Tag: patient estimates

The final blog of our post-COVID-19 patient journey series explores how patients have come to expect convenience, flexibility and transparency when paying for healthcare. How can providers ensure the real-life patient payment experience delivers? Read the full white paper here. Despite creating a more transparent approach to healthcare pricing, medical bills remain a major concern for many Americans. Nearly three in ten worry about the cost of healthcare. The prospect of an unanticipated and unaffordable final bill looms large over their entire healthcare experience, exacerbated by the job losses and insurance changes that left many on unsteady financial ground during the pandemic. Patients aren’t only looking for greater certainty about what they’ll owe, they also want the payment experience to be easier. The pandemic created a new baseline in digital patient access and pulled healthcare closer to other service experiences, where digital and contactless payment methods are the norm. To ease patients’ concerns and meet consumer expectations, providers should focus on redefining payment operations through the eyes of the patient. Patients want to know about their medical costs upfront so they can prepare. Experian Health’s State of Patient Access 2.0 survey found that nine out of ten providers agree that this also increases the likelihood that bills will be paid. They want quick and convenient ways to pay and utilize digital apps with user-friendly interfaces. They don’t want a one-size-fits-all approach to their healthcare experience ­– and that includes the payment process. Personalized estimates, payment plans and proactive reminders can all help patients feel confident about their medical bills. The right tools exist to help providers create a great patient experience and reduce the amount of revenue lost to bad debt – it’s all a matter of integrating those tools into existing systems. Help patients plan for bills with transparent pricing According to a study by Pew Research, around half of nonretired adults feel the pandemic has made it harder for them to reach their long-term financial goals. Many patients are keeping a closer eye on household finances in the wake of COVID-19, so helping them to understand their bills from the onset is key. This can help providers enroll patients in the right payment plans, and will lead to smoother patient collections. Accurate, upfront estimates should be utilized to improve the patient payment experience. Patient Payment Estimates give patients a clear cost breakdown straight to their mobile, so they can plan accordingly for out-of-pocket payments. Providers that implement these solutions now will be better prepared as price transparency legislation continues to evolve and grow. Offer flexible payment methods for faster payments Accurate estimates are just the first step: next, providers should make it as easy as possible for patients to pay their bills. Healthcare has typically lagged behind other industries when it comes to quick and convenient digital payment options. However, the pandemic nudged consumers and providers alike to embrace alternate payment models for medical bills. Many patients want to continue using digital and contactless payment methods – including credit cards and mobile payment apps. With a service such as Patient Financial Advisor, providers can direct patients to an appropriate and flexible payment plan, as well as secure ways to pay, without the need for multiple patient calls. Create a personalized payment experience with third-party data and analytics These tools are effective because they enable personalized experiences for every patient. Some patients may prefer to pay in full before they come in for care, while others may need to pay in installments. Some may prefer to pay via a mobile app, while others may choose to pay in person with their credit card. Certain patients may prefer to receive statements and other communications via email, while others will want to speak to an advisor on the phone. A personalized approach not only creates a better patient experience but also increases patient payments and reduces providers’ cost to collect. Achieving this requires access to accurate and reliable third-party data that paint a fuller picture of an individual patient’s needs and preferences. With consumer data that draws on lifestyle, demographic, psychographic, behavioral and financial information, providers can tailor the payment experience to make it as accessible and frictionless as possible. Similarly, Collections Optimization Manager draws on multiple datasets to check coverage information, segment and prioritize patient accounts, and use staff resources efficiently to maximize revenue recovery. Heather Grover, VP of Product Management and Consulting – Patient Payments and Collections, says, “Clients seek processes that are not only tailored to each patient’s unique situation but one that helps automate their collections and payments workflow. Minimizing the use of resources in today’s environment – whether IT, operational or call center – helps lower the cost of collections while delivering a positive patient experience.” Find out more about how Experian Health’s suite of patient estimates and payment tools can help your organization offer a personalized and compassionate financial experience. Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience COVID-19 highlights an acute need for digital patient intake solutions Automated prior authorization: getting patients the approved care they need Getting a holistic picture of patients with social determinants of health 3 data-driven denial management strategies for faster claims processing

COVID-19 transformed the patient journey, and it's clear when we evaluate every step. Data and technology gave patients the convenience, flexibility, and control to get care on their terms, and these changes will be here to stay. From marketing to scheduling to payments and more - providers and payers have ample opportunities to respond to these changes and will need to adapt their future strategies accordingly. Self-scheduling, mobile registrations, and automated authorizations are a few examples of tools and technologies that are more than likely to remain prominent in healthcare. What other changes are here to stay? In this new infographic, we take a dive into each of the 7 steps to see how data and technology has impacted the patient journey, and provide strategic recommendations on how providers and payers can adjust post-pandemic: The use of data and digital tools opened up new doors for greater patient access, engagement, transparency, and control. The post-COVID-19 patient journey is going to continue to evolve - payers and providers will need to adapt to keep up with the changes, to ensure that patients experience the best outcomes. To get a deep dive into all of the changes to the patient journey, download our white paper.

