All posts by Kelly Nguyen

Key takeaways: Manual work and disconnected claims management systems are often error-prone, resulting in delayed and denied claims. Technology, like automation and AI, can help healthcare organizations predict and prevent potential claims issues before submission. Implementing AI-powered claims management solutions should be a top priority for revenue cycle leaders. Healthcare claims denials are on the rise — but so is a new era of technology that can predict and prevent denials before they occur. Leveraging artificial intelligence (AI) for claims management can help organizations break the denial cycle and keep revenue cycles churning. In this article, we’ll explore how solutions like Experian Health’s innovative Patient Access Curator and AI Advantage™ are designed to help providers reduce claim denials with ​AI. Explore how Experian Health is reshaping the way health systems manage Coordination of Benefits. Learn how automation and AI are eliminating manual errors, reducing denials and unlocking millions in recoverable revenue. Watch now > Updating healthcare claims management tools  Claims management is one of the most pressing challenges in healthcare billing. In Experian Health’s 2024 State of Claims survey, 77% of providers said they were moderately to extremely concerned that payers won’t reimburse them, largely due to changing payer policies and prior authorization requirements. Revenue cycle leaders know that good claims management is the key to healthy cash flow and a strong financial foundation. However, with patient volumes growing and complex payer rules increasing, traditional claims management solutions can no longer keep up. As a result, today’s healthcare organizations are feeling the squeeze to update their claims management processes and adopt solutions that rely on automation and AI-powered analytics to better predict, prevent and process denials. Predicting and preventing denials with artificial intelligence​ Healthcare providers can stop the denial spiral before it begins by capturing accurate and complete patient data at registration. According to Experian Health data, 46% of denials are caused by missing or incorrect information. Now, many healthcare organizations are accelerating their digital transformations by implementing automation and AI tools designed to predict and prevent denials. Automation creates consistent workflows, standardizes routine tasks and reduces human errors. At the same time, AI takes claims management to the next level by predicting denials, flagging claims errors before submission and prioritizing claims that need attention. Leveraging AI solutions that form a closed-loop system can ensure clean data at registration while predicting and preventing denials. Front-end solutions Tools like Patient Access Curator automatically find and correct patient data within seconds — across eligibility, Coordination of Benefits (COB) primacy, Medicare Beneficiary Identifiers (MBI), demographics and insurance discovery. Machine learning and predictive analytics allow providers to identify and correct bad data in real time, without the need for guesswork. Ken Kubisty, VP of Revenue Cycle at Exact Sciences, shares how Patient Access Curator improved eligibility processes, reduced errors and more. Back-end solutions Experian Health’s AI Advantage uses AI and machine learning to predict and prevent denials. AI Advantage not only predicts claim outcomes mid-cycle, but pushes urgent tasks to the front of the queue — allowing staff to prioritize the claims that matter most financially. Extending the automation advantage To minimize denials and delays, providers can look to implement automation and artificial intelligence across the entire claims ecosystem. For instance, Patient Access Curator and AI Advantage integrate seamlessly with solutions that manage the entire claims cycle, like Experian Health’s ClaimSource® — using real-time insights generated by ClaimSource to detect patterns and predict future payer behavior. Additionally, tools like Claim Scrubber can automate the claim scrubbing process — reducing potential errors, administrative burden and the need for costly reworks. Organizations can also add a denials workflow manager to automate and optimize the denial management portion of the claims cycle, improve staff productivity and speed up reimbursement. Artificial intelligence for claims management ​FAQs Want to learn more about how Experian Health’s AI tools can help reduce and prevent claim denials? Consider these commonly asked questions. What is AI Advantage, and how does it help with healthcare claims management? AI Advantage works in two stages of claims management, with two offerings: Predictive Denials and Denial Triage. In stage one, Predictive Denials uses AI and machine learning to look for patterns in payer adjudications and identify undocumented rules that could result in new denials. This solution also flags claims with a high potential of denial, so the right specialist can intervene before claims go to payers. After a claim has been denied, AI Advantage’s stage two component uses advanced algorithms to identify and segment denials based on their potential value. What is Patient Access Curator, and how does it help reduce claim denials? Experian Health’s Patient Access Curator is a robust patient intake and verification solution designed to eliminate errors that often result in denials, such as missing or incorrect information. Through AI and robotic process automation, Patient Access Curator automatically checks and verifies patient demographic information, insurance details, eligibility and more — reducing claim denial rates and administrative burden. How can AI Advantage and Patient Access Curator work together? Patient Access Curator and AI Advantage form a closed-loop system that offers healthcare organizations a smarter, faster and more scalable way to reduce denials and increase reimbursements while reducing administrative burden on staff. What are real-world results from using these ​solutions? Case study: Experian Health and Exact Sciences See how Exact Sciences used Patient Access Curator to reduce denials by 50% and add $100 million to their bottom line in six months. Case study: Experian Health and Schneck Medical Center See how Schneck Medical Center used AI Advantage to achieve a 4.6% average monthly decrease in denials. The bottom line: Providers can reduce claim denials with AI Leveraging artificial intelligence for claims management can improve the overall efficiency and accuracy of healthcare claims processing — leading to fewer denials and a more seamless patient experience. Instead of waiting for denials to occur before taking remedial action, healthcare organizations can stay a step ahead with claims management solutions that utilize AI and automation. These tools can help proactively detect errors and diagnose claims process weaknesses for a healthier revenue cycle. As Jason Considine, President at Experian Health, recently shared: “With the power of AI and predictive intelligence, we’re no longer waiting for denials to happen; we’re helping providers proactively prevent them. Tools like Experian Health’s Patient Access Curator and AI Advantage allow healthcare organizations to identify issues at the point of registration and throughout the revenue cycle, so teams can focus on care, not corrections. It’s about working smarter, reducing risk and protecting ​​revenue.” Find out more about how Experian Health’s AI-powered claims management solutions help healthcare providers improve reimbursement rates and reduce denials. Learn more Contact us

