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As margins tighten, traditional revenue cycle management strategies are on shaky ground. Many healthcare providers are turning to automation and AI to simplify payments, prevent revenue loss and protect profits. This article breaks down some of the most common revenue cycle management (RCM) challenges facing healthcare leaders and offers a practical checklist to optimize patient access, collections and claims management, while building a resilient and patient-centered revenue cycle. Common challenges in revenue cycle management Revenue cycle management is how healthcare organizations handle the financial side of patient care, from patient billing to claims management. Healthcare providers rely on RCM to ensure they are properly paid, so they can keep the lights on, pay their staff and deliver quality patient care. Are traditional RCM strategies still fit for purpose? Consider some of the current challenges: Patients are responsible for a larger share of costs due to high-deductible health plans. How can providers help them understand their financial obligations and make it easier to pay without hurting their experience? Minimizing claim denials is a daily focus, thanks to constantly changing policies and regulatory updates. How do revenue cycle teams keep up with payers? Staffing shortages remain on the agenda. How can providers ease pressure on staff to maintain productivity and morale? There's also the question of how to turn mountains of data into actionable insights. How do teams interpret it correctly to identify bottlenecks and opportunities for improvement? Automation and AI offer a way through. When implemented thoughtfully, these tools can speed up processes, reduce errors and clear operational roadblocks for a more resilient revenue cycle. The following revenue cycle management checklist includes some of the key questions to consider along the way. Checklist for improving revenue cycle management Automating patient access Can patients book appointments online? Does the online scheduler automate business rules to guide patients to the right provider? Are patient identities verified at registration and point of service? A healthy revenue cycle starts with efficient patient access. According to the State of Patient Access 2024, 60% of patients want more digital options for scheduling appointments, managing bills and communicating with providers. Providers who see improvements in patient access also credit automation, which speeds up intake and improves accuracy. A good first step is to replace paper-based processes with online self-scheduling and self-service registration. These tools make life easier for patients, boosting satisfaction, retention and engagement. Behind the scenes, Experian Health's new AI-powered tool, Patient Access Curator, helps providers get paid faster by verifying and updating patient information with a single click – accelerating registration and paving the way for faster reimbursement. Register now: Exact Sciences and Trinity Health will share how Patient Access Curator is redefining patient access in this upcoming webinar. Optimize patient collections with data and analytics Are patient estimates provided upfront? Are notice of care requirements being addressed? Are patients offered appropriate financial plans and easy ways to pay? With more financial responsibility resting on patients' shoulders, patient collections are under the spotlight. The State of Patient Access report shows that upfront estimates and clarity about coverage are top priorities for patients, because when they know what they owe, they're more likely to pay on time. Implementing tools to promote price transparency and easy payment methods should feature in any RCM checklist. With Coverage Discovery, healthcare organizations can run checks across the entire revenue cycle to find billable commercial and government coverage that may have been forgotten, to maximize the chance of reimbursement. Meanwhile, Patient Payment Estimates offers patients clear, accessible estimates of their financial responsibility before treatment, so that hose who need financial assistance can be directed automatically to payment plans and charity options. Case study: How UCHealth secured $62M+ in insurance payments with Coverage Discovery® Improve claims management to reduce denials Are high-impact accounts prioritized? Are remittances reconciled with payments received? Does claims management software generate real-time insights and reports? With 73% of healthcare leaders agreeing that denial increased in 2024, and 67% saying it takes longer to get reimbursed, claims management is a great use case for automation. ClaimSource®, ranked Best in KLAS in 2024 for claims management, automates the entire claims cycle in a single application. It integrates national and local payer edits with custom provider edits to verify that each claim is properly coded before submission. By focusing on high-priority accounts, providers can target resources in the most effective way to ensure a higher first-pass payment rate. A major advantage for ClaimSource users is access to AI Advantage™. This tool utilizes AI to “learn” from an organization's historical claims data and trends in payer behavior to predict the probability of denial. It also segments denials so staff can prioritize those that are most likely to be reimbursed, reducing the time and cost of manual appeals and rework. Case study: After using AI Advantage for just six months, Schneck Medical Center reduced denials by an average of 4.6% each month, and cut rework time from 12 to 15 minutes per correction to under 5 minutes. Benefits of implementing a revenue cycle management checklist The key to choosing the right RCM tools and technologies is to build the strategy around what patients need most. A clear, transparent and compassionate billing experience is more manageable for patients and helps providers get paid faster. An RCM checklist helps teams stay focused on the tasks that matter. Providers can build on the suggestions above by choosing the key performance indicators (KPIs) that align with their specific goals. Metrics like financial performance, billing efficiency and collections rates can be combined to guide resource allocation, drive improvements and speed up reimbursement. With a well-designed checklist informed by clear KPIs, revenue cycle leaders can keep their teams on track and take their organizations from “surviving” to “thriving.” Learn more about how Experian Health's revenue cycle management tools can help healthcare providers meet current challenges, improve the patient experience and increase cash flow. Learn more Contact us

