eCare NEXT® within their existing Cerner® system. As a result, their registration process became more streamlined, enabling them to cut two to three minutes from more than half of their registrations. Ensure patient matching is as accurate as possible Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1000 for each mismatched pair of records, that’s a lot of lost revenue. Resolve your patient identities with the most robust data sources, and not only will you reduce claim denials, you’ll also have a more complete picture of each patient, which in turn will give them a better patient experience. Streamline prior authorization checks A survey by the American Medical Association found that prior authorization checks created a substantial burden for providers, with physicians spending an average of nearly 15 hours per week dealing with related tasks. For patients, this process can lead to delayed or even abandoned treatment. Using automated software, you can check claims against payer rules for medical necessity, frequency, duplication and modifiers, so you can quickly spot any claims that may be denied and correct them before submission. Process claims effectively Once you’ve streamlined the front-end of the claims process, you should of course look for ways to improve efficiencies throughout the rest of the cycle and immediately before the claim is sent to the payer. In fact, providers are expected to invest up to  , as the need to crack down on denials grows. Submitting claims in the correct format is a common and frustrating challenge. Since each payer has different requirements and formatting preferences for claim forms, edits should be customized. A revenue cycle service provider can help you build these custom edits and check each claim line by line, so you can submit with confidence and avoid having to redo them later. Monitor and analyze your revenue cycle Regular analysis is essential to consistently improve denial rates. By monitoring your internal processes across a range of metrics, you can gain a holistic view of the entire revenue cycle to see where there are further opportunities to optimize performance and prevent denials. When you have confidence in the freshness and accuracy of your data – including patient access data, payer performance information and patient matching – you can make confident decisions about exactly what needs to happen to improve your claims denials. Learn more about how leveraging data-driven insights to tighten up your claims management systems and take proactive steps to find lost revenue.  

Over the last twenty years, American hospitals have provided more than $620 billion of uncompensated care for cases where no payment was made by a patient or insurer. This includes financial assistance, where hospitals provide care at a reduced cost for those unable to cover their full bill, and bad debt, where patients have not applied for financial assistance and cannot or will not pay their bill. Despite extensions to Medicaid coverage under the Affordable Care Act, the number of uninsured people in the United States is still approaching 30 million. For these often-vulnerable populations, safety-net hospitals provide essential care regardless of the patient’s ability to pay. But safety-net hospitals are themselves under increasing financial pressure, experiencing more than double the uncompensated care costs of other acute hospitals. And when safety-net hospitals are closed down or struggle to meet demand, nearby hospitals must cover the shortfall in care. It’s a problem for everyone. A Kellogg Insight report found that when more people are uninsured, hospitals bear the cost by providing uncompensated care to the tune of $900 for each additional uninsured patient. Craig Garthwaite, Assistant Professor of Strategy, describes hospitals as “insurers of last resort”: “People are still going to the emergency room and they are still receiving treatment – so the cost is still there. When governments do not provide health insurance, hospitals must effectively provide it instead.” Hospitals might respond to the burden of uncompensated care in three ways: shifting the cost of care to other payers, cutting the cost of services to all patients and removing unprofitable services, or accepting lower total profit margins. All have the potential to damage quality of care as well as revenue and workflow. But beyond these major systemic responses, there are steps providers can take to reduce their risk of unpaid care and optimize their existing revenue framework. Protect your revenue by finding missing coverage quickly The new reimbursement landscape forces providers to manage more self-pay patients, with high-deductible health plans and health savings accounts. This puts a lot more responsibility and stress on patients themselves, who may not be able to afford their co-payments. Uncovering missed or undisclosed insurance coverage is also costly and time-consuming for providers. Regardless of ability to pay, if your patients are wrongly classified as uninsured or as having only one insurance option, you’re likely to lose revenue. As the financial risk of uncompensated care continues to grow, there are important questions for healthcare executives to consider: How do you decrease your accounts receivable balances and self-pay write-offs? How do you increase cash flow from re-billed claims? Are you missing any opportunities to bill additional payers for services? Are you identifying coverage for emergency department inpatients in time to meet your notice of admission requirements? The answers boil down to having the right processes in place to discover which patients can and cannot afford to pay, ideally before they go through the billing system. When you know this, you can move quickly to direct them to alternative sources of funding. How to find insurance coverage to avoid bad debt and charity write-offs An automated coverage discovery solution could help you identify patient accounts that don’t have sufficient insurance coverage, without the expense and hassle of engaging a collections agency. This proactive software integrates with your revenue cycle to search government and commercial payers automatically, so you can find insurance coverage that may have been missed or forgotten. It relies on multiple data sources and reliable demographic information to detect any inaccurate financial classifications and alternative coverage options. It can also shed light on product usage, productivity and financial results, which may help you fine tune your revenue cycle in other ways. Murry Ford, Director of Revenue at Grady Health System explains how Coverage Discovery allows his team to identify an accurate coverage match for patients without the patient having to share this information: “We use Coverage Discovery when the patient is admitted… the system automatically attaches the coverage to the patient’s account. No one has to get involved – it’s touchless, it’s seamless, and it’s worked really well for us. It’s brought in revenue that we would not have identified otherwise.” Every dollar found in this way is a dollar you’re not writing off to bad debt, or spending on unnecessary patient collections and admin. Mike Simms, Vice President of Revenue Cycle at Cone Health says: “Coverage Discovery is wonderful... After every admission, the next day we get a file which gives us insurance on those that we’ve missed. We can add that insurance to the patient account and bill the insurance company. In the end it helps us resolve accounts in a timely manner. Since we’ve been using Coverage Discovery, we’ve received over $3 million in payments, and that’s more than a 300% ROI.” An automated solution like this can be plugged in immediately to handle unresolved accounts for you, resulting in faster and more accurate collections, greater patient satisfaction, and improved staff workflow – ultimately reducing your organization’s risk of uncompensated care. Learn more about how Coverage Discovery Manager works.