For patient access leaders at large healthcare organizations, the pressure is mounting and has been building for some time. Healthcare claim denials are climbing. Staffing is stretched, and the tools healthcare organizations have relied on for years are no longer enough. But what if providers could stop denials before they start? Welcome to the new era of denial prevention in healthcare, powered by predictive intelligence. Experian Health's innovative artificial intelligence (AI) solutions, Patient Access Curator and AI Advantage™, were designed to help organizations prevent denials before they occur. Explore how Experian Health is reshaping the way health systems manage Coordination of Benefits. Learn how automation and AI are eliminating manual errors, reducing denials and unlocking millions in recoverable revenue. Watch now > The denial spiral explained: A systemic challenge in revenue cycle management  Claim denials aren't just a back-end billing issue. They're a symptom of upstream breakdowns—often rooted in inaccurate or incomplete patient data at registration. According to Experian Health's 2024 State of Claims Survey, 46% of denials are caused by missing or incorrect information. And the cost of reworking a denied claim? $25 for providers and $181 for hospitals. The result? A denial spiral that drains resources, delays reimbursements, and frustrates patients and staff alike.  Why Epic users are especially vulnerable While Epic is a powerful EHR platform, many Epic-based organizations still rely on staff to make complex decisions at registration. Questions like: Is this coverage primary? Should discovery be run? Is this data accurate? ...are often left to frontline staff. This guesswork leads to inconsistent outcomes—and denials. What's needed is a layer of predictive intelligence that works within Epic to automate and correct data before it becomes a problem.  How Patient Access Curator fixes registration errors Patient Access Curator is that layer. Patient Access Curator is an all-in-one solution that automatically finds and corrects patient data across eligibility, Coordination of Benefits (COB) primacy, Medicare Beneficiary Identifiers (MBI), demographics and insurance discovery—within seconds. It integrates directly into Epic workflows, eliminating the need for staff to toggle between systems or make judgment calls on the fly. Instead of relying on registrars to catch every error, Patient Access Curator uses machine learning and predictive analytics to: - Identify and correct bad data in real time - Return comprehensive coverage directly into Epic - Reduce denials, write-offs, and vendor fees - Improve staff morale by removing administrative burden As one early-adopting Patient Access Curator client puts it: "If your current workflow still depends on frontline decisions, you're not just risking denials—you're building them in."  Predictive intelligence in healthcare: AI Advantage at work While Patient Access Curator fixes the front end, AI Advantage tackles the middle of the revenue cycle, where claims are scrubbed, edited, and submitted. At Schneck Medical Center, AI Advantage helped reduce denials by 4.6% per month and cut denial resolution time by 4x. The tool flags high-risk claims before submission and routes them to the right biller for correction. It also triages denials based on the likelihood of reimbursement, so staff can focus on the claims that matter most. Together, Patient Access Curator and AI Advantage form a closed-loop system: - Patient Access Curator ensures clean data at registration - AI Advantage predicts and prevents denials mid-cycle - Both tools integrate seamlessly with Epic and ClaimSource®  Why predictive denial prevention matters for patient access leaders  By implementing denial management technology and predictive intelligence, healthcare teams aren't just managing workflows; they're managing risk. Every inaccurate field, every missed coverage, every manual decision is a potential denial. Patient Access Curator and AI Advantage remove that risk by replacing guesswork with certainty. And the benefits go beyond revenue: - Fewer denials mean fewer patient callbacks and less frustration - Cleaner data means faster reimbursements and fewer write-offs - Automation means staff can focus on patients, not paperwork As Jason Considine, President at Experian Health, recently shared: "Our mission is to simplify healthcare. That starts by getting it right the first time, before a claim is ever submitted. With the power of AI and predictive intelligence, we're no longer waiting for denials to happen; we're helping providers proactively prevent them. Tools like Patient Access Curator and AI Advantage allow healthcare organizations to identify issues at the point of registration and throughout the revenue cycle, so teams can focus on care, not corrections. It's about working smarter, reducing risk and protecting revenue."  Denial prevention checklist: Preparing patient access teams for predictive denial prevention  Denial prevention is here, but what if billing teams aren't quite ready? To move toward a predictive denial prevention strategy, healthcare organizations can invest in the following five areas:   Audit front-end workflowsMap out every step from patient registration to claim submission. Identify where manual decisions are being made—especially around eligibility, COB, and insurance discovery. Ask: "Where are we relying on staff judgment instead of system intelligence?" Train staff on data quality awarenessReinforce the impact of inaccurate or incomplete data on downstream denials. Use real examples to show how a single missed field can lead to rework, write-offs, or patient frustration. Introduce the concept of "first-touch accuracy" as a team-wide goal. Evaluate Epic integration readinessAssess whether current Epic environments are configured to support automation tools like Patient Access Curator. Work with IT to assess whether the current setup allows for real-time data correction and coverage updates. Confirm that teams understand how new tools will integrate into their existing workflows, not replace them. Establish a denial prevention task forceBring together leaders from patient access, billing, IT and revenue cycle to align on goals. Assign ownership for key metrics like clean claim rate, denial rate, and registration accuracy. Use this group to pilot new tools like Patient Access Curator and AI Advantage and gather feedback from frontline users. Communicate the "Why" behind the changeFrame automation as a way to reduce burnout, not replace jobs. Highlight how tools like Patient Access Curator eliminate guesswork and free up staff to focus on patient care. Share success stories from peers (like Schneck Medical Center) to build confidence and momentum. The bottom line: Strategic denial prevention is the future Denial management is reactive. Denial prevention is strategic. For healthcare organizations using Epic, Patient Access Curator and AI Advantage offer a smarter, faster and more scalable way to increase reimbursements and improve the patient experience. Learn more about how Experian Health can help protect revenue, reduce staff burdens and reduce claim denials—starting at the first touchpoint. Learn more Contact us

Manual prior authorization workflows represent one of the most tedious and expensive aspects of the healthcare revenue cycle. However, despite access to automated prior authorization software, only 31% of providers use electronic prior authorizations, according to the Council for Affordable Quality Healthcare (CAQH). The CAQH predicts that providers who switch to automated prior authorization software could not only gain back valuable staff time, but also see significant cost savings. What is prior authorization and why is it important? In healthcare, prior authorizations are when providers and payers decide in advance if a patient's insurance plan will pay for a specific treatment. Prior authorizations are crucial to reimbursements and keeping revenue cycles on track. Providers that offer services without prior authorization are unlikely to receive reimbursement from the patient's insurer. This can result in unpaid medical bills, leaving billing teams chasing patient collections or writing off bad debt. During the prior authorization process, providers submit a rationale for a proposed treatment to the payer. The request is approved or denied based on certain criteria, including payer policies and medical necessity. The payer may reject a prior authorization request if the treatment or service isn't covered under the patient's insurance plan, if it's not considered medically necessary or if a more affordable alternative is available. Simple paperwork errors, like missed deadlines or incomplete documentation when submitting a prior authorization, may also result in a denial. Challenges of manual prior authorization processes Despite the importance of prior authorizations in the revenue cycle, tedious manual prior authorization processes present challenges for many healthcare providers. Some of the key obstacles providers face using manual prior authorization include: Heavy administrative burden Healthcare providers spend a significant amount of time starting, completing and revising prior authorization paperwork. An AMA survey found that 86% of physicians say prior authorization has increased healthcare resource usage. At the same time, additional AMA data reports that providers spend around 13 hours working on 39 prior authorizations each week, and nearly one-third of providers report that these prior authorization requests usually end up being denied. Changing payer policies Keeping up with multiple payers and ever-evolving payer policies adds strain on staff and ultimately results in prior authorization denials. Changes are often unannounced, making it hard for providers to stay on top of updates. As a result, prior authorization submissions aren’t always accurate and may be based on outdated rules. This can lead to instant rejection and wasted time correcting and resubmitting requests. Inefficient