Published: January 28, 2025 by Experian Health

Self-service patient access is a growing trend that's here to stay. Tech-savvy patients want to see their doctor faster and don't want to jump through complicated hoops to schedule an appointment, complete their registration paperwork or pay their medical bills. Opening the digital front door must be a priority for providers who want to keep pace with evolving patient expectations. That's why 79% of providers plan to invest in patient access improvements soon, according to Experian Health’s 2024 State of Patient Access survey data. This article takes a closer look at what patient self-service means and why it should be a top consideration for today's revenue cycle leaders. What is patient self-service? Patient self-service is a collection of digital tools that offer patients more access at every step of the patient journey. Building on innovations that gained momentum during the pandemic, like telehealth and virtual care, today's tech-driven patient self-service experiences offer a seamless patient engagement experience, from scheduling to collections. Patients use self-service tools to easily connect with providers online and manage administrative tasks 24/7. Common patient self-service tools include patient portals, online scheduling and mobile registration. Self-service solutions also include robust financial tools that help patients check eligibility, complete their insurance information, get accurate estimates, apply for charity care and set up payment plans. Why should providers prioritize patient self-service? Providers that prioritize self-service tools to give patients more access gain a competitive edge in today's challenging healthcare landscape. Clunky manual processes and outdated systems frustrate patients and burden staff, often resulting in scheduling gaps, claims delays, increased denials and other revenue cycle disruptions. In today's fast-moving digital world, patients want it to be as easy to book a medical appointment as it is to order takeout from an app. However, according to Experian Health data, just 28% of patients feel access improved in 2023, while more than half (51%) said patient access remained fairly static since the previous year. The data also shows that 60% of patients are looking for more digital and mobile options, with roughly the same percentage saying they'd consider switching providers to get the access they crave. Providers seeking to boost patient satisfaction and shore up a sustainable revenue cycle must invest in a digital front door that includes the self-service tools patients demand across the patient journey—from patient intake to collections. Healthcare organizations that prioritize implementing these self-service solutions free up overburdened staff from tedious, time-consuming administrative tasks, keep provider schedules full, reduce claim denials and increase revenue. Current challenges in patient access The healthcare industry continues to face ongoing challenges that affect patient access. Some of the top obstacles include: Outdated systems and processes The healthcare landscape is riddled with complex, disconnected and often archaic administrative systems. In fact, around 25% of patients say they delay care due to administrative obstacles, and 85% are tired of filling out paperwork after providing the information elsewhere. Today's patients desire frictionless, digital solutions that make it easy to schedule an appointment, submit personal information, understand the cost of care and make secure medical bill payments. Ongoing staffing shortages According to the American Hospital Association (AMA), staffing shortages aren't expected to let up anytime soon. By 2028, the healthcare industry will face a shortage of around 100,000 critical workers. Ongoing staff shortages put increased pressure on a strained healthcare system to keep up with patient care and administrative tasks. Difficulties keeping up with rising healthcare costs Healthcare affordability continues to decline, with around 50% of Americans reporting that paying medical bills is a struggle. Understanding how much insurance covers is also an obstacle, with more than half of patients reporting they need their provider's help to understand how much insurance pays. Growing patient volumes Short-staffed healthcare organizations are treating more patients than ever before. AMA data reports that providers saw more