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Success at a glance: finding unidentified coverage

January 7, 2021 by Experian Health

Register here 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

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