Patient Access

The State of Patient Access 2024 marks the fourth installment of a series of surveys initiated in 2020, comparing patient experiences and providers' perceptions of those experiences. Experian Health's latest infographic highlights findings from the latest survey, conducted in February 2024, involving 200 healthcare revenue cycle decision-makers and over 1,000 patients. The study reveals an overall improvement in perceptions of access to care, indicating a positive trend in providers' efforts. However, there are still significant challenges ahead. Providers continue to believe access is better than what patients actually experience, a consistent finding across surveys. Check out the highlights in the infographic: Despite progress, there's a clear need to bridge the gap between patient experience and provider perception. How can providers turn their perceptions into reality for patients? Download The State of Patient Access 2024 report to gain deeper insights into patients' and providers' perspectives on access to healthcare.

“We are really happy with Experian. It takes away duplication of efforts and allows us to see the bigger picture. The eligibility solution works well for our team and patients.” —Emily Brown, Director of Operation Excellence at Providence Health  Challenge Providence Health is a leading health system comprising of 56 hospitals and over 1,000 physician clinics. With an annual patient volume of over 28 million, Providence strives to prioritize the well-being of their patients by providing convenient, accessible, and affordable medical services.   Because of high patient volumes, they faced issues with slow payer eligibility processes and increased eligibility denials, which meant their staff spent a lot of valuable time verifying eligibility manually.   Additionally, as Epic's payer plan table expanded, Providence Health needed an efficient way to consolidate and align the data pertaining to insurance plans, contracts, and reimbursement details. In order to streamline the process and keep their staff within the system, Providence Health sought to automate eligibility tracking.  Solution Providence Health implemented Eligibility Verification and leveraged the Bad Plan Code Detection tool, which identifies coding errors before they're submitted to payers. With this solution, the system immediately alerts users when an incorrect plan code is flagged, allowing users to fix any issues quickly and avoid costly claim rework. Additionally, integration with Epic facilitated seamless 1:1 plan mapping, and automated the creation of new coverage records in Epic based on responses received. This streamlined the process, eliminating guesswork for staff and ensuring accurate plan selection. Emily Brown, Director of Operation Excellence says, “Our search for a solution that seamlessly integrates with Epic led us to choose Experian Health as our preferred vendor, given their proven track record of working with Epic.” By working with Experian Health, Providence has uninterrupted service and connections to over 900 payers, with backup connectivity to 300 additional payers. Providence staff can utilize automated work queues fueled by response data and custom alerts, which allows them to work more efficiently.   Outcome Thanks to Eligibility Verification, Providence Health achieved the following results:  Found an average of $30 million in coverage annually   Saved $18 million due to decreased denial rates within five months  By automating eligibility checks for high patient volumes, Providence Health boosted patient satisfaction while significantly reducing staff workload. Partnering with Experian Health allowed them to identify an increased amount of active eligibility, ensuring accurate reimbursement and avoiding claim denials. Automation also eliminated time-consuming tasks, allowing staff to focus on providing better patient care.   “Checking if my insurance was accepted was a fast and friendly process. The staff even helped clarify which insurance was the right one for me since I had multiple cards.”   - Providence Health Patient  Learn more about how Eligibility Verification helps healthcare organizations access real-time insurance coverage data, improve reimbursement rates and avoid claim denials.  