patients in 2024, compared to 2019. However, this growing demand for healthcare isn't the only issue burdening overtaxed healthcare organizations. Today's patients are also sicker and have more complex care needs than they did five years ago. Benefits of patient self-service solutions Self-service solutions offer many benefits to both patients and providers across the entire revenue cycle. Here's a closer look at three ways patient self-service solutions improve patient access. Boosts patient volume It's clear the demand for digital tools is a trend that's here to stay. Patients want more access and are prepared to switch providers to get it. Providers that adopt self-service technology are more likely to retain existing patients and make positive first impressions with new patients. In today's highly competitive healthcare landscape, frictionless patient engagement experiences for scheduling, registration, estimates and payments are key to patient satisfaction. Patient self-service tools, like mobile registration, let patients complete registration forms at their earliest convenience. Automated patient intake solutions, such as Experian Health's Registration Accelerator, help providers save time and verify important patient details quickly. Patients can begin registration with one click, with a text-to-mobile experience, which improves booking rates and reduces administrative burdens. Conserves valuable staff time When staff are overworked, patient access and care often suffer. Self-service tools empower patients to handle numerous administrative tasks, like scheduling and bill payments, with little to no staff help needed. Patients get the 24/7 access they crave, and staff spend less time on patient communication, training and other manual tasks. Self-service tools like Patient Schedule automate scheduling workflows while integrating seamlessly with provider appointment criteria and calendars. Patients can make, change or cancel appointments online, with no login required. Reminders for appointments are sent to patients automatically via text or interactive voice response (IVR), allowing busy administrative staff to spend less time on the phone. Other tools like Experian Health’s Self-Service Patient Financial Clearance solution allows patients to upload forms and complete eligibility checks on their mobile devices, without having to reach out to their providers. Improves financial transparency and boosts revenue Patients want to know how much care will cost before seeing their provider. Healthcare organizations that offer accurate, real-time estimates are more likely to have patients who are better prepared to cover their medical bills. In fact, 80% of patients say understanding their financial responsibility helps them better prepare to cover the bill, according to Experian Health data. Self-service solutions that allow patients to access transparent pricing and billing options, like Experian Health's Patient Payment Estimates, help patients make a plan to pay. Patients get real-time estimates through an easy-access text link or the web-based app. Digital payment solutions, like PatientSimple®, ease cost concerns by allowing patients to apply for charity, make secure payments, set up flexible payment plans and more. See it in action: improving patient access with digital solutions How IU Health used patient scheduling tools to boost patient satisfaction and improve operational efficiency even as patient volumes increased. How Banner Medical Group uses Patient Estimates to boost patient satisfaction and meet compliance requirements. How West Tennessee Healthcare modernized patient intake with automation. Give patients the control they crave with self-service Digital solutions that put patients in the driver's seat are a win-win for patients and providers. With self-service tools, patients are empowered to manage key aspects of the patient experience across the entire patient journey. They're more likely to get the care they need, show up for appointments, be prepared to cover the cost and even benefit from better patient outcomes, according to data from a 2024 HIMSS study. Providers see reduced no-show rates, spend less time on manual tasks and experience more financial stability. Find out more about how Experian Health's patient engagement solutions help healthcare organizations improve the patient experience at every stage of the patient journey. Learn more Contact us