workflows Prior authorization requirements can be complicated, especially when providers are juggling different payers, standards and service lines. Coping with these complexities often puts strain on manual systems, especially when multiple staff and notetaking methods are involved. Staff members may each get different pieces of information from payer websites (or over the phone) and not have the ability to benefit from their shared knowledge efficiently. Navigating communication hurdles and rapid payer information changes can result in workflow inefficiencies that snowball quickly. How prior authorization software can improve efficiency Replacing manual prior authorization processes with automated prior authorization software can help providers improve efficiency. Here are some key ways providers benefit from automated prior authorization solutions, like Experian Health's Authorizations. Reduces manual interventions: This solution limits guesswork, human errors, and misinterpretations by automating data originating from the EMRs. Automation saves staff time and energy and prevents frustration. Stays current with latest payer policies: The prior authorization system stays up-to-date with the latest regulations and payer requirements. Automatic updates provide staff with the most current information, eliminating the need for staff to visit multiple payer websites or cross-check data by hand. Provides real-time updates: Providers can promptly clear authorizations for service by proactively identifying authorization status as pending, denied or authorized. This allows physicians to make timely treatment plans and for patients to avoid disruptions in care. Reduces risk of denials: Through automation, electronic prior authorization software ensures the accuracy and completeness of submissions by automatically checking with payers and vendors to validate that the authorization is on file. Payers and providers also get a shared view of account information, reducing the need for prolonged discussions about the status of authorization and rework requests. Key features to look for in prior authorization software When implementing prior authorization software, look for a solution that offers a wide range of features to automate and streamline the prior authorization process. Experian Health's prior authorization solution, Authorizations, for instance, offers healthcare providers the following key features: Real-time knowledgebase: Access to up-to-date prior authorization requirements and criteria in the National Payer Rulesets Submissions support: Removes guesswork and directs users to the correct payer portal based on procedure Automated inquiries: Automates the prior authorization payer inquiry process Enhanced workflow: Dynamic work queues display status and guide users through next steps Postback: Allows users to easily send authorization status, number and validity dates to health information systems (HIS) and practice management systems (PMS) Image storage: Receives and securely stores payer responses in an integrated document imaging system Reconciliation: Provides insights into authorization variations and helps resolve them, so staff can take proactive steps to prevent denials and appeals Integration with electronic health records and billing systems: Why it matters Providers often choose a prior authorization platform that seamlessly integrates with existing Electronic Health Records (EHR) and billing systems for maximum efficiency. Solutions like Experian Health's automated prior authorization management tool, Authorizations, easily adapt to existing processes. This eliminates the need for a complete workflow overhaul and minimizes the learning curve for staff. Embracing prior authorization software for a more efficient revenue cycle Revenue cycle leaders who implement prior authorization automation strategies could see significant savings – $494 million annually as an industry, according to CAQH data.  Claims and revenue management processes are often complex and outdated, costing healthcare organizations time and money. High denial rates and slow reimbursements can hurt cash flow and get in the way of financial stability. Automating prior authorization can reduce claim denials, speed up reimbursements and improve the bottom line. Learn more about how Experian Health's electronic prior authorization software, Authorizations, uses automation to achieve greater consistency and efficiency for healthcare organizations. Learn more Contact us

Healthy revenue cycles rely on efficient patient collections. Collections processes that drag on can frustrate both providers and patients, leading to delayed payments, a high administrative burden on staff and unpaid balances piling up. For many providers, adopting collections optimization technology is a proven strategy to make the collection process more efficient, compassionate and patient-centered.   What is collections optimization in healthcare?  The title says it all: optimizing patient collections. More specifically, collections optimization in healthcare refers to technology-based solutions that streamline the patient collections process to collect a greater percentage of the money owed. Using data-driven, patient-centric insights, collections optimization solutions allow billing staff to efficiently identify patient payment capabilities, focus collection efforts and improve patient communications. Collection performance metrics are often built into collections optimization platforms and help providers continuously improve collections strategies over time. So, it's not simply a process to collect, it's a holistic approach to improving a health system billing team's cashflow, in addition to capturing revenue that's owed to the organization. Key components of the collections optimization process  The collections optimization process typically includes specific key components to help providers accelerate patient collections strategies. For instance, Experian Health's Collections Optimization Manager solution has six foundational areas that save time and accelerate payments:  Screening: Cleans up accounts receivable data by screening patient accounts for bankruptcy, deceased, Medicaid and charity so that staff can spend their collection efforts on accounts that have a higher likelihood of payment. Collections staff often spend time on accounts that are deceased, bankrupt, or eligible for Medicaid or charity—accounts unlikely to yield payment. This diverts attention from accounts with higher recovery potential, ultimately impacting overall cash flow. With Collections Optimization Manager, this AR becomes more manageable, and staff can work high-yield accounts in-house, while saving time and money.  Segmentation: Uses credit, behavior and demographic data to help providers identify which accounts are most likely to pay. Experian Health has robust patient data and powerful predictive analytics that reveal which accounts are most likely to pay. By leveraging propensity-to-pay scores, providers can prioritize efforts where they'll have the most impact. This targeted approach helps increase collections while reducing time and cost to collect.  Routing and reconciliation: A data-driven rules engine builds routing and recall rules that distribute accounts to the internal and external servicing channels that are most likely to collect the amount owed and reconciles provider and agency inventory  Agency management: Offers real-time insights into third-party collections agencies' performance with reports and dashboards. This puts a focus on key metrics, so teams can measure performance against industry standards to improve patient payment forecasting and successfully manage bad debt reserves   Monitoring: Monitors unpaid patient accounts for changes in a patient's contact information or ability to pay, and notifies in-house staff so that they can re-engage patients to collect their pending balances   Consulting and analytics: Collections consultants evaluate reports, suggest best-practice collections strategies and provide users with industry know-how. They can also provide quarterly performance reports to show performance and progress.  Discover how Weill Cornell Medicine and Experian Health implemented a smarter collections strategy that delivered $15M in recoveries — and how you can do the same. This on-demand webinar shows how to move faster, work smarter and collect more, without adding headcount. Watch now > The link between collections and financial success in revenue cycle management  Healthy revenue cycles rely on timely patient payments. With so many other financial pressures on patients today – paying for groceries, filling up the family car or basic home repairs - it can become overwhelming to manage it all. When bills are confusing, reminders are missed or affordability is a concern, it can result in late payments. Busy billing teams are then tasked with chasing down collections, leaving little time to focus on other revenue-generating activities. As collection timelines drag on, providers may experience cash flow issues, revenue losses and even bad debt. This can lead to disruptions in the revenue cycle, affect the bottom line and ultimately impact the quality of patient care.  