What do patients and providers really think about patient access services in 2024? Drawing insights from more than 1000 patients and 200 healthcare executives, Experian Health's fourth State of Patient Access survey pulls back the curtain. Previous surveys revealed a persistent gap between patient and provider perspectives on patient access, but could the gap finally be closing? The State of Patient Access 2024 report suggests that while discrepancies remain, the two groups appear closer than ever. This article provides a summary of the State of Patient Access 2024 report, and gives a run-down of patient and provider perspectives on patient access, what they see as top challenges, where opinions diverge and the steps providers can take to continue building a positive patient access experience in the year ahead. How do patients feel about patient access? 1. More patients think access has improved compared to last year 28% of patients believe patient access has improved over the last year, which is up from just 17% in 2023. As in previous years, patients' perception of whether access has improved hinges on how quickly they can see their doctor. Anything providers can do to accelerate scheduling and registration will be a winner. 2. Patients welcome the efficiency and accuracy of digital tools Patients have noticed improvements in scheduling and registration processes. They welcome the ability to book appointments anytime and avoid unnecessary paperwork using digital technology. That said, financial considerations trump convenience: the ability to look up insurance coverage and obtain accurate price estimates before care have risen to the top of the list of what patients consider the most important aspects to improve. 3. Cost of care remains a concern Unfortunately, patient sentiment around healthcare payments has remained relatively flat since 2022. Slightly more patients are receiving upfront cost estimates compared to previous years, but accuracy appears to have dropped, with 74% of patients reporting accurate estimates compared to 78% in 2023. Patients must have faith in their estimates if they are to plan for upcoming bills with confidence, and providers should be able to provide transparent and accurate payment estimates. What do providers think about patient access? 1. Providers are again more optimistic about improvements than patients Like patients, providers are generally positive about the state of patient access, though they may be a little too optimistic about the effect of improvement efforts. Around twice as many providers think access is better than the previous year compared to patients (55% compared to 28%). For providers, perceptions of improvements in patient access are closely tied to the impact of staffing levels. 2. Self-scheduling is back in favor Providers are aligned with patients on the need for digital scheduling and registration options. Interestingly, after the urgency to implement contactless scheduling during the pandemic began to wane in 2022, the latest survey suggests that self-scheduling is back in fashion, with 63% offering self-scheduling compared to 40% in 2022. 3. “Dirty data” remains a stubborn challenge Data collection at patient intake is a persistent headache for providers. Almost half (49%) say that inaccurate patient information contributes to claim denials. Improving the speed and accuracy of resolving patient information prior to claims submission were frequently listed in providers' top three challenges. See how healthcare organizations are using AI AdvantageTM to improve data accuracy and reduce claim denials. Digital technology bridges the gap between patient and provider perspectives on patient access When asked for their top three priorities for improvement, both groups ranked accurate price estimates and efficient insurance verification among their top two. While they diverge on the third – access to online health management tools for patients, and automated pre-authorizations for providers – it's interesting to note that these both reflect a desire to use digital solutions for greater efficiency and convenience. The survey highlights several opportunities to use digital technology to address upcoming challenges and continue to close the gap. Key challenges in patient access in the year ahead 1. Improving accuracy of upfront price estimates The survey showed 79% of providers plan to invest in patient access improvements soon. Given shared concerns about patients' ability to cover the cost of care, and worrying hints that some may postpone care due to cost concerns, prioritizing and providing accurate patient estimates would be a smart choice. While patients and providers are in closer agreement that estimates are accurate most or all of the time (74% and 85% respectively), there's clearly room for improvement. 2. Accelerating insurance verification and claims submission processes Several of the providers' top challenges speak to how difficult it can be to collate accurate information prior to claims submission. The need for better insurance reviews, more efficient management of prior authorizations, and more accurate patient information all contribute to the overarching goal of getting properly reimbursed. Almost a fifth say that managing multiple tools to determine eligibility, coordination of benefits (COB), and other pre-service checks is a top challenge. Could a single solution be the answer? Experian Health's new Patient Access Curator solution checks eligibility, COB, Medicare and commercial coverage, demographics and financial status in less than 30 seconds. Staff can check off several of these tedious tasks with just a single click. 3. Bolstering workforce capacity with technology A final challenge in the year ahead is the ongoing impact of staffing shortages. For the of providers who feel that staffing levels are disrupting delivery of scheduling and registration services, technology may offer a way through. Automation and artificial intelligence not only reduce the burden on staff by eliminating time-consuming manual tasks, but also allow staff to work smarter and faster on remaining tasks by improving data accuracy and insights. Most importantly, digital technology can improve scheduling, registration and payment processes for patients – and bring the patient experience in line with what both groups aspire to see. Download the full report: State of Patient Access 2024, or contact Experian Health to learn how technology can help streamline patient access.