Published: January 10, 2025 by Experian Health

Nearly 46% of patients say being able to manage their health online is their top priority in accessing care, according to Experian Health's State of Patient Access 2024 survey (SOPA). However, the availability of a “digital front door” in healthcare – with online scheduling, mobile registration, and frictionless payments – is not yet meeting demand. Many patients still face convoluted booking systems and stacks of repetitive paperwork. Meanwhile, consumer-friendly tech and retail giants are edging into healthcare. As disruptors set new standards for simple and convenient care, traditional providers are under pressure to open their digital front door to remain competitive. Many are already investing in AI and automation to simplify workflows, cut costs, and upgrade the patient experience. Could 2025 be the tipping point for healthcare's digital transformation? A digital front door strategy could help more providers boost patient engagement, simplify the patient experience and increase profitability. What is a digital front door? The digital front door is more than a well-designed website. It's a single point of access that gives patients convenience, choice and control at every touchpoint in their healthcare journey. It promises patients faster appointments, fewer headaches and more coordinated care. From their mobile device or computer, they can log in to schedule visits, sign intake forms, update insurance details, see costs upfront and even settle their bills. It's secure, easy to use and lets patients handle tasks on their own time. On the back end, patient-facing digital tools can integrate into the provider's existing systems to improve workflows, reduce manual tasks and generate analytics to simplify care. What are the key benefits of implementing a digital front door? Patient satisfaction: According to SOPA, 60% of patients want more digital and mobile options for communicating with their provider, scheduling appointments and managing payments. Fewer no-shows: Patients are less likely to cancel or no-show when they can schedule and manage appointments that work for their time and needs. Frees up resources: Automating repetitive administrative activities means staff can focus on higher-value activities. Fewer errors: Manual processes are rife with data entry errors that increase the risk of denied medical claims and add time on the back end to resolve. Digital patient intake saves time and money by reducing opportunities for human error. Essential features of an effective digital front door What are some of the digital must-haves to simplify access to care? The checklist might include: Online appointment scheduling, to make it easy to book, reschedule, or cancel appointments Digital tools to complete pre-visit paperwork – even better if these automatically prepopulate patient info to save them time and reduce errors Transparent pricing, with tailored information delivered directly to the patient A choice of payment methods, including familiar digital options so patients can pay quickly Access to a patient portal or central hub for managing appointments, medical records and prescriptions Mobile-friendly interfaces and simple designs, so patients can see key data at a glance, from any device, without needing to be tech-literate Secure and compliant communications to protect patient data and privacy. Where to start with a patient-centric digital front door Three specific tools that would check off the above include the following: 1. Multi-channel patient scheduling What matters most to patients is being able to see their doctor quickly. Online appointment booking gives them the 24/7 self-service scheduling options they expect. It delivers quantifiable gains for providers too. For IU Health, automating patient scheduling has been shown to do the work of two full-time schedulers, with more than 35,000 appointments booked with self-scheduling. Experian Health's patient scheduling software guides patients to the appropriate provider and appointment while keeping the provider in control of their calendar. It integrates with a provider's website, call center, and physical office so patients can book their next appointment, even outside of office hours. On-demand webinar: See how IU Health increased one-call resolutions with Patient Schedule 2. Registration Accelerator 49% of providers say that a primary cause of denied medical claims can be traced back to errors in patient registration, forcing health systems to divert revenue to remediate claims that could have been avoided. An automated, data-driven patient registration process improves accuracy, making costly errors less likely. With Registration Accelerator, patients get a text when it's time to register, instead of completing forms in the waiting room. There's no need to download an app or create a user profile: they scan the data from their identity and insurance cards, and Registration Accelerator takes care of the rest. Anthony Myers, Director of Admitting and Registration at West Tennessee Healthcare, says that replacing clipboards with clicks also makes for a much better patient experience: “With our paper-based systems, it seemed like West Tennessee was stuck in the 1990s. We knew our patients expected a more modern experience. We wanted to meet them where they are, rather than forcing them to come to the registration desk. Our goal was to make pre-service registration easier and smoother for patients and staff.” Case study: How West Tennessee Healthcare simplified registration with Registration Accelerator. 3. Patient Financial Advisor The SOPA report shows that almost seven in ten providers believe their patients postpone care at least occasionally because they don't understand the cost of care. Eight in ten patients agree that accurate estimates help them prepare to pay. While price transparency is improving, too many patients still find themselves with bills that are higher than expected. Patient Financial Advisor delivers a pre-service estimate of the patient's financial responsibility based on real-time benefit information directly to their mobile device. It takes account of current provider pricing, payer contracted rates, and any relevant discounts or payment plans for greater accuracy. A secure payment link allows patients to settle their bills quickly and conveniently, at any time. Read more: How to maximize patient collections with digital technology Choosing the right partner for digital transformation Implementing a successful digital front door strategy comes down to one key factor: keeping it laser-focused on the patient. When choosing a vendor, providers should ask how the platform will make life easier for patients. Will it encourage proactive engagement? Is it easy to navigate and demonstrably secure? And on the back end, will it integrate smoothly with the provider's existing systems and workflows – and even improve them? The right partner will bring specialized expertise for a digital transformation, with the capabilities to meet both patients' and providers' needs. Find out how Experian Health's Patient Access solutions help healthcare providers open their digital front door to simplify patient care across the entire revenue cycle. Learn more Contact us