Why collections optimization matters  Healthcare costs are rising, and Americans are carrying about $3,100 in medical debt on average, up from $2,000 the previous year. One in five patients report experiencing distress over healthcare costs they can't afford, and 15 million Americans have medical collections on their credit reports, according to 2024 data from the Consumer Financial Protection Bureau.   By adopting collection optimization solutions, providers not only strengthen the revenue cycle but also have the opportunity to improve the overall patient financial experience. Tools like Collection Optimization Manager help billing teams quickly understand their patients' ability and willingness to pay, identify charity eligibility and implement effective and compassionate patient billing outreach. Plus, performance analytics help staff assess performance over time and adjust collection strategies accordingly. Healthcare institutions aim to understand a patient's financial situation and take steps to assist them in their medical journey. This approach is central to their mission.  On-demand webinar: Boost self-pay collections - Novant Health & Cone Health's 7:1 ROI & $14M patient collections success Hear how Novant Health and Cone Health achieved 7:1 ROI and $14 million in patient collections with Collections Optimization Manager.  Key challenges    Maximizing patient collections is always a priority for providers. However, getting patients to pay their medical bills often comes with challenges, due to:    Poor financial insights: Billing staff may not have enough information about patients' financial circumstances to make predictions about how likely they are to pay. This can make prioritizing accounts and creating patient engagement strategies tricky. Collections staff may often spend time on accounts that are deceased, bankrupt, or eligible for Medicaid or charity – accounts unlikely to yield payment.   Ineffective outreach: Collections staff may spend hours calling patients with low collection yields.  Affordability concerns: Patients may be worried about how they'll pay for their bills, especially if they have a high-deductible healthcare plan. This can lead to late payments.  Insurance policy updates: Busy billing staff might not always be able to stay on top of frequent insurance changes and regulatory updates. This can lead to errors in patient billing or incorrect cost calculations, resulting in late or unpaid payments.   Lack of easy payment options: Patients want convenient, secure ways to pay on their time. When easy options like online and mobile payment methods aren’t available, it can lead to frustration and late payments.   Outdated manual processes: Valuable staff hours are often lost to cumbersome steps in the collections process, like phone calls and follow-up paperwork.   How technology is transforming collections ​​optimization  When implementing billing and collections optimization, today's providers are turning to technology that includes a growing range of automated solutions for more transparent billing, personalized payment options and increased efficiencies. Combining collections and automation enables a more transparent, user-friendly process that gives patients more financial control. Additionally, new technologies, like predictive analytics, machine learning and artificial intelligence, also help providers better understand their patients' financial needs so that they can deliver a more compassionate and supportive collections experience. Case study: How Wooster Community Hospital collected $3.8M in patient balances with Collections Optimization Manager Read more about how automated collections strategies helped Wooster Community Hospital achieve a $3.8 million increase in patient payments.  Three best practices that accelerate collections A strong collections optimization solution should be able to accomplish the following:  Segment accounts based on propensity to pay  Billing teams can improve collections optimization by using automation and segmentation to obtain the data needed to prioritize high-value accounts. Collections Optimization Manager, for instance, uses multiple data sources to automatically screen and segment accounts based on propensity-to-pay scores.   Improve patient communication   Providers can use collections optimization tools and complementary automated patient outreach tools to foster better patient communication without putting additional strain on busy staff. Solutions like PatientDial and PatientText send patients timely bill reminders and self-pay options via voice or text message, while other financial assistance tools, like Patient Financial Clearance, assign patients to the correct financial pathway.  Benchmark performance  Billing teams can use their collections optimization tools to review comprehensive reports and scorecards on their agencies' performance. This allows healthcare organizations to compare performances across multiple vendors. Advanced reporting helps identify performance improvement opportunities, refine patient payment forecasts and manage bad debt. In some cases, such as with Experian Health's Collections Optimization Manager, users can also access expert consultative support to refine collections strategies further.   How can healthcare companies measure success?  Revenue cycle leaders know that “what gets measured, gets managed.” Using a collections optimization solution to monitor key performance indicators (KPIs) enables providers to fine-tune their collections process and assess performance over time. For instance, Experian Health's Collections Optimization Manager captures critical KPIs, such as accounts receivable days and collection rates. User-friendly dashboards and reports allow staff to measure performance against past metrics and industry trends. Plus, users benefit from consultants who can help choose the ​​right KPIs to track, evaluate reports and develop new collection strategies.  Learn more about how Experian Health's data-driven patient collections optimization solution helps revenue cycle management staff collect more patient balances.  Learn more Contact us

Highlights: Patient payment estimator tools give patients a clear, accurate view of the cost of care upfront. Patients who understand their financial responsibility have better financial experiences and are more likely to make a plan to pay their medical bills. Experian Health data has found that 43% of patients say they're likely to postpone or cancel care without an estimate. However, when patients know the cost of care up front, 81% say it helps them better prepare to pay, and nearly 40% say they have a better payment experience. As price transparency laws become stricter and enforcement tightens, providers can use patient estimator tools to ensure compliance with evolving regulations. When healthcare estimates are inaccurate, patients are more likely to cancel medical appointments or struggle to pay their bills. Despite upticks in the number of estimates sent to patients, accuracy has declined, leaving patients unsure about the cost of care and providers vulnerable to chasing collections and potential compliance issues. With healthcare costs continuing to climb and pricing transparency regulations getting tighter, nearly 90% of providers feel an urgent need to improve or implement accurate estimates. Patient payment estimator tools offer a solution that providers can leverage to improve accuracy and stay compliant. On-demand webinar: Price Transparency Audits Are Coming. Are You Audit Ready? This webinar will help you understand what’s changing, what’s at stake, and how to prepare your organization for audit-readiness and long-term success. What is a patient payment estimator? In healthcare, a patient payment estimator is a technology solution providers can use to create and send patient estimates. These estimators use specific data inputs like insurance benefits, contracted payer rates, and provider service pricing to generate estimates. Providers are then able to print them in-office or send them to patients through a self-service web portal or mobile device with a secure text link. Patient payment estimators play an important role in keeping revenue cycles on track. When patients have accurate upfront estimates, they can make more informed decisions about their healthcare and make a plan to pay. Payment estimating tools are also commonly leveraged by providers to meet regulatory requirements, like the