Healthcare organizations have been forced to deal with billing challenges for so long that many might consider the struggle to simply be the price of doing business. Denied claims and contractual underpayments are regular occurrences in the payment cycle. And these issues can cause problems in the rest of the healthcare ecosystem when left unchecked. Fortunately, a robust claim scrubbing solution can reduce costs and speed up reimbursement. Healthcare billing costs can add up quickly. The estimated cost of billing- and insurance-related jobs at one large academic healthcare center ranged from $20 to $215 per patient visit, according to a study published in 2018. For years, the State of Franklin Healthcare Associates (SoFHA) was all too familiar with the challenges of the claims process. In 2010, the organization had to keep 12 full-time employees on its payroll devoted to the correction and resubmission of denied claims. When claims are denied, Crowe reports that it takes an average of 16.4 additional days for a hospital to receive payment. And those delayed payments are costly to healthcare organizations. Without the tools that enable a proactive approach, healthcare organizations' only option is to submit claims and then wait to correct the ones that are denied. SoFHA’s large network of 109 providers included a wide variety of specialties and services, from diagnostic imaging and internal medicine to OB/GYN and family practice. SoFHA needed a flexible presubmission claim scrubbing technology that would identify and correct errors before claims could be submitted. To overcome the obstacles in the claim submission process, SoFHA turned to Experian Health's Claim Scrubber. Claim Scrubber stood out to the group in two ways. The first was the price, as users pay a fixed monthly rate rather than pay for each transaction. The other highlight was the ability to build customized claim edits, which are available to all clients immediately when the tool is deployed. For Amanda Clear, SoFHA’s director of business services, that capability made all the difference. “With Claim Scrubber, I have the ability to go into the system and create my own edits,” Clear said. “Other systems either didn’t accommodate customized edits or required you to call, perhaps pay a fee, and go through a long process.” Plus, Claim Scrubber reduces demands on healthcare provider personnel because the tool comes with around 350 edits maintained by a dedicated content team. Payer-specific edits replace between 60 and 75 percent of an organization’s custom edits right away. Claim Scrubber ensures claims are correct and complete the first time they're submitted. Experian Health regularly updates its system with coding and payer changes. The tool adjusts for coding variances on claims submitted to Medicare, Medicaid, and private insurance companies. It reduces denials and drives down rebilling costs for healthcare organizations. With Claim Scrubber, SoFHA generated a clear return on investment, and the group was able to expedite accounts receivable by 13 percent. Perhaps even more telling was the reduction in full-time claim correction employees that accompanied the adoption of Claim Scrubber — a change that occurred in spite of a growing volume of claims. By auditing claims and spotting errors before submission, Claim Scrubber can ease the burden of claims denials and allow healthcare providers to instead focus on their job of providing the highest-quality patient care. --- Learn more about how we can help you ensure all claims are complete and accurate before submission to the appropriate payer or clearinghouse.  

