Tag: registration accelerator

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.

This is the third in a series of blog posts highlighting how the patient journey has evolved since the onset of COVID-19. Explore how digital patient intake solutions are transforming the registration process - presenting patients with self-service options and providers with an automated and more efficient process. To read the full white paper, download it here. Registration is a familiar pain point in the patient journey, but COVID-19 has pushed both patients and providers to embrace digital patient intake processes and solutions. These new solutions move registration out of the waiting room, reduce errors and inefficiencies, automate billing, payments and create an enterprise-wide approach to data. Digital patient registration, once considered a “nice to have,” is now a widespread priority. A reveals that 88% of providers plan to invest in patient intake capabilities as a result of the pandemic, up 15% over a year ago. Patients lead the way on post-pandemic digital experiences COVID-19 marked a tipping point in the digital patient experience. Contactless care in the form of telehealth, along with increased use of patient portals and self-service scheduling tools, helped patients access care from a distance. Now, even though 81% of patients say they believe their provider has made on-site facilities safe, many still prefer online and mobile registration options. The study also revealed that 64% of patients prefer an online or mobile-enabled registration experience. “There’s an ‘ick’ factor,” explains Spiro Kalapodis, Director of Product Management for Registration Accelerator and Patient Financial Advisor at Experian Health. Patients actively dislike filling out paper forms, using registration kiosks and handling iPads set out for public use. “I don’t blame them,” says Kalapodis. “Even though the initial wave of COVID-19 restrictions has passed, I would prefer completing the registration process from the comfort of my car, rather than fill out forms in a crowded waiting room.” Simplifying a difficult process with digital registration and digital patient intake solutions One reason automated registration can be such a relief is that manual processes are notoriously difficult for providers to manage. Manual patient registration has always been labor-intensive and subject to human error; COVID-19 magnified these limitations. Paper forms are inefficient – they require design, printing, paper, clipboards, pens, secure storage and disposal. So many things can go wrong: receiving illegible responses, inputting data incorrectly, misplacing forms, the list goes on—and each step consumes valuable staff hours, with questionable results. Meanwhile, patients moved, visited new providers, changed jobs and switched insurance companies which meant there was more information needing capture. At the same time, providers are struggling to recoup revenue that was lost when patients deferred care during the pandemic. Optimizing both human and digital resources is key to delivering on an improved patient experience and regaining consistent profitability. “Patient intake solutions automate everything so data can be used consistently across the patient journey,” says Kalapodis. “For example, when a patient scans their insurance card and submits it through Experian Health’s Registration Accelerator, we leverage technology behind the scenes that can automatically indicate the patient’s insurance provider, policy details, and correctly return the patient’s subscriber details —information that staff members otherwise have to figure out for themselves. By automating this process, we’re saving time and resources, reducing misunderstandings and preventing data entry errors, which can be costly for providers and confusing for patients.” With the right data, providers can also create accurate estimates and even invite patients to pay their bills as part of the registration process. The patient receives a text message with a link to their estimate, along with the opportunity to pay online or on their mobile device. “Not only does this streamline the billing and collection process for providers, it creates a frictionless experience and increases greater transparency for the patient,” says Kalapodis. Getting to a single view of the patient Maintaining accurate data records can help providers deliver smooth patient experiences, better care, simpler payment processes and allows for better communication. Unfortunately, COVID-19 created another challenge on this front. During the pandemic, many patients signed into patient portals to schedule vaccine appointments. In their hurry to secure a shot, many inadvertently created duplicate accounts—and now have duplicate records. Obviously, multiple vaccine logins are not the only source of duplicate, inaccurate and incomplete patient data. But thanks to COVID-19, providers have this additional problem to contend with. Automation can make fast work of data issues. A universal identity manager creates a single view of the patient using unique patient identifiers, which prevent duplicate data records. The result: fewer billing errors and reduced associated costs, better care and a more frictionless patient experience. Patient intake can be painless Digital patient registration was a good idea even before COVID-19. Paper forms, entry errors, fragmented data, duplicate records, slow billing, and a lack of transparency made the registration process costly and inefficient. But COVID-19 made the need for digital more acute. Providers that hope to re-engage patients and recover profitability in the post-COVID-19 era need the power of data and automation. Learn more about how Experian Health can help you deliver a patient registration experience that fits post-pandemic expectations while improving efficiency, reducing errors and leveraging patient data. Download the white paper to learn how digital patient intake solutions are revolutionizing healthcare.   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