new executive order aimed at strengthening hospital price transparency signed by the U.S. president on February 25, 2025. Benefits of implementing a patient payment estimator Patients want to understand the cost of care before receiving services and how much insurance will cover, while providers want to keep schedules full and spend less time chasing point-of-service payments. Patient payment estimator solutions benefit both patients and providers. According to recent Experian Health data, 43% of patients say they're likely to postpone or cancel care without an estimate. However, when patients know the cost of care up front, 81% say it helps them better prepare to pay, and nearly 40% say they have a better payment experience. Patient payment estimator solutions allow providers to easily create and send clear and accurate upfront estimates. This helps providers avoid revenue leaks, improve revenue cycles, streamline estimate delivery, reduce errors and replace outdated manual processes. Additionally, today's healthcare providers are tasked with meeting new regulatory requirements for price transparency, like the Hospital Price Transparency Rule and No Surprises Act. Failure to do so can result in non-compliance penalties or other enforcement actions by the Centers for Medicare & Medicaid Services (CMS). Adopting patient payment estimator technology can help providers stay audit-ready, avoid hefty fines and remain vigilant as compliance requirements rapidly evolve. Report: State of Patient Access 2025 Download The State of Patient Access 2025 report for a full run-down of patient and provider views about access to care. Key features of an effective patient payment estimator When adopting a patient payment estimator solution to strengthen price transparency and deliver more accurate upfront estimates, providers should look for the following key features: Real-time data integration Patient payment estimator tools are only as accurate as the information available to create the estimates, so it's critical that the data is up-to-date. Solutions offering seamless real-time data integration with the latest payer contract terms, patient insurance benefits, claims history and other data sets influencing patient costs can provide the most accurate estimates. User-friendly interface A patient payment estimator solution must be easy to use for both providers and patients. Web-based platforms make it simple for busy staff to create and send accurate estimates to patients with just a few clicks. Then, patients can access their estimates through a secure self-service web portal or a link sent to their mobile device. Audit protection With the passing of the new executive order, providers must have audit-ready patient payment estimator tools. Solutions like Patient Estimates from Experian Health and Cleverley + Associates log every estimate into a robust reporting system and automatically format estimates as compliant machine-readable files. How to implement a patient payment estimator Implementing a price estimate solution often helps providers improve the accuracy of patient estimates, eliminate tedious manual tasks and boost self-pay collections. Here's a closer look at the steps to take. Assess the needs of the healthcare organization. Before adopting a new patient estimator technology, evaluating current billing and estimating processes is critical. Providers need to think about what's working and where there are opportunities for improvement. What are the overall goals for implementing a patient payment estimator? Is the organization looking to improve accuracy or reduce administrative burden? Are there any apparent compliance or regulatory gaps that need filling? Select the right solution. Providers must choose a patient estimator solution that meets the needs and goals of the healthcare organization and its patients. Does the tool integrate with existing systems? Is it easy for staff to send estimates and for patients to access their them? Is it compliant with price transparency regulations? Does it offer audit protection? Train staff. Once a patient estimator tool is in place, staff must be trained to use the new system effectively. Training may include teaching staff to use the platform to create and send estimates, utilize reporting tools for compliance audits or educate patients on how to access estimates. Ongoing education on changing regulatory requirements Monitor performance. With payer requirements, insurance benefits and regulatory requirements constantly changing, healthcare providers must continuously monitor the performance of their patient payment estimator solution. Are the estimates accurate? Is it scalable to keep up with a growing practice? Does it offer flexibility to adapt to evolving compliance needs? Have point-of-service collections metrics improved? Improving transparency with patient payment estimators As the demand for more accurate patient estimates grows and jumping through compliance hoops becomes more challenging, providers can adopt patient payment estimator solutions to strengthen price transparency. Tools like Experian Health's Patient Estimates solution and partnership with Cleverley + Associates offer more accurate, compliant estimates, streamlined workflows and improved patient access. Audit-ready reporting and regulatory support, like educational webinars, help providers stay equipped and competitive when transparency requirements shift. Learn how Experian Health's Patient Estimates and price transparency solutions can help healthcare providers stay compliant with current regulations and help patients better understand the cost of care. Learn more Contact us

Key takeaways: As healthcare costs increase, the demand for patient financial assistance also rises as more patients find themselves without insurance coverage or facing economic hardship. Early identification of charity care eligibility reduces patient financial stress, makes the financial experience more compassionate, and protects providers from bad debt. Automated screening tools like Patient Financial Clearance, built on accurate, real-time data, are essential for flagging eligible patients before accounts go to collections and ensuring that no one misses out on vital support. Too often, patients who qualify for financial assistance aren't identified until after their accounts have been sent to collections. As healthcare costs increase and coverage becomes less certain, more patients will likely face financial challenges, making timely support even more critical. With estimated income data and financial behavior indicators, healthcare organizations can identify patient eligibility for charity care earlier, before the bills pile up. This article looks at how automated charity screening tools like Patient Financial Clearance can help providers support patients, protect revenue and remove the financial barriers that get in the way of care. The rising demand for patient financial assistance Demand for financial support is climbing quickly as economic pressures and policy changes make it harder for patients to keep up with medical costs. Nearly one in four adults are uninsured, often delaying or forgoing care because of high deductibles and out-of-pocket costs. Medicaid redeterminations have already resulted in more than 19 million disenrollments. At the same time, the Congressional Budget Office estimates that new federal spending provisions could push an additional 10.9 million people out of health coverage by 2034. As a result, revenue cycle teams will increasingly find themselves trying to collect payments from patients who are more likely to need financial help. "We're also seeing more states pass legislation that effectively mandates early screening for financial assistance before billing, such as Oregon's HB 3320," says Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health. "These policies are becoming major drivers of financial clearance efforts. Identifying financial need early in the process helps patients avoid unexpected medical debt, and gives providers the insight they need to manage accounts appropriately and protect revenue." For providers, growing administrative costs, claim denials and underpayments mean less flexibility to absorb uncompensated care. Early screening protects against the burden of medical debt and facilitates the transparency and clarity patients need to manage their bills. Why does early identification of patient charity care eligibility matter? When charity care eligibility is missed or delayed, patients can quickly accumulate medical debt they can't afford. In an interview about the latest State of Patient Access survey, Clarissa Riggins, Chief Product Officer at Experian Health, explains why this is so important: "Cost is a major pain point," she says. "The report shows that 34% of patients struggle to pay for healthcare. That