Rising medical debt, now a staggering $140 billion, is the largest source of debt for American families. A large portion of this is a direct result of surprise billing, with a third of insured adults saying they’ve received an unexpected bill in the previous two years. What’s no surprise, then, is that two-thirds of US adults worry about being able to afford these unanticipated medical bills. It’s a problem that concerns so many patients that it now has the attention and action of both state and federal governments. To help solve this problem, Congress signed the No Surprises Act into law. Experian Health can help your healthcare organization navigate the regulatory landscape  and implement solutions ranging from transparent, patient-friendly estimates to our all-new FREE No Surprises Act (NSA) Payer Alerts Portal.  The No Surprises Act, effective January 1st, 2022, aims to protect consumers from at least one contributor to the problem: unexpected bills for out-of-network care in emergency and non-emergency settings. Around a fifth of emergency claims and a sixth of in-network hospital stays include an out-of-network bill, often due to emergency or ancillary care. Since patients lack meaningful choices when it comes to choosing these unexpected services, they have no option but to pay up or face negative marks on their credit reports. Typically, while health plans cover some of the bills, patients will still be responsible for the remaining balances. Webinar Series: Unpacking The No Surprises Act and Q&A with an expert Industry expert Stanley Nachimson, Health IT Implementation Expert, recently hosted a series of webinars to help providers get up to speed on what they need to do to comply with the No Surprises Act. Learn about the Good Faith Estimate, how NSA will apply in different care settings, and more. By enforcing better price transparency and consumer protection, the new regulations will help to create better patient experiences and ensure that fewer bills are written off to bad debt. However, according to a recent survey conducted by Experian Health, only 72% of providers are familiar with the No Surprises Act. That’s not all - only 40% of respondents are moderately confident their organization will be able to solve for the No Surprises Act. Payers and providers must act now to ensure their processes are ready to comply with the changes. Experian Health is now offering a FREE comprehensive, updated list of No Surprises Act (NSA) payer policy alerts for United States hospitals, medical groups, and specialty healthcare service organizations. Tackling the price transparency problem with the No Surprises Act Healthcare pricing has been under the spotlight for a while, with several new regulatory measures introduced over the last few years. The new Act, which was signed into law under the Consolidated Appropriations Act of 2021, builds on previous federal actions to empower patients by giving them greater access to healthcare cost information. Come January 2022, balance billing will no longer be permitted for out-of-network emergency services, out-of-network air ambulance services, and out-of-network non-emergency services provided at in-network facilities. Insurers must cover emergency services without any prior authorization, regardless of whether the provider is within the health plan’s network, and patients should expect to pay the same as in-network services. The Act requires both providers and health plans to help patients access healthcare pricing information, and providers must provide consumers with tools to get better price estimates, including a “Good Faith Estimate” covering all relevant codes and charges. The Act sets out a process for health plans to reimburse providers and an arbitration path in the event of disagreement. Summary of provisions in the No Surprises Act: Protects patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network facilities Holds patients liable only for their in-network cost-sharing amounts, and requires that the patient’s share cannot exceed in-network rates without patient consent Provides guidance for how providers and insurers can negotiate fair reimbursement for out-of-network services Includes the requirements that providers submit Good Faith Estimates to payers and that payers utilize those estimates to create and provide Advance Explanation of Benefits to members. However, enforcement of this requirement has been delayed until more guidance can be provided related to standards for the transmission of these files (as of October 2021) What do