Many healthcare providers believe pairing “revenue cycle” with a qualifier like “predictable” is an oxymoron. From healthcare staffing shortages that slow down reimbursement tasks to increasing payer denials, financial regularity can seem like an unattainable goal for these organizations.  The American Hospital Association (AHA) reports over one-half of U.S. hospitals had financial losses in 2022. Another AHA survey shows that 84% of these organizations say the cost of complying with complicated payer policies is climbing. Providers throw an excessive amount of time and staff at chasing revenue, but reimbursement complexities make for anything but smooth financial sailing. How can healthcare providers even out the ebbs and flows of the revenue cycle? Experian Health's suite of revenue cycle management (RCM) solutions can help. Revenue cycle predictability during the life of a claim When it comes to finances, U.S. healthcare providers rarely have an easy go of it. Today, the average life of a claim is anything but average. From registration to collections, hospitals established a new normal over the past decade: Widening gaps between service delivery and reimbursement. How can providers tackle this untenable situation? The answer is two-fold: with technology and at each stage of the life of a claim. Here are three ways healthcare providers can use technology to create reimbursement predictability at each stage of a claim's life. 1. Establish payment accountability at patient registration with price transparency Reimbursement problems begin at patient registration. Healthcare price transparency demands patients understand the cost of care. According to Experian Health's State of Patient Access survey, 81% of patients agreed that an accurate estimate helps them better prepare to pay for their care costs. However, only 31% of patients received a cost estimate before care. There are three significant impacts of this troubling trend: Nearly 40% of patients say they put off needed care due to cost. The number rises to 61% if the patient is uninsured. Patients can't afford to pay for needed care. Currently, 41% of U.S. adults have medical debt. An Experian Health study showed four in 10 patients spend more than they can afford on healthcare treatment. Uncompensated care causes a significant drop in healthcare provider income, which has amounted to almost $745 billion, according to the AHA. Experian Health offers several data-driven solutions to improve price transparency. These tools make it easier for patients to handle their financial responsibilities while helping providers find solutions to help ease their burdens.Patient Financial Advisor creates more accurate service estimates for patients before their procedure. The mobile-first platform offers patients a detailed cost breakdown on their preferred digital device. Patient Estimates is a web-based platform offering real-time service estimates. Blessing Health System uses the tool to provide patient estimates that are up to 90% accurate. The provider increased collections by 58% and credits the software with a 1,200% return on their investment. Patient Access Curator automatically initiates communication with payers to improve coordination of benefits and maximize return. It also automatically identifies missing or incorrect Medicare Beneficiary Identifier (MBI) numbers or errors in patient contact details. This solution also helps providers understand the patient's ability and propensity to pay, allowing these organizations to predict revenue streams after service delivery. Behind the scenes, Experian Health also automates insurance eligibility verification to unlock hidden reimbursements. This software roadmaps the correct coverage, connects to more than 900 payers and verifies insurance coverage at the time of service to improve cash flow and ease patient payment burdens. 2. Reduce claim denials by decreasing manual paperwork errors Claim denials are one of the biggest impediments to revenue cycle predictability. Providers are stuck in an endless cycle of inaccurate payer submissions, rejected claims, and rebilling, creating a chaotic chase for payment long after the service. Today, 35% of healthcare organizations report $50 million or higher in lost revenue due to claims denials. Even worse, Experian Health's State of Claims 2022 report showed that 30% of providers say denials are increasing by up to 15%. According to that data, the top three reasons for claim denials are: Missing or incomplete prior authorizations. Failure to verify provider eligibility. Coding inaccuracies. Experian Health's Claim Scrubber software levels out provider cash flow, creating predictability amidst the chaos. The solution reviews complete claims for errors, generating actionable edits before submission. Claim Scrubber also reviews approved reimbursement rates to prevent undercharging. Transactions process within three seconds and providers reduce the need to rework claims. Experian Health's AI Advantage solution uses the power of artificial intelligence (AI) to evaluate every claim for its propensity to turn into a denial. Instead of submitting claims and hoping the payer will accept them, this solution takes the guesswork out of reimbursement for a more rational, predictable process. The software automatically scans for payer updates to reimbursement requirements that significantly contribute to claims denials. Hospitals like Schneck Medical Center use this tool to streamline the revenue cycle by preventing denials. After just six months, the provider’s denied claims reduced by an average of 4.6% each month. Claim corrections that took up to 15 minutes manually are