number is up from 23% last year. And nearly all patients, 95%, say they at least sometimes have trouble paying. It's clear that affordability is still one of the top reasons people delay care." Identifying charity care eligibility early on ensures these patients don't fall through the cracks. This reduces financial stress for patients and protects providers from avoidable write-offs and bad debt. When staff know which patients are likely to need support, they can have more compassionate and helpful financial conversations and connect patients with appropriate resources. Unlock patient charity care eligibility with automated screening  Manual charity care screening processes are often time-consuming and prone to delays, especially when staff have huge volumes of information to handle. Automated financial assistance screening tools use real-time data to identify patients who may qualify for charity care with greater speed and accuracy. For example, Patient Financial Clearance (PFC) helps providers screen patients earlier in the financial journey by automatically checking for eligibility at or before the point of service. It uses a range of estimated data points, including household income, household size and Federal Poverty Level (FPL) percentage, to assess whether a patient qualifies for charity care, Medicaid or other financial assistance. After calculating a risk score to evaluate the patient's propensity to pay, PFC can pre-fill application forms, reducing the need for staff input and accelerating enrollment. For those who may not qualify for charity care, PFC can recommend payment plan options that align with the provider's financial policies. This proactive, behind-the-scenes screening enables providers to flag eligible patients at multiple points in the care journey, ensuring more patients get the support they qualify for while minimizing manual work for staff. See how Patient Financial Clearance is helping Community Health System prepare for a potential rise in uninsured patients in 2026 by automating eligibility verification and coverage screening. Take a smarter approach to patient financial assistance with Experian Health Automated charity screening tools like Patient Financial Clearance are faster, more consistent and easier for staff to act on. But they'll fall short without reliable data. "Strong data practices are key," says Riggins. "That means better systems to catch errors before they become problems, regular staff training, and giving patients the chance to double-check their records… By automating tasks traditionally performed by human staff, healthcare organizations can save time associated with administrative intake and coverage verification. This also means solving for bad data in real-time, which can prevent billing and claim errors in the long run. Clean data makes everything easier, from billing to insurance verification to patient trust." Case study: How UCHealth wrote off $26 million in charity care with Patient Financial Clearance See how UCHealth partnered with Experian Health to create a more streamlined approach to providing charity care to patients who needed it. She gives the specific example of Patient Access Curator, which uses artificial intelligence to run multiple data checks at once, covering eligibility verification, coordination of benefits, Medicare Beneficiary Identifiers, demographics, and coverage discovery. When thinking about how to use data to find charity care eligible patients, tools like this lay the foundation for more proactive financial engagement. By cleaning up data and automating repetitive tasks, Experian Health's revenue cycle solutions enable providers to streamline their financial operations and give financial counsellors the details they need to engage patients at the right time and help them understand their options. The bottom line Automation and accurate data aren't just backend upgrades. They're essential to building a smarter, more compassionate financial experience, with fewer accounts going to collections. By embracing the best practices for identifying patients needing financial assistance, early action, better data quality, and automation, providers will be better placed to make sure no one misses out on the help they need. Find out more about how Patient Financial Clearance can help healthcare organizations automate financial assistance and identify patients eligible for charity care. Learn more Contact us

Highlights: Payer contract management software helps reduce revenue lost through denied claims and underpayments – two of the biggest pain points for providers – by validating reimbursements, supporting compliance and flagging policy changes in real time. Named "Best in KLAS" three years in a row, Experian Health's contract management tools optimize payer contracts and improve financial performance without adding staff. Experian Health's Contract Manager enabled OrthoTennessee to achieve an 86% success rate on appeals, saving time and recovering thousands of dollars. Claim denials and underpayments continue to cut into provider revenue, making them top pain points for healthcare chief financial officers. In Experian Health's 2024 State of Claims survey, 73% of providers reported an uptick in denials over the previous year, while 77% were seeing more frequent payer policy changes. When contract terms aren't up to date or properly understood, these changes can lead to costly surprises. Many healthcare organizations are turning to claims management automation to improve front-end operations and prevent downstream denials. But could they be overlooking another digital tool? Implementing payer contract management software is a practical way to strengthen early revenue cycle performance and ward off discrepancies that lead to denials. This software helps hospitals and health systems recover hundreds of thousands of dollars annually by auditing payer contracts and identifying underpayments. The role of payer software in enhancing contract efficiency Payer contracts set the terms for how providers get paid. These agreements cover details like claim submission timelines, reimbursement schedules, covered services, reimbursement rates, dispute procedures, contract duration and renegotiation terms. When managed well, they ensure providers are reimbursed accurately and promptly. However, monitoring complex payer contracts is becoming increasingly challenging for providers. According to the State of Claims survey, 43% of providers are very or extremely concerned about receiving full reimbursement. Frequent changes to pre-authorization rules and other payer policies are the main reason for this. Many contracts renew automatically or are amended with little notice, making oversight difficult. "Depending on how the contract is written, providers may receive very little notice of these changes," says Tricia Ibrahim, Director of Product Management, Contract Manager Suite. "Without a way to systematically and efficiently monitor these agreements throughout the contract term, there is simply no way for a provider to ensure they're paid properly." Payer contract management software addresses this by streamlining contract workflows and standardizing how agreements are handled. Built-in modelling tools allow providers to simulate different claim scenarios so they can negotiate terms from a stronger, well-informed position. Dashboards offer real-time insights that help staff ensure compliance, prevent denials and secure proper reimbursement. Key benefits of healthcare payer software for managing contracts A big part of the challenge for providers is that they are often juggling multiple contracts with multiple payers, including private insurers, Medicare, Medicaid and third-party administrators. Each has its own rules, rates and timelines. Without an automated way to track everything, it's easy for revenue to slip away. Payer contract management software helps by: Centralizing all contracts in one place Tracking critical dates like renewals and amendments Flagging changes in reimbursement terms Linking payer terms directly to claims workflows Identifying underpayments by comparing actual and expected reimbursements. This amounts to more than just good record-keeping: these tools offer instant feedback to reduce errors that could trigger denials. Teams save significant time because they no longer need to review contracts or chase down missing payments manually. Frances Thomas, Manager of Payer Strategy at OrthoTennessee, uses Experian Health's payer contract management software to negotiate more favorable settlements and terms with payers. "The system gives us the information we need to be successful," she says. "They can't really argue with you on that." Watch the webinar: See how OrthoTennessee achieved an 86% successful appeals rate with Contract Manager. Optimizing payer contracts with advanced