Published: January 6, 2025 by Experian Health

Patient eligibility verification is a critical part of the healthcare revenue cycle. It can help prevent errors with claim submissions, reduce denials, boost the bottom line, and help patients understand what their insurance will cover. However, checking insurance eligibility isn't always efficient or accurate, thanks to outdated systems and complicated manual processes. Ever-evolving payer requirements and new regulations, like the No Surprises Act, add even more complications during insurance eligibility checks. In 2024, providers also treated more patients than they did five years ago, making it harder to keep up with patient eligibility verification. This growing volume of patients have more complex health issues and may struggle to afford medical bills, putting a more pressing urgency on providers to run accurate eligibility checks before service. Having the right health insurance eligibility verification solution can make or break a provider's revenue cycle and allow staff to stay focused on patient care instead of digging for insurance information and correcting errors. This article takes a closer look at why patient eligibility matters, common challenges providers face and strategies to improve insurance eligibility checks, reduce payment delays and minimize denials. What is patient eligibility verification? Patient eligibility verification is an administrative process providers use to check whether or not patients have active medical insurance. It's typically completed before service occurs to confirm coverage for treatment and care. Sometimes called a health insurance lookup, the eligibility check verifies different aspects of a patient's coverage, including insurance status, coverage details and medical service benefits. During patient eligibility verification, billing information is also confirmed. Why is it critical for healthcare providers? Patient eligibility verification offers providers a first line of defense to protect revenue cycles against revenue leakage. It can help healthcare organizations with accurate billing, reduce claims denials and avoid footing the bill for uncompensated care. When eligibility checks are conducted diligently, providers see improved cash flow, staff efficiency is gained, the risk of bad debt is lower, and patients are empowered with accurate upfront estimates. The importance of patient eligibility verification Claim denial rates are growing and show no signs of slowing down. Experian Health's State of Claims 2024 survey reports that nearly three-quarters of respondents saw a rise in denials, with four in ten saying claims are denied 10% of the time. Eligibility issues, along with missing or inaccurate data, are a top reason for denials, according to 15% of providers surveyed. A reliable eligibility verification process is crucial to minimizing the claim denials, rework and billing errors that arise from inaccurate insurance information. It also lets patients know their financial responsibility upfront so there are no surprises when the bill comes. This trust and transparency fosters positive patient-provider relationships while ensuring patients get the care they need and providers get paid. Common challenges in patient eligibility verification Findings from Experian Health's State of Patient Access and State of Claims surveys point to several common challenges in patient eligibility verification. Evolving payer policies and pre-authorization requirements Insurance provider prior authorization requirements change often, making it hard for providers to keep pace. More than 75% of providers report an increasing amount of payer policy changes, and secondary eligibility checks take time and impact efficiency. When a necessary authorization is missed due to manual verification or rushed eligibility checks, it can result in denial, delayed payment and extra work – especially when care is urgent. Incomplete or outdated insurance information Insurance details in the provider's system don't always match the payer's record. This can happen for a wide range of reasons, including job switches, insurance plan changes or patients not being aware of or forgetting to mention secondary coverage. When these changes aren't caught before service, they can lead to rejected claims, billing delays and extra work for staff.  