providers need to do now to prepare? Creating a “no surprises” billing experience will require payers and providers to make major process changes. Roger Johnson, VP of Payer Solutions at Experian Health, says, “The new regulations require the industry to innovate significantly in a very short timeframe. Determining network status is a huge challenge for providers, as is engaging patients electronically pre-service. There will also be challenges in tracking and submitting consent forms, producing Good Faith Estimates, applying appropriate cost-sharing, billing, payment reconciliation, and the new dispute resolution process.” See what Roger had to say in our Interview with the Expert: CMS has provided a list of documents and requirements for patient notices. These include: A statement that the provider or facility is OON (if that is the case) An itemized, good faith estimate of the cost of care Information on prior authorization and utilization management limitations The notice must be in a format the patient can understand and is accessible (i.e., preferred language and apart from other documents). A variety of model forms and notices are available on the CMS “Overview of Rules and Fact Sheets” page: Standard notice & consent forms for nonparticipating providers & emergency facilities regarding consumer consent on balance billing protections: Download the Surprise Billing Protection Form Model disclosure notice on patient protections against surprise billing for providers, facilities, health plans and insurers: Download Patient Rights & Protections Against Surprise Medical Bills Paperwork Reduction Act (PRA) model notices and information collection requirements for the Federal Independent Dispute Resolution Process: Download Model Notices and Information Requirements Paperwork Reduction Act (PRA) model notices and information collection requirements for the good-faith estimate and patient-provider payment dispute resolution Download Model Notices and Information Requirements Additionally, The Department of Labor published a Model Notice link on its No Surprises Act overview page. Experian Health is engaging with industry partners to clarify the regulations and collaborate with clients to adapt workflows for a smooth transition. Find out more in our on-demand webinar. What price transparency tools are available for healthcare organizations?  In the meantime, various price transparency tools exist to help providers meet ongoing regulatory requirements and create a better patient experience with easy-to-understand cost breakdowns. For example: Patient Payment Estimates give patients clear and accurate estimates of authorized services before, or at, the point-of-service, so they feel more in control of their financial obligations. With a user-friendly interface, the tool helps patients plan and pay their bills – while directing them to appropriate financial assistance options. And because it’s automated, hospital staff will no longer need to manually update price lists. For providers, this tool can create an on-demand Good Faith Estimate using out-of-network benefits. Patient Financial Advisor is a text-to-mobile service that lets patients see their estimated costs of care before they come to the hospital. This solution provides a full breakdown of the procedures, as well as a total estimated amount based on in-network benefits. Registration Accelerator has the ability to collect provider forms and return them back to the client’s document imaging system. ClaimSource can identify claims that are at risk, prior to being submitted to payers. Claim Scrubber can identify claims at risk from various angles, such as: Non-Network payers Non-participating providers Services provided without an approved authorization Services provided outside of the approved authorization criteria While regulatory change can seem daunting, price transparency is already trending in the right direction. Our second State of Patient Access survey indicated that both patients and providers want more price transparency. Nine out of ten providers told us they agree that price transparency improves the customer experience and increases the likelihood that patient bills are paid. The regulations may be a catalyst for change, but making it easier for patients to understand and pay their bills continues to pick up momentum. That’s good news for patients’ wallets and for providers’ bottom lines. Download our on-demand webinar, "Unpacking the No Surprises Act," to learn more about how the new regulation will impact patient and provider workflows.