now processed in less than five. 3. Increase collections efficiency with automation Patients trust their healthcare providers to take care of them. Providers also rely on patients to pay their bills. It's a mutually beneficial arrangement. However, it's also a problem forcing providers to walk a delicate tightrope between caring for a sick patient while still chasing payment for their services. Unfortunately, the increasing cost of healthcare leaves patients on the hook for more than $88 billion in debt. The volume of healthcare payments in arrears is staggering, causing a substantial drain on provider cash on hand. However, technology offers healthcare providers a way to improve the patient collections process. For example, Coverage Discovery impacts the revenue cycle at every stage of the claim: Before providing care, the software scans patient data to determine reimbursement coverage options from Medicaid, Medicare, and commercial insurance. It scans for active insurance 30, 60, and 90 days after care delivery. The tool scans patient data before determining whether the account moves to bad debt collections. A more robust understanding of patient payment options at every stage of claims management allows healthcare providers to forecast reimbursements more accurately, increasing the predictability of the revenue cycle. Collections Optimization Manager provides organizations with actionable insights, so that providers can segment and prioritize accounts by proprensity to pay. This solution increases patient collections by leveraging Experian's data driven segmentation models, and helps providers screen out bankruptcies, deceased accounts, Medicaid and other charity eligibility ahead of time. Experian Health's AI Advantage – Denial Triage prioritizes rejected claims based on their yield potential, automating workflows for claims managers so they focus first on the patients more likely to pay. This tool segments denials based on their potential value to help even out the revenue cycle with a faster rate of financial return. Denial Triage expedites A/R by increasing revenue collection per person per hour. Revenue cycles can be more predictable, but the complexities of reimbursement require technology to achieve this goal. Experian Health offers a comprehensive line of revenue cycle management solutions to help healthcare providers maximize collections and improve RCM. Find out why Experian Health ranks Best in KLAS for 2024 in the categories of Claims Management & Clearinghouse and Revenue Cycle: Contract Management, or contact us for a more predictable revenue cycle, better cash flow, and a healthier organization.

Improving the patient pre-registration process continues to present a challenge on both sides of the front desk. For patients, dealing with paperwork, struggling to provide the right information, and worrying about payment and insurance coverage make in-person registration feel fraught. Meanwhile, providers are searching for digital solutions to make the patient registration process simpler, more accurate, and more efficient. How are providers tackling these patient registration challenges? Barb Terry, Product Manager at Experian Health, who oversees Registration Accelerator, a digital pre-registration solution, shares her perspective on the state of the industry and insights from Experian Health's State of Patient Access 2024, a survey of 200 healthcare executives and more than 1,000 consumers conducted in February, 2024. Q1: Why is patient registration still so challenging for providers? “It continues to present challenges for both providers and patients,” says Terry. Despite the growing availability of patient registration software, many providers and their patients still contend with outmoded manual processes and confusion over insurance and the cost of care. For providers still coping with staffing shortages, manual registration can be time-consuming and error prone. According to the State of Patient Access 2024 survey, 82% of providers who say access is a challenge cite staffing as a reason. Meanwhile, Terry estimates a typical registration process consumes 15 minutes of staff time and 10 minutes for patients: “It's time that neither the provider nor the patient has,” she points out. “The manual registration process for most offices requires printing, scanning, faxing, calling the patient a few times, and then manual data entry into the office systems,” Terry explains. “The provider is also under pressure to obtain financial clearance before the appointment. In many cases the provider team is working with reduced or new staff, managing repetitive and manual tasks for registration, all while striving to maintain a positive patient experience.” Q2: Why is creating a positive registration experience important for patients? “Patients are evolving into consumers of healthcare, meaning they're more active in their healthcare decisions,” says Terry. “They have growing expectations of their healthcare experience and expect the same convenience and modernization they find with other industries like retail and financial services.” To keep up, healthcare providers need to meet patients where they're used to completing tasks and communicating---namely, on their smartphones. “Patients use their smartphones to complete many everyday tasks at their convenience. Many prefer to be contacted via text rather than with a phone call, since text allows them to answer when they have time.” Terry says. Helping patients complete registration on their time increasingly means providing mobile solutions. As an example, Registration Accelerator sends patients a pre-registration link they can use to scan in