Case study: How AI-powered registration checks helped Eskenazi Health cut denials by 38%

Key takeaways:

• Registration teams can only prevent eligibility and coordination of benefits (COB) denials if they have accurate, up-to-date coverage information before a claim is submitted.
• Experian Health’s Patient Access Curator™ (PAC) automates eligibility verification, coverage discovery, COB and demographic validation in a single step – reducing manual work and giving staff more confidence in front-end decisions.
• At Eskenazi Health, rebuilding the registration process around Patient Access Curator led to a 38% reduction in COB denials and a 27% reduction in coverage and eligibility denials, demonstrating how stronger front-end processes can improve financial performance.

Challenge: Registration teams were missing real-time insights into patient coverage

Decisions made at registration influence everything that follows in the revenue cycle, so having timely and accurate data is essential. Even a small error can disrupt billing and trigger denied claims. Patient access teams need to know they’re seeing the patient’s complete coverage information as it exists today, not as it appeared at a previous visit or as the patient remembers it. That’s becoming more challenging amid frequent, sudden coverage changes.

At Eskenazi Health, a high-Medicaid population meant that insurance coverage was constantly changing. Teams conducted registration and eligibility checks using Premium EDI, but often learned too late that a patient’s coverage had ended or changed. Preventable denials related to COB and eligibility were a persistent challenge, and registration staff were held responsible for issues they couldn’t have foreseen.

They needed to be able to see accurate information earlier in the process, rather than waiting for a denial to land in their work queue and playing detective to find out what went wrong.

Solution: Rebuilding registration with faster, more accurate patient information

Eskenazi Health found the solution in Experian Health’s Patient Access Curator. Instead of asking staff to manage even more front-end checks, the organization rebuilt its registration process around a single AI-powered workflow. Patient information could now be verified and corrected before claims entered the billing process.

Registration teams could complete demographic checks, eligibility verification, insurance discovery, coordination of benefits (COB) primacy and Medicare Beneficiary Identifier (MBI) validation in one step. Information was verified in real time and automatically returned to Epic, with insurance plans placed in the correct primacy order. Instead of working through separate transactions and work queues, staff could complete registration with fewer manual steps and less complex decision-making.

Stephanie Williams, Director of Patient Access Services at Eskenazi Health, was optimistic about the kind of results they might see with Patient Access Curator, after hearing another health system share its experience at an industry conference:

“Within the first three months, OhioHealth saw an 8% decrease in denials specifically around eligibility codes 22, 26 and 27. That was fascinating to me because those are the codes that we struggle with here at Eskenazi Health.”

This showed what was possible when teams have reliable data. Patient Access Curator would turn routine front-end checks into a denial defense strategy.

Looking back, Williams’ assessment of the decision hasn’t changed: “It’s a lifesaver.”

Outcome: Better front-end data, better financial performance

More complete patient information at registration

One of the biggest wins for Eskenazi Health has been the ability to find real-time coverage information that would previously have been overlooked. This included state exchange and marketplace plans, giving staff a 360-degree view of each patient’s coverage before a claim was submitted.

This is particularly valuable when Eskenazi’s out-of-state trauma patients arrive with complex insurance arrangements. Patient Access Curator helps teams identify billable coverage sooner and initiate prior authorization workflows earlier, reducing the financial risk associated with high-acuity care.

Measurable reduction in preventable denials

Because Patient Access Curator takes care of those registration checks, staff can spend less time on manual tasks. They have more time to focus on patients and resolve issues before claims are submitted.

“What used to require manual lookup and separate work queues now happens automatically. What a win,” says Linder. “One thing I really like about Patient Access Curator is the fact that you always get corrected MBIs returned.”

These data and workflow improvements soon showed up in denial metrics since introducing Patient Access Curator.

A partnership that continues to improve performance

Introducing a new registration workflow affected both patient access and billing teams, so close collaboration was essential as the new tool was rolled out.

For Linder, Experian Health’s support meant any challenges that cropped up during implementation could be dealt with swiftly. He notes, “The team I worked with was extremely helpful and proactive, with experts in each area who could troubleshoot any issues along the way.”

That collaborative approach has continued beyond go-live, with Experian Health helping Eskenazi refine payer mapping and track denial trends. The ongoing partnership means registration teams can continue to fine-tune their workflows as payer requirements and denial patterns change.

Find out more about how Patient Access Curator helps healthcare organizations check coverage quickly and early for fewer denials and a stronger revenue cycle.