COVID-19 changed every aspect of the patient journey – placing unprecedented demands on the healthcare system and accelerating the need for digital transformation industry-wide. Telehealth, touchless engagement, and self-service scheduling became the new normal; however, this created new stress on operations, administration, and finance. While this new normal comes with many challenges, data and digital tools have created greater accessibility, engagement, transparency, and control for patients and providers. In this blog, we examine COVID-19’s impact on the patient journey and explore the digital tools and data that are helping the healthcare industry recover and thrive. To get more insights, read the full whitepaper here. COVID-19 strained the healthcare system more than ever before. To say that COVID-19 challenged the healthcare system is a massive understatement. Seven in 10 patients deferred or canceled treatments during the pandemic, causing disruptions to both revenue and patient engagement. Even behind the scenes, novel diagnostic codes and new sources of information—together with rising inpatient volume and government intervention—affected costs, billing and reimbursements at scale. Patient-provider relationships became much more complex. Many people moved, changed jobs and changed insurance during the pandemic. In fact, an estimated 40 million Americans lost work during the pandemic and just over half of all workers in North America plan to look for new work in 2021.  As a result, relationships between physicians and patients became disrupted. While re-engagement is critical for providing care, simply finding patients remains a challenge. The digital experience raised patient expectations. As consumers turned to technology to cope with changes, digital engagement increased in healthcare services and elevated consumer expectations. This trend began before the pandemic: A pre-COVID-19 AARP survey of older adults (50+) found that a majority would prefer to have their healthcare needs managed by a mix of medical professionals and technology. During the pandemic, patients used telehealth to access care from home, mobile registrations to avoid filling out paperwork in the waiting room and digital payment options that made paying bills simple and seamless. Now that patients have experienced telemedicine, self-service scheduling and easy digital payments, there is no going back. Expectations have changed permanently, and providers that don’t offer an updated patient experience may suffer by comparison. Opportunities for better outcomes: transforming the patient journey with digital transformation We looked at key parts of the patient journey where technology is helping healthcare providers engage and care for their patients successfully across the marketing, scheduling, registration, authorization, treatment, claims and payment. Here are a few strategic opportunities for providers to consider post-COVID: 1. Use smart data for better outcomes Third-party data is helping providers find and re-engage patients, deliver more holistic care and facilitate better financial outcomes. For example, integrating data on social determinants of health (SDOH), can provide physicians with a more holistic picture of non-medical factors that may influence medical outcomes, such as a patient’s socioeconomic status. SDOH data can also shine a light on a patient’s ability to pay, which in turn may inspire a wider range of payment options so that more patients can afford care, and more providers can avoid write-offs. 2. Continue using technology and automation for the recovery to come Using digital self-service applications for registration does more than just provide the patient-friendly option of completing paperwork at home (instead of the waiting room). It also eliminates the need for staff hours spent inputting information, reduces the potential for error, and improves efficiency. Advances in automation make it possible for providers to reduce the effort of manual tasks - like sorting through patient records from disparate sources to create a single, comprehensive patient file, or gathering the information necessary to revisit claims authorization for deferred care. Across the board, digitalization provides greater transparency, flexibility, and seamless experiences for patients and providers alike. 3. Clear the path for payments Going digital can help patients and providers better navigate the patient journey, especially when it comes to payments. As many as half of nonretired adults expect long-term financial effects as a result of the pandemic. This makes it more imperative than ever to improve and accelerate authorization, claims, and payment processes so that both patients and providers have a clearer understanding of how care will be paid for. Accurate patient estimates, coverage discovery, automated authorizations, and payments all play a role in creating a better financial experience going forward. Digital transformation gains traction as we look to the future Although the digital transformation was already underway before COVID-19, the pandemic has accelerated the need for data, automation, and self-service tools. Find out how Experian Health can help your organization meet the data challenges of the post-COVID-19 patient journey by downloading our white paper.