Healthcare providers should be able to focus on what's important: their patients and the care they need. However, providers and their staff must spend much of their time on administrative tasks. A study by AMA Prior Authorization revealed that providers are spending two business days per week just completing prior authorizations. That doesn't even account for other administrative tasks. Meanwhile, providers rely on more payers and plans than ever before, which is often tied to their clinical performance, and patients are becoming increasingly more responsible for the cost of their care. This is leading to an increase in operating losses per physician of 17.5 percent of net revenue in 2017. Providers must prioritize their revenue cycle efficiency if they want to remain financially solvent in the ever-shifting healthcare field. To safeguard its revenue, Schneck Medical Center in Indiana, the only hospital serving four counties, wanted a way to optimize claims follow-up by identifying and targeting the claims needing attention as quickly as possible. This was especially important because an estimated 10 percent of the population lacks insurance and 13 percent lives in poverty in the primary county the medical center serves. Schneck's goals were to: Ensure denials did not exceed 3 percent of net patient revenue. Achieve the estimated total net preventable denials of $3.2 million or a 2 percent increase to operating margin. Reduce denials by confirming patient insurance eligibility, verifying medical necessity, and obtaining prior authorization when appropriate. Makenzie Smith, director of patient financial services at Schneck, said that industry pressures to reduce healthcare expenses and provide a better patient experience are what drove the healthcare organization to look at the revenue cycle technologies and processes it had in place. A better denials management system The denial management process can be cumbersome, especially for community hospitals like Schneck. It takes up too many resources and far too much time. Schneck was looking for better denial analysis reporting and automation software so it could more effectively manage denials and significantly increase collections. The organization's search led to Experian Health's automated approach to tracking the root causes of denials and identifying the trends in order to improve procedures. The software tool provided a comprehensive solution and allowed Schneck to optimize its claims workflow with remittance detail and analytics. It now helps the medical center identify denials, holds, suspends, and zero pays and uses electronic remittance advice and claim status transactions to identify appeals won or lost with payers. This allows Schneck to identify and target the claims that require immediate attention. The payoff With executive leadership buy-in and support, Schneck created a new, better process for claims denial management by: Reviewing preventable denials with customized queues in real time. Identifying directors with staff responsible for checking a patient's benefits and obtaining prior authorizations. Reviewing all denials over $500 in the revenue cycle department. Establishing a schedule for reviewing denials each month. Schneck's new streamlined process and real-time visibility into denials data has allowed staffers to work on denials more efficiently. The ability to link denials to a specific staff member in a specific department has further streamlined the process. The relationship between the front and back office has improved because both sides have achieved a better awareness of processes. With the right denial analysis and automation, healthcare organizations like Schneck can manage denials effectively and increase collections significantly.

It's no secret that claim denials cost healthcare organizations. They take about 16 more days to pay out than claims that have not been denied. On average, this delay in payment equates to one percent of a healthcare organization’s cost structure.   Final claim denials — or claims in which the payer never pays the provider — lowers a typical hospital’s annual net revenue by 1.9 percent. These tack on additional administrative costs because of the work it takes to close them.   The good news is that 76 percent of claim denials are eventually paid off — but the staff time it takes to get the payments can be costly.   Claims roadblocks   Experian Health recently worked with a large healthcare organization that manages more than 200,000 claims per month, which exceeds $1 billion in claims dollars. The organization has almost 50 hospitals in its network, as well as urgent care and cancer care centers, which creates a large number of transactions and claims to process. This includes Medicare, Medicaid, private insurance, worker's compensation, managed care, and more.   Before partnering with Experian Health, a number of errors were leading to denied claims, including discharge-not-final-billed errors, claims errors, stop bills, late charges, clearinghouse edits, and other factors that created roadblocks. But claims automation helped turn things around.   Automation reduces errors   Automation provides benefits to healthcare organizations and patients because it speeds up evaluation, ensures correct and timely billing, and reduces the number of manual touches needed for each claim.   According to the Council for Affordable Quality Healthcare, manual processes slow down claim reimbursement. People take an average of four minutes to process claims, but automation reduces this to three minutes.   Although a minute doesn't sound like much, it translates to thousands of hours saved for a healthcare organization that processes 200,000 claims each month. Automation also frees up time for billing teams to focus on more pressing tasks.   How organizations can benefit   By automating, this healthcare organization could ensure clean claims by utilizing an expansive library of national payer edits and implementing custom edits. This eased the follow-up process because teams had detailed insight into claims status, an analysis of denial reasons to efficiently process them, and automated workflow and payment posting to handle splits and contractual adjustments.   One of the biggest reasons this healthcare organization partnered with Experian Health was the ease of implementation with its medical records system, Epic. For example, ClaimSource easily loaded customized edits and the edits library into Epic, tracked and corrected claims, found and repaired issues with the system build, and created opportunities for cross-training and centralized reporting.   Long-lasting results   Through this automated process, the healthcare organization now has detailed insight into its claims management process and can monitor rejections data, review effectiveness, and find ideas for even more system automation.   Through its partnership with Experian Health, this healthcare organization has improved its claims metrics across the board. It improved its acceptance rate by 10 percent, and it became an Epic top performer for claims acceptance, averaging a 99 percent acceptance rate. It has also increased its clean, paid claims percentage by over 10 percent.   Start automating to streamline your claims process.