More than four in ten providers report adding at least 10 minutes of staff time per incomplete eligibility check. Inadequate technology to verify eligibility Staff must often wrangle a wide range of disjointed solutions, processes and logins during eligibility checks. While more than 70% of providers feel their organization runs insurance verification checks efficiently and accurately, nearly 60% of providers still use at least two different tools to gather the necessary patient information for claim submission. This can make navigating patient eligibility verification tedious and error-prone, and leads to staff burnout, denied claims and patient dissatisfaction. Strategies to improve patient eligibility verification In today's changing health insurance landscape, providers need to pay more attention than ever to their patient eligibility verification processes. Accurate and timely insurance verification streamlines the claims process, clarifies how bills will be covered (or not) ahead of time and helps patients prepare to pay their bills. Adopting the following strategies to improve patient eligibility verifications can help providers reduce the risk of denied claims, improve the revenue cycle and create positive patient experiences. Automate eligibility verification processes Verifying coverage early in the billing process increases the chance of submitting clean claims the first time. However, it can be tedious for providers to navigate outdated methods like online portals, file batching, automated systems and stay on top of ever-changing payer policies. Automated eligibility verification software helps providers optimize intricate insurance checks, access verified and comprehensive resources to confirm eligibility (with solutions like the MBI Lookup tool), and improve efficiency. Automatically track changing payer policy requirements With payer requirements undergoing constant updates, providers need to have access to solutions that keep up in real-time. Eligibility Verification, for example, seamlessly connects to more than 900 payers and features advanced patient matching tools. It can also be used with Experian Health's automated prior authorization tool, which tracks national payer requirements and flags providers when mandatory pre-authorization information is missing. Offer upfront, accurate cost estimates Patients want to know their financial responsibility up front. When armed with accurate estimates that help patients understand their coverage, co-pays and deductibles, more than 80% of patients say it helps them prepare financially. Eligibility tools allow providers to create more accurate estimates based on actual insurance coverage. This helps patients know what they're responsible for out-of-pocket and reduces surprise billing. Patient eligibility verification is more critical than ever in ensuring smooth and efficient revenue cycle management. With rising patient volumes, evolving regulations and other challenges impacting revenue cycles, providers need to maintain accurate insurance eligibility checks to reduce costly errors, streamline workflows and improve claims success rates. More importantly, accurate eligibility checks empower healthcare staff to focus on delivering quality care, while helping patients better understand and manage their financial responsibilities. Find out more about how Experian Health's insurance eligibility verification solution helps revenue cycle managers prioritize reimbursements with automated eligibility checks. Learn more Contact us