The delta variant is still surging – and flu season is about to begin. How can healthcare providers leverage innovative technologies to streamline care and prepare for a potential “twindemic?” The summer of 2021 has not been kind to healthcare professionals.  After a brief period of hope that the worst of the COVID-19 epidemic was over, the delta variant started its march across America, flooding hospitals and physician practices with a new wave of seriously ill patients. Autumn and winter look like they might be trouble, too, as delta joins forces with the seasonal flu to form a potential “twindemic.” After a mild season in 2020, many experts are predicting that the flu will reemerge with a vengeance this year as people return to in-person work and school. The combination of the two illnesses could easily overwhelm providers who aren’t prepared with technologies and workflows that allow them to serve patients efficiently and remain responsive to fluctuating demands. As providers look to navigate the coming months, they will need to make sure that they have self-service tools in place to keep patients safe and relieve strain on staff.  With a few key digital solutions, resources can be maximized, unpredictable patient volume can be managed effectively, and difficult circumstances won’t slow down operations. Online self-scheduling can improve experiences for patients and staff Online self-scheduling is in high demand because it provides flexibility. patients want to move on with their busy lives without having to sit on hold with a representative. In Experian Health’s recent survey, the State of Patient Access 2.0, more than seven out of ten patients wanted to take the appointment-making process into their own hands, citing the speed and convenience of choosing their own appointments. Providers and physician groups appear eager to oblige.  More than 70 percent of providers responding to the survey stated they are planning to offer online appointment tools to improve experiences and manage complex operations as the pandemic continues. The benefits for providers are significant.  Online self-scheduling can measurably reduce administrative burdens on staff, allowing practices to reallocate their people power to other high-priority tasks. Giving patients the tools to make appointments may also help to reduce patient no-show rates, which can drain billions of dollars each year from provider organizations. Using self-scheduling tools, patients with transportation issues or concerns about exposure risks may be able to opt for telehealth visits, as opposed to unplanned visits to urgent care centers or the emergency department. This can help protect other consumers and staff from illness while allowing them to manage their own calendars. Mobile patient registration keeps patients safe from exposure during a "twindemic" Shifting patient registration from the clinic to the home can also be beneficial for patients and providers.  When patients fill out new forms or update existing information in person, they increase their exposure risk by staying in the waiting room longer than necessary. In contrast, a digital registration accelerator solution offers a quick, touchless, and convenient intake experience on the patient’s own mobile phone.  Patients can complete the process in their homes (where they are more likely to have all their personal information at hand), or in the parking lot while waiting for clearance to enter the building. On the provider’s side, automating patient intake improves operational efficiency and avoids errors that come from illegible handwriting and verbal information communicated through masks and plexiglass.  Data integrity algorithms and real-time feedback for patients can correct mistakes quickly to ensure high accuracy of patient data – a crucial competency for treatment and reimbursement. Patient portals boost convenience, communication, and security As providers prepare to battle two illnesses instead of just one, practices shouldn’t forget to leverage one of the most important parts of the digital arsenal: the patient portal. Portals are instrumental for staying connected with patients, particularly with the 40% of patients who skipped medical care in the early months of the pandemic. As a complement to necessary in-person care, patient portals offer a convenient way to communicate with providers, complete administrative tasks, and access personal health information at their leisure. Providers must be certain, however, that their portals don’t become avenues for medical identity theft.  Healthcare organizations must maintain tight security policies that simultaneously deliver an optimized patient experience. A patient identify-proofing and authentication solution that automates patient portal enrollment while adhering to the high standards of HIPAA and other industry requirements is key.  Solid security can reassure patients that sharing digital health information with their trusted providers is safe - fostering more open relationships and leading to better care. Hopefully, fears of a “twindemic” will fizzle as communities continue to take sensible precautions against the spread of COVID-19.  However, if the flu does roar back into life, providers must be prepared. Self-service technologies and robust security measures can safeguard practices against the strain of higher-than-expected patient volumes and supporting the continued delivery of high-quality patient care. Learn more about how Experian can help your organization incorporate these new technologies and prepare for a potential "twindemic."