The pandemic dominated healthcare in 2020, but it won’t be recognized as a reason to delay complying with CMS’ price transparency mandate, which went into effect on Jan. 1, 2021. A recent study conducted by HealthAffairs indicated that 65 of the 100 largest hospitals in America had not complied as of February 2021. And new reports from CMS suggest $300 daily fines will follow if CMS warning letters have no impact, in addition to the possible public exposure of facilities failing to be compliant. There are a number of reasons why price transparency has generated so much attention – both before and during the COVID pandemic. Consumer advocates point to other transactional experiences, such as auto and home purchases, where understanding the price is complicated, but achieved. There’s been a lot of research on price transparency’s impact on patients, as well; helping consumers understand healthcare billing reduces the stress of their financial experiences. Transparent pricing makes sense in many cases for providers, too. They may benefit from patients being able to plan for the costs of care, which can result in fewer missed payments and write-offs. For these reasons and others, price transparency has been a hot topic for the last few years. The Centers for Medicare and Medicaid Services (CMS) final rule on price transparency became effective on January 1, 2021, requiring hospitals to give patients clear information about their medical costs, including a list of charges for the hospital’s 300 most shoppable services, so patients can make informed decisions. Payers are expected to provide similar pricing information beginning January 1, 2022. The spotlight on healthcare pricing seems unlikely to dim any time soon. What does this mean for providers and payers? Price transparency is here to stay There were legal challenges made against the price transparency final rule, questioning federal authority and invoking constitutional rights violations, but the DC Circuit Court dismissed the claims in December 2020. Arguments against the current mandate are not limited to disputing legal authority, suggesting that government should not interfere with private sector pricing – and that complex pricing information could create the opposite effect of confusing consumers. In fact, many providers and payers voice support for price transparency, but not as put forward by the final rule. Despite this, consumer demand for pricing clarity before delivery of services continues to grow and current government regulation is the most far-reaching attempt so far to remedy this. A few state legislatures are moving forward with their own regulations, which could prompt more local collaborations between providers and payers to clarify out-of-pocket cost estimates. Achieving the level of transparency that CMS and consumer groups hope for will be challenging, but attempts to find common ground are growing. What will price transparency look like under the Biden Administration? Since President Biden entered the White House, the trend towards transparent pricing has continued. Provider compliance has been slow – many pointing to 12 months of battling COVID as the primary reason – prompting legislative pressure to step up audits and penalties. CMS has already started issuing noncompliance warning letters and, while it may modify the ruling under a new administration, there’s no sign of any plans to reverse the policy. Consumer action groups have voiced concerns that the regulation falls short, citing the difficulty a consumer may have trying to find pricing at provider web sites. Other consumers are limited to payer-negotiated rates and have little choice but to stick with their current providers. Making information available is likely an early step toward what price transparency will ultimately look like, but making that information easy to find, understand and act on is what consumers value – and what many providers and payers say they want to provide in a more customized, less one-size-fits-all application. A marketing strategy for price transparency As patients bear more responsibility for healthcare costs, they’ve come to expect a consumer experience that affords them greater control and choice. A Pioneer Institute study found that 70% of healthcare consumers want to see pricing information before undergoing a medical procedure. Actively communicating a commitment to price transparency can be a powerful marketing strategy to attract and retain loyal consumers. Not surprisingly, this messaging resonates more with user-friendly tools to guide patients through their financial journey and make sense of charges. Many providers believe they’re complying with the final rule but may actually be vulnerable to penalties because their pricing files are in user-unfriendly formats. A web-based pricing tool can help solve for this by offering patients accurate estimates and recommended payment plans before or at the point of service. Similarly, a text-to-mobile tool, such as Patient Financial Advisor, can send automated text messages to patients with personalized estimates and bills. Keeping an eye on healthcare price transparency More tools are now available to help patients make sense of their billing and it’s becoming easier for providers and payers to create a patient financial experience that’s supportive from the start. Not only will this help patients understand their cost of care (and with that understanding likely comes better collections performance), it’ll help reduce the risk of uncompensated care ¬– and avoid penalties as the final rule takes root. The Biden Administration’s focus on consumer-friendly healthcare services will likely keep price transparency at the forefront. What that looks like over the next few years depends on regulatory and market forces, but providers and payers alike will benefit from offering solutions that make sense for their organizations and patient populations. Find out how Experian Health’s price transparency tools could help your organization with the transition.