their identity and insurance cards. Patients can locate their cards and scan them in wherever and whenever they prefer. Data is captured accurately and sent automatically to the eCare NEXT platform, where it can be verified and used for billing. “Compare this process to time-consuming phone calls that must be made and re-made until contact happens,” Terry says, “or trying to collect information at the time of the appointment. Simply put, patients do not want to spend time in a waiting room completing paper forms that could have been completed digitally.” Q3: How is patient pre-registration important to the revenue cycle? “The traditional registration process isn't very efficient,” says Terry. “Manual processes can easily lead to inaccurate patient information. If the registration process does not include real-time insurance verification, there will likely be more denials and a slower revenue cycle process." “Waiting until the patient's appointment to collect insurance information doesn't give providers much time to verify insurance, or to determine the patient's financial responsibility for copays, deductibles, and out-of-pocket expenses,” Terry continues. “At the same time, patients don't have time to prepare for their out-of-pocket costs. In the 2024 survey, 94% of providers said they felt a sense of urgency to implement a faster, more comprehensive review of insurance coverage." “We know from past surveys that 40% of providers say registration errors are a primary cause of denied claims,” Terry concludes. “When the provider has patient information early, they can start facilitating an estimate and confirm insurance coverage before the appointment. Obtaining patient registration data before the appointment helps to ensure revenue cycle processes flow efficiently to reduce denials and financial risks.” Q4: Greater efficiency is better for providers, but how does it help patients? “The State of Patient Access 2024 survey found that patients expect efficiency as well as convenience,” Terry says. “Here's an example: 85% of the patients surveyed think they shouldn't have to fill out paperwork if their information hasn't changed.” Digital pre-registration solutions that allow providers to re-use valid patient information on file simplify registration all around. “For the patient, spending less time filling out paperwork in the waiting room contributes to a positive experience and improves their overall satisfaction with their provider, in turn leading to increased consumer loyalty,” says Terry. “Instead of managing forms at the appointment, the staff can focus on addressing any questions or discrepancies, and getting the patient settled in for their appointment. For many reasons, going to the doctor can be stressful for patients. Minimizing the forms they need to complete in the waiting room can alleviate some of that pressure.” Q5: How are providers improving the patient pre-registration process? “Providers are presenting additional registration options to their patients, including a modernized and digital process,” says Terry. “In the 2024 survey, 65% of providers agreed that patients prefer digital and self-service pre-registration,” so patient-facing mobile solutions like Registration Accelerator are a clear option for providers to explore. “Patients expect an easy digital experience,” Terry continues, “and, in response, providers should make registration as simple and straightforward as possible.” Yet, the same tools that make pre-registration better for patients can improve the process for providers as well. “Optical character recognition (OCR) is a great example of a feature that creates mutual benefits,” says Terry. “OCR can be leveraged to read insurance cards and pull out relevant and correct information. Staff members are under less pressure to avoid manual errors, and so are patients, who are relieved of the pressure of having to decipher their own insurance cards. “A registration solution should streamline the workflow, reuse patient information, keep data private and secure, and reduce manual entry,” Terry concludes. “By putting the registration process in the patient's hands, the provider is gathering information directly from the source while reducing their operational costs. Once registration data is obtained, it should flow into the front-end revenue cycle processes, so that eligibility is validated and errors are highlighted. This helps the provider ensure they have up-to-date insurance information for billing, leading to faster claims processing and reimbursement.” Q6: What does the future of pre-registration look like? “As patient expectations and provider demands grow, providers will increasingly turn to digital solutions,” says Terry. “Our survey found that 42% of providers have already expanded digital/mobile patient communications to reduce intake friction, and that trend is likely to continue.” “Digital solutions like Registration Accelerator give patients the ability to complete the registration process at their convenience and give providers more consistency in gathering information, less manual data entry errors, and opportunities to integrate with other patient access processes. All these benefits provide much-appreciated efficiencies for providers, and can lead to a better healthcare experience for the patient, so they can focus on their appointment and time with their provider.” Learn more about Registration Accelerator, a patient-facing mobile solution that lets patients scan in their own insurance and identity cards, captures data accurately, and uploads it automatically into Experian Health's eCare NEXT® platform, simplifying registration for patients and providers.