Published: December 19, 2024 by Experian Health

Medical excellence is a given when it comes to improving the patient experience, but what about the non-clinical side of care? Long waits, confusing processes and financial uncertainty can overshadow even the best medical treatment. As many as one in four patients delay care because of hidden administrative obstacles. As providers look to improve the patient experience in 2025, tackling these frustrations is top of mind. How easy is it for the patient to schedule their appointment? How quickly can they complete registration? Do they understand their insurance coverage, and do they have the right support to manage and pay their bills? Clear and straightforward patient access processes give patients support, convenience and control, and allow providers to focus on delivering care. This article looks at the challenges and opportunities that may affect patient access over the next year and highlights three ways to use digital tools to improve the patient experience. The patient experience in 2025: a rollercoaster of risks and opportunities Over the next year, patients' shifting needs and attitudes will change how they access care. Informed, tech-savvy patients armed with wearables and health-tracking apps want streamlined access and contact with their providers, and expect efficiency and personalization when they do seek care. At the same time, an aging population and increasing numbers of people with multiple chronic conditions drive demand for more complex and ongoing support. On the provider side, challenges like staffing shortages and remote work demands will continue to strain patient access teams. Payers' rapid adoption of artificial intelligence (AI) will continue to widen the denials gap. Rising costs will persist. Amidst this uncertainty, the forthcoming change of government may bring additional regulatory and legislative changes, so providers must be ready to adapt. Opening the digital front door is a way to elevate the patient experience to meet changing consumer expectations, while simplifying and streamlining processes so they can respond to whatever's in store. How can digital tools help improve the patient experience? Digital tools take the patient journey from a series of disjointed encounters to a coordinated and personalized experience. Building on innovations that gained momentum during COVID-19, like telehealth and virtual care, these tools keep patients and providers connected throughout the care process. By tailoring experiences to individual needs in real time, digital tools integrate into daily life and meet the rising demand for convenient, tech-driven options. Three ways to improve the patient experience Experian Health's latest State of Patient Access survey offers some pointers as to what providers should prioritize: 1. Expedite scheduling so patients can see their practitioner quickly Patients measure the patient experience by how quickly they can see their doctor. In the State of Patient Access survey, both those who think patient access has improved and those who think it has worsened give this as their reason. As patients' top priority, efficient scheduling is an obvious focus for providers who want to improve the patient experience. Online scheduling, mobile registration and self-service portals can simplify how patients book and check in for appointments. Patient Schedule lets patients book appointments anytime they like without needing to call. It only offers specific types of appointments with the right provider and makes it easy to cancel and reschedule, so no-shows are less likely. This also increases providers' capacity, giving patients more options so they can see their doctor sooner. Mobile registration complements digital scheduling by allowing patients to complete registration forms anytime, anywhere. Automated registration prefills information held on file to minimize paperwork, which is good news for the 85% of patients who do not want to fill out paperwork if they've already provided the information. Reducing manual errors also reduces delays so that patients can get on with their visit. 2. Help patients understand their insurance coverage and bills Patients and providers both cite financial challenges among their top priorities for improving patient access. More than eight in ten patients say pre-service price estimates help them prepare for the cost of care, while more than half say they need their provider's help to understand what their insurance covers. Providers should consider digital tools that support transparent pricing and billing to improve patients' financial experiences. Experian Health's Patient Payment Estimates generates accurate, upfront estimates of what a patient will owe, incorporating real-time pricing information, benefits and discounts. Estimates and secure payment links can be sent to patients via text or through the web-based app for a convenient and user-friendly payment experience. Additional tools can help patients find missing coverage and identify suitable payment plans, empowering patients and accelerating collections for providers. 3. Explore how automation and AI can support a better patient experience The growing use of AI will continue to reshape all aspects of care. By processing vast amounts of information at an unprecedented rate, AI presents exciting opportunities in patient access: keeping patients informed, generating performance insights and reducing the errors, delays and bottlenecks that come with manual processes. One of the highest-ranking challenges for providers in the State of Patient Access survey was the difficulty of managing multiple solutions to run patient eligibility and coverage checks. Patient Access Curator uses AI to address this with a single-click solution that captures all patient data at registration. It checks and verifies eligibility, Medicare Beneficiary Identifiers, coordination of benefits and demographics, delivering results in just 30 seconds. This prevents denials on the front end and takes the pain out of registration and scheduling for patients. Read the blog: How Patient Access Curator uses real-time, automated discovery to prevent denials and improve patient access Put patients in the driver's seat in 2025 As competition intensifies with new providers and disruptive technologies entering the market, patient satisfaction will no longer be optional — it will define success in 2025. Investing in digital patient access tools gives patients the autonomy, choice and convenience they crave as modern digital consumers. Simplifying and streamlining access will not only help meet and exceed patient expectations, but will help providers future-proof their operations and build a sustainable revenue cycle for the years ahead. Find out more about how Experian Health's patient engagement solutions will help providers improve the patient experience in 2025. Patient Engagement solutions Contact us

Published: December 4, 2024 by Experian Health

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

Published: October 22, 2024 by Experian Health

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

Published: October 8, 2024 by Experian Health

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

Published: October 1, 2024 by Experian Health

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.

Published: September 10, 2024 by Experian Health

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