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  

How did Starbucks lose $1.2 billion in sales during the pandemic, but still exceed revenue expectations in the last quarter? The answer lies in contactless mobile payments. By making it possible for coffee lovers to pre-order and pay for their morning cappuccino through a mobile app, the company was able to offer a safe and convenient slice of normality during the pandemic. While stores were limited to drive-thru and takeout, customers could still get their caffeine fix, but in an easy, socially distanced way. And customers want convenient and contactless ways to pay – as evidenced by $6.2 billion in quarterly sales. Thanks to the app introduced a few years ago, the company has been able to withstand much of the disruption that’s hit the rest of the industry hard. Can healthcare providers learn from Starbucks’ strategy? Yes. Social distancing measures and fears about face-to-face contact are preventing many patients from visiting healthcare facilities and it’s becoming harder for providers to collect payments and maintain a steady revenue cycle. Self-service and contactless payment methods are now a necessity if providers want to remain profitable during these uncertain times. But it’s not just about facilitating payments in the context of social distancing. Even before the pandemic, patients were looking for more convenient ways to manage their out-of-pocket expenses and thinking more like active consumers than passive participants in their healthcare journey. Starbucks’ story shows how prioritizing the consumer experience wins out in the end. So how do providers accelerate collections, ensure patients and staff remain safe, and keep up with consumer expectations? Here are three ways to use pre- and post-service online and mobile payment tools to optimize both collections and consumer satisfaction: 3 ways to improve the patient financial journey with easy contactless payments 1. Empower patients with upfront payment estimates Imagine sending patients an email or text as soon as their appointment is scheduled, with a personalized cost estimate, relevant payment options and convenient ways to pay before they even arrive. Healthcare payments could be as easy as ordering and paying for a coffee! With Patient Financial Advisor and Patient Estimates, providers can do just that. With a single text message, providers can give patients transparency, control and reassurance about what they’re going to owe and how they can settle their bill quickly and easily. 2. Help patients find the right payment plan The pandemic means finances are tighter than usual for many families as well as many organizations, so helping patients manage their bills and get on the right plan pre-service is especially important. With a consumer-friendly online portal, patients can check their balances, manage payment plans and apply for financial support at the tap of a button. Quicker insurance checks will also increase the likelihood of faster payments and minimize the risk of claim denials for providers. 3. Make it easy to pay – before or after treatment Reducing friction at the point of payment is probably the biggest dial-mover when it comes to accelerating collections. If patients can settle their bill at the click of a button, the job is ticked off quickly without too much effort on their part, and with minimal input from providers taff. Why make paying harder than it needs to be? Consider offering patients safe and secure digital payment methods that they can access anytime, anywhere, both before and after their appointment. Post-service, maintain a positive consumer experience with proactive follow-up, timely account information and options to navigate payments from home, if not already settled. The pandemic has intensified the need for healthcare payments to evolve. Contactless and mobile payments can keep revenue coming in the door (even when the real doors are shut). And as Starbucks has shown, consumers expect easier ways to pay. Every day that a patient struggles to pay a bill is a missed opportunity for the bottom line. Find out more about how pre- and post-service contactless payments could help your organization withstand financial turbulence, during the pandemic and beyond.