The State of Patient Access 2024 is the fourth in a series of patient and provider surveys that began in 2020. This year's report compares how patients experience access to care and providers' perceptions of those experiences. This blog post highlights findings from the survey, which was conducted in February 2024 and is based on 200 healthcare revenue cycle decision-makers and more than 1,000 patients. The study finds that perceptions of access to care are improving. It's a positive sign that providers are moving in the right direction—but there are still have mountains to climb. What remains the same from prior surveys is that providers believe access to care is much better than what their patients are truly experiencing. The survey showed 55% of healthcare providers believe patient access has improved. It's a big jump from 2022, when just 27% of doctors felt access increased. What's striking, however, is that patients don't completely agree. Only 28% say patient access improved in 2023, an 11% increase from the prior year. Over half (51%) of patients and 26% of providers say patient access has remained fairly static. While the findings show access is improving, there is still a gap between patient experience and provider perception. How can providers improve care access and make their perceptions a reality for their patients? Download The State of Patient Access 2024 report to get the perspectives from patients and providers on their perceptions of access to healthcare. Myths vs. realities of patient access The good news from the survey is that most providers and patients agree access to care isn't worsening. Despite increasing patient volumes and chronic staff shortages, patient access is better than before the pandemic. The findings are a sharp reversal from last year's report, where almost one-half of providers and one-fifth of patients reported care access had grown more challenging. Patient access is: Better Patients: 28% Providers: 55% The same Patients: 51% Providers: 26% Worse Patients: 22% Providers: 20% Consistently, across these annual surveys, providers believe access to care delivery is better than what their patients experience. The survey highlights opportunities to bridge this gap by using digital technologies to align the patient experience and provider assumptions. Opportunity 1: Provide accurate upfront financial estimates 96% of patients want an accurate upfront estimate of treatment costs. 88% of providers agree an accurate upfront estimate contributes to successful patient payments. The survey showed upfront cost estimates are central to a better patient experience. A high percentage of patients (96%) said an accurate estimate of treatment costs is essential before service—so crucial that 43% said they would cancel their procedure without it. Yet 64% of patients did not receive a cost estimate before care, despite increasing state and federal regulations that require this transparency. Perhaps even more troubling, the accuracy for those estimates is questionable. Of the 31% of patients who received a pre-procedure cost estimate, 14% reported the final cost was much higher than anticipated. At the same time, 85% of providers say their estimates are accurate most or all the time. The gap in provider perception and patient reality come together at the point of understanding the need for accurate cost estimates. Understanding what is covered by insurance helps patients manage their healthcare costs. Providers are invested in getting estimates correct because they are a key part of getting paid on time, in full. Patient payment estimates software can automatically create a more accurate picture of costs, reducing the burden on healthcare staff and eliminating unwelcome patient surprises. Consolidating service pricing estimate data from multiple sources empowers patient accountability and decision-making. One health system used these digital tools to increase point-of-service patient collections by nearly 60%, producing estimates that were 80 to 90% accurate. Opportunity 2: Improve data collection at patient intake 85% of patients dislike repetitive paperwork during the intake process. Almost half (49%) of providers say patient information errors are a primary cause of denied claims. The survey showed patients and providers are frustrated with the data collections process during registration. More than eight of 10 providers say automation could improve this process. Yet, in practice, intake remains primarily manual. Patients complain they shouldn't have to complete the same paperwork at each visit. Providers know these manual tasks lead to errors that cause big headaches for claims departments later. However, only 31% consider improving the speed and accuracy of collecting patient information a priority. The top reasons for claim denials are paperwork inaccuracies and missing or incomplete claim information. Human errors cause challenges when it's time for providers to get paid. Up to 50% of claims denials stem from a paperwork processing error at patient intake. As a result, in 2022 alone, healthcare providers spent nearly $20 billion pursuing reimbursement denials. Everyone agrees that providers must do all they can to prevent errors. Providers understand claims denials are a significant roadblock to cash flow. Patients grow frustrated when account balances remain in limbo long after their procedure is complete. Digital technology can streamline patient access and transform the healthcare revenue cycle. Experian Health's Patient Access Curator solution can check eligibility, COB, MBI, demographics, insurance coverage, and financial status in less than 30 seconds, in one click, speeding up the laborious human intake process that creates anxiety—and errors—for patients and providers. Opportunity 3: Give patients online self-service options 89% of patients said the ability to schedule appointments anytime via online or mobile tools is important. 