contract management tools A first step in reducing denials and boosting revenue should be ensuring the revenue cycle team thoroughly understands their payer contracts. Contract management systems support this by rooting out ambiguous language, complex reimbursement terms or overly strict coding requirements. By analyzing contracts in detail, these tools identify hidden pitfalls that might go unnoticed until revenue is at risk. Experian Health's Contract Manager and Contract Analysis solution optimizes this process by checking claims before submission, then validating expected reimbursement against allowed amounts. Rates and authorization rules are populated automatically to reduce manual input, while contract mapping and real-time alerts help teams stay compliant. Providers also benefit from extra support through Experian Health's team of contract analysts, who are on hand to review contract terms, fee schedules and payment policies to ensure nothing is overlooked. This end-to-end visibility and guidance is why Experian Health's payer software has been named "Best in KLAS" for three consecutive years. One major benefit for OrthoTennessee was being able to handle claims in bulk. Thomas says, "We had over 600 claims for one day in the wrong network. I was able to take that bulk of claims and handle those. Otherwise, I was going to have to sit there and go claim by claim. It's a huge time saver to work smarter, not harder." Listen in to hear how another Experian Health client, Boston Children's Hospital, used Contract Manager to resolve underpayments and work with payers to resolve issues and errors, resulting in increased revenue. Learn more about how payer contract management software optimizes revenue, ensures compliance and streamlines payer contracts. Learn more Contact us

Key takeaways: The healthcare industry isn't necessarily recession-proof, but revenue cycle leaders can take steps to build financial resilience. Financial resiliency strategies in healthcare should include: diversified revenue streams, operational efficiencies and strategic financial planning. Leveraging technology to optimize patient collections helps providers enhance the collections process and improve financial resiliency now, and in the case of a recession. The relationship between economic downturns and the resilience of the healthcare industry is complex. Healthcare is an essential service, so whether the economy is considered good or bad, people still need to see their provider. However, with many economists anticipating a potential recession, it begs the question: is healthcare truly recession-proof? In this article, we'll explore healthcare's economic resilience and why financial resiliency and collections optimization may be the key to surviving the next recession. The healthcare sector's economic resilience: fact or myth? While not necessarily recession-proof, the healthcare sector has historically been more insulated against economic uncertainty than other industries. However, since healthcare delivery organizations, like hospitals, typically operate with narrow health margins to begin with, a recession could further compound the issue. Factors that already affect a hospital's everyday bottom line could significantly worsen during a recession. Today's hospitals are burdened by high fixed costs, staffing shortages, regulatory and compliance costs, value-based care pressures and the financial challenges of low reimbursement rates and insured patients. During a recession, even the slightest shift could potentially knock a healthcare delivery organization's revenue cycle off balance. The importance of financial resilience in healthcare Financial resilience is crucial for healthcare organizations that want to cultivate long-term stability, regardless of what's happening in the economy. To weather economic uncertainty, healthcare organizations must have a solid financial foundation. The cornerstones of creating financial resilience for healthcare organizations include: Diversified revenue streams: Providers that offer multiple service points have more opportunities to better serve patients. To attract and retain patients, healthcare organizations must stay nimble and invest in new revenue-generating services, such as virtual or outpatient care. Efficient operations: Streamlining every aspect of the revenue cycle — especially through technology like automation and artificial intelligence (AI) — not only eliminates costly, error-prone processes, but also bolsters the bottom line, prevents revenue leaks and allows for new investments. Strategic financial planning: The healthcare industry is constantly evolving, from automated patient collections technology to artificial intelligence (AI) in claims management. Revenue cycle leaders can use data-driven insights from these technologies to inform short- and long-term financial planning. Patient collections during a recession: a critical area of focus Accelerating patient collections is always a top priority for revenue cycle leaders, especially as patients shoulder an increasing financial burden for the cost of care. However, during a recession, the focus on patient payments becomes even more critical. Recessions often bring job loss, leaving patients without insurance or the income to pay their medical bills. This can leave providers scrambling to update insurance information, chasing patients for payment, sending unpaid bills to collections, or worse — getting stuck with bad debt. Healthcare organizations can improve patient collections and maintain steady cash flow during tough economic times by adopting technology to optimize the patient collections process. Tools like Experian Health's Collections Optimization Manager streamline the entire patient collections process without adding additional workload for existing staffing. Leveraging technology for recession-proofing healthcare operations Recessions often come with many unknowns, but healthcare organizations can take steps to help recession-proof their financial operations. Adopting healthcare technology, like collections optimization tools, can help providers in these key ways: Streamline collections Solutions like Collections Optimization Manager uses intelligent segmentation to help billing teams quickly prioritize high-priority accounts based on propensity-to-pay scores. This frees up busy staff from the burden of chasing accounts — and is especially beneficial with large accounts receivable volumes. Instead, billing teams can focus on a small amount of patient accounts that have a high propensity to pay and bring in high revenue. Additionally, costs are further reduced since these accounts don't need to be sent to an external collections agency. To further streamline collections, complementary automated patient outreach tools, like PatientDial and PatientText can send patients bill reminders and self-pay options via voice or text message. Patient Financial Clearance takes this a step further by helping providers run their presumptive charity process, which estimates a patients' Federal Poverty Level percentage (FPL%), to identify those who qualify for greater financial assistance. Enhance financial forecasting Collections Optimization Manager offers healthcare providers real-time insights into collection performance with reports and dashboards that focus on key metrics. Billing teams can see how their team measures against industry standards to improve patient payment forecasting and successfully manage bad debt reserves. Plus, users get access to an experienced collections consultant to evaluate reports and further refine collections strategies. Improve financial resilience Implementing billing and collections optimization gives providers more visibility into the collections cycle, allowing for improved short- and long-term strategic planning. This can be useful for healthcare organizations that need to make financial decisions to prepare for upcoming recessions or shift priorities as needs change mid-recession. Emerging technologies, like predictive analytics, machine learning and artificial intelligence also offer providers a deeper understanding of patients' financial needs, allowing for a more compassionate collections experience. In times of economic uncertainty, when patients may struggle to afford their medical bills, a supportive collections process can help improve collection rates and reduce the chance of bad debt. Building a recession-resilient healthcare organization While it may not be possible to fully recession-proof a healthcare organization, revenue cycle leaders can take proactive steps to make their organization recession-resilient. Turning to technology that leverages a growing range of automated solutions for clearer billing, personalized payment options and increased efficiencies is one way healthcare organizations can start to build financial resiliency for today – and for any future economic downturns. Learn more about how Experian Health's data-driven patient collections optimization solution helps revenue cycle leaders enhance the collections process and improve financial resiliency during challenging times. Learn more Contact us