Few of us would buy a new car or TV without checking the price tag first. Why should our healthcare be any different? Yet this is exactly what many patients are forced to do when they need medical tests or treatment. Following the breadcrumbs on a provider’s website is a time-consuming and confusing way for patients to piece together a price estimate. Even with a rough idea of the cost of care, variations in health plan pricing often bump up the final bill. The lack of transparency is stressful for patients and costly for providers, who end up chasing slow payments and losing revenue to bad debt. But could things be about to change? Many providers have been proactive in offering transparent pricing, and thanks to recent regulatory changes, this could soon be an industry-wide requirement. The CMS Price Transparency Final Rule mandates that by 1 January 2021, hospitals should publish consumer-friendly pricing information on certain ‘shoppable’ services, to help patients understand and plan their bills ahead of time. The proposed Health PRICE Transparency Act would similarly compel providers to publish real cash prices alongside rates negotiated with insurers. As households, businesses and public bodies grapple with the economic impact of COVID-19, any additional clarity around pricing that could help make a dent in healthcare-related debt is to be welcomed. Liz Serie, Director of Product Management and Patient Experience at Experian Health, says that regardless of changes to the regulatory landscape, pricing transparency is here to stay: “It’s great for the patient because they have visibility, transparency and clarity about what they owe. They can prepare financially before their visit, so they can focus on what matters most – healing. Providers are excited about price transparency tools because they let patients pick and plan payment options, reducing the total cost to collect. And with more reliable billing data, it’s a win from a decision-making perspective too.” Transparency is becoming the norm in other aspects of healthcare consumer experience, and billing should be no different. 4 steps to fast and simple patient-friendly pricing 1. Remove the guesswork with accurate, upfront pricing estimates No one wants to play detective with their deductibles. Giving patients pricing information upfront puts them in control of their payments, improving their engagement and increasing the likelihood of faster collections – a top priority for providers today as they continue to feel the effects of COVID-19 on the bottom line. A Patient Estimates tool can generate accurate, easy-to-understand estimates based on known treatment costs, payer rates and real-time benefits data. Estimates and secure payment options can be sent straight to the patient’s mobile device, improving the patient financial experience with a single text message. 2. Give patients 24/7 control through their online portal With COVID-19 pushing even more of our lives online, a 24/7 patient portal is a must for providers that want to stay competitive. Yale New Haven Health (YNHH) used PatientSimple to give patients a mobile-friendly, self-service portal through which they can generate price estimates, choose payment plans, and monitor payment information. Sharlene Seidman, Executive Director Corporate Business Services at YNHH says patients have welcomed online access: “ROI is not just tangible dollars in additional revenue, it’s patient satisfaction and improving the financial experience.” 3. Minimize delayed payments with quicker insurance checks Millions of Americans have experienced sudden job losses or changes to their insurance status in the wake of the pandemic, causing confusion about their current coverage. Payment delays and denied claims are an inevitable side-effect. Providers can help by offering fast, automated insurance eligibility verification, so patients can confirm coverage at the point of service and take the next steps with confidence. 4. Move to mobile for a more convenient patient experience Imagine if your patients could have all the information they need about their healthcare account, right there in their pocket. Patient Payment Solutions offer real-time pricing estimates based on provider pricing, payer rates and benefit information, so patients can review their bill at a time and place that suits them. There’s also the option to offer secure and contactless payment methods, so they can settle their bill at the click of a button. Estimates suggest that the average family of four could save up to $11,000 a year if they had the option to choose care on the basis of more transparent pricing. Savings on this scale mean that demand for clear information about out-of-pocket expenses is going to soar, whatever happens with price transparency regulations. Learn how Experian Health can help your organization support patients and improve collections through more transparent pricing.

The regulatory requirements for price transparency are in full effect. The Centers for Medicare and Medicaid Services (CMS) is moving forward with the OPPS Price Transparency Final Rule (CMS-1717-F2), which states that hospitals must provide transparency that will help consumers understand medical costs and make informed decisions. At this point, it is recommended that hospitals begin to form a strategy for price transparency. The concept behind price transparency is simple: provide transparency that will help consumers understand medical costs and make informed decisions. Experian Heath's commitment is simple: provide solutions that benefit the patient and the provider, that improve collections and patient satisfaction. Discover how Experian Health can help you succeed with price transparency.