63% of providers have or plan to implement self-scheduling options. According to this year's survey, self-scheduling is hot; waiting on hold with a call center is not. Digital and paperless pre-registration is increasingly important to patients and there is evidence that providers are finally starting to listen. For example, 84% of the providers strongly agreed that digital and mobile access is important to patients. However, self-scheduling did not make the list of the top three provider priorities for improving patient access to care. But the data tells us patients hold out hope for a mobile-first online scheduling process that puts them in the driver's seat to control their access to care. Convenient online scheduling software gives patients control over booking, canceling, and rescheduling appointments. It's a digital front door that's easy to use across any device. Automated notifications can remind patients of annual health exams, replacing the need for staff calls and closing any gaps in preventative care. These tools can reduce time spent scheduling patients by 50% and significantly decrease appointment no-shows. More importantly, they give patients the digital experience they demand. Digital technology brings together patient experience and provider perceptions The State of Patient Access 2024 survey illustrates a narrowing gap between what providers perceive and patients experience. That's good news because a lack of access to healthcare is a contributing factor to a sicker population, which costs much more in the long run. According to Deloitte, barriers to accessing healthcare in this country will grow to a $1 trillion problem by 2040. Patients will continue to experience care access issues in the coming years, from staffing shortages and a lack of rural providers, higher co-pays and more. Can we bridge these future gaps? The answer is a resounding yes. While there's still work to do, the survey showed that 79% of providers plan to invest in patient access improvements soon. Download The State of Patient Access 2024 to get the full survey results, or contact us to see how Experian Health can help your organization improve patient access. 

A recent Peterson-KFF brief found that around 20 million adults have unpaid medical bills, with 14 million owing at least $1,000. Data from the Survey of Income and Program Participation puts the total figure at more than $220 billion. Healthcare providers must find ways to streamline patient financial assistance screening, to help patients and prevent unpaid bills piling up from uncompensated care. Many patients who would be eligible for financial assistance miss out on much-needed discounts due to outdated screening processes, leaving their unpaid bills to linger in accounts receivable. Automated presumptive charity screening offers a cost-effective solution for healthcare providers to modernize the process and reduce avoidable write-offs. Patient financial assistance software can also aid providers in fostering compassionate patient experiences, by identifying individuals in need of help and efficiently guiding them towards appropriate financial assistance pathways. The hidden consequences of medical debt Rising costs, unexpected medical emergencies and lack of insurance are the main culprits in the growing problem of medical debt. Though uninsured rates have dropped, millions of insured Americans remain without adequate coverage: high deductibles and co-payments leave many individuals “underinsured” with out-of-pocket costs they cannot afford. Providers end up shouldering the costs, leading to revenue loss, operational strain, and impaired capacity to deliver high-quality care. In some cases, the burden of an individual's medical debt may be initially concealed from the health system, papered over with credit card bills and loans. But it does not remain hidden for long: medical debt becomes simply “debt,” as families cut back on food and clothing, fall behind on other household bills, or even declare bankruptcy. The repercussions can escalate for patients and providers as patients opt out of further care, which eventually causes their medical needs – and costs – to spiral. Creating a more compassionate financial experience for patients will help avoid these ripple effects, with benefits for providers, too. Who is eligible for patient financial assistance programs? Patients who cannot afford to pay may be eligible for support via a patient financial assistance program. These programs, offered by providers, charities and government agencies, alleviate the financial