Prompt patient payment after service is a key factor in keeping revenue cycles on track. However, patients don't always pay right away or in full. Despite around 90% of Americans having health insurance coverage, many patients still face medical debt. Unpaid patient bills often leave providers on the hook chasing patient collections and footing the cost for uncompensated care.   This article covers some of the key patient collections metrics to help revenue cycle leaders get insights on how to measure and improve revenue cycle collections.  Why measuring patient collections is critical in revenue cycle management  When protecting profits in today's increasingly challenging healthcare landscape, revenue cycle management (RCM) leaders know that “what gets measured, gets managed.” The first step to improve patient collections rates is reviewing current data for issues. To do this, healthcare organizations must identify key performance indicators (KPIs) for measuring patient collections in the revenue cycle. Patient collections metrics are quantifiable measures that illustrate if a healthcare organization is effectively optimizing its collections process. They provide RCMs visibility and insights that help indicate if the organization is achieving its goals and effectively managing inflows and outflows.   Key revenue cycle patient collection metrics  Streamlining revenue cycle collections often hinges on collecting patient payments — and quickly. Here are a few common ways healthcare organizations can measure patient collections in revenue cycles.    Days In Accounts Receivable (A/R) Rate - The days in Accounts Receivable rate is a metric that measures the average number of days it takes healthcare providers to collect payment for services — from both payers and patients. Lower days in A/R typically indicate an efficient billing and collections process. Days in A/R over 30 could lead to an increase in collections efforts, unloading to collections agencies, and even write offs to bad debt – all potentially resulting in cash flow issues and revenue loss.  Gross Collection Rate - The Gross Collection Rate, or GCR, shows the percentage of total patient balances collected and indicates the health of the overall effectiveness of an organization's billing and collections process. Healthcare providers generally strive to keep GCRs as high as possible to prevent cash flow issues. The industry benchmark is typically around 95%, but this can vary by provider.  Adjusted Collection Rate - Also known as the Net Adjustment Rate (NCR), this metric is shown as a percentage of the reimbursement healthcare providers collect in comparison to what they could have collected. It represents the amount of revenue healthcare organizations are losing, and a high NCR is typically an indicator of issues in the revenue cycle like uncollectible bad debt.  Patient Balance After Insurance Ratio - The Patient Balance After Insurance Ratio, or PBAI Ratio, is the percentage of financial responsibility that falls on the patient after insurance pays. Tracking PBAI Ratios closely helps providers identify trends early on to stay ahead of issues that could potentially impact cash flow. As today's patients shoulder more self-pay costs, keeping tabs on this metric can help providers prioritize billing and collections that are compassionate and simple to access.   Patient Contact Rate - The Patient Contact Rate measures how often a provider contacts patients with outstanding balances. Higher Patient Contacts Rates typically indicate high levels of engagement with patients about their unpaid bills that often leads to an easier collections process and improved cash flow. When Patient Contact Rates are low, providers may have an opportunity to increase patient communication efforts. Bad Debt Rate - The Bad Debt Rate shows providers how much patient debt goes uncollected and is written off as “bad debt” over a period of time. A high Bad Debt Rate often indicates a need to tighten up process improvements, like collecting more patient patients upfront. A good rule of thumb is to aim for a Bad Debt Rate of less than 5%. The lower the rate, the more efficiently the billing team collects patient balances. Cost to Collect - The cost to collect is a percentage-based metric that refers to the expenses healthcare organizations spend to recover payments from patients and payers. Many times, hospitals spend more to collect than what the patient owes, whether it's from time and resources calling unresponsive patients, paper statements sent to wrong addresses, etc., which makes this an important metric to track. Contingency Fees - When healthcare organizations turn to third-party agencies for their collections, a contingency fee is often paid for their services. This fee is usually a percentage of what the third-party agency is able to recover, and is often around 20-50% of the total amount. Some healthcare organizations work with multiple collections agencies, which can strain hospital cash flow even further. Hospitals must weigh the cost of outsourcing collections against maintaining in-house billing departments.  Strengthening the revenue cycle with effective patient collection metrics  Optimizing patient collections metrics helps strengthen the revenue cycle. Here are some strategies revenue cycle leaders can consider to help boost patient collections rates overall, improve patient engagement and lower bad debt rates:  Improve patient communication: Sometimes patients need additional reminders to pay their bills. Providers looking to raise their Patient Contact Rate might benefit from engaging more with patients. Strategies can include making additional phone calls or  sending monthly billing statements. Healthcare organizations that want to scale patient contact without adding to headcount may also benefit from tools like Patient Outreach Solutions, which increases collections through automated solutions like touchless text messaging, queue callback and bill reminders.   Make it easier for patients to pay: Providers can shorten the amount of time it takes to collect payment from patients by implementing billing and collections processes that make it simple for patients to know costs up front and pay their bills. With a solution like PatientSimple, patients get access to self-service account management tools, like secure self-pay and patient estimates. Tools that automate the payment process, like Experian Health's PaymentSafe®, further enhance the payment experience by helping providers collect more revenue earlier and creating a seamless payment experience.   Utilize data and analytics solutions to optimize patient collections: Experian Health's Patient Access Curator solution uses artificial intelligence (AI) to quickly verify patient insurance eligibility and coverage data in real-time. This can help ensure patient estimates and bills are accurate before the patient collections process even begins.  Segment and screen patients by propensity to pay: During the patient collections process, Collections Optimization Manager helps identify high-value patient accounts and screen out bankruptcies, deceased accounts, Medicaid and other charity eligibility in advance. This solution segments patients by propensity of pay scores, and reduces the cost to collect. The Screening component of Collections Optimization Manager alerts staff to accounts that are not worth collecting from – whether it's a deceased or bankrupt, or charity care account. This saves valuable staff time and resources. Discover how Weill Cornell increased collections by $15M with Collections Optimization Manager. Gaining clear visibility in patient collections metrics  Patient collections metrics data must be current and easily accessible in order to provide healthcare organizations with the most valuable insights into billing and collections challenges and opportunities. However, RCM analysts are often tasked with compiling data from numerous legacy processes and disjointed systems. Bringing together critical patient collections information into a revenue cycle dashboard can help revenue cycle leaders track the KPIs that matter most and show changes over time. This visibility into trends can help RCM understand how what areas of patient billing and collections need the most attention to improve patient communication, create workflow efficiencies and reduce revenue leaks.  Learn more about how Experian Health's collections optimizations solutions can help healthcare organizations improve collections and increase their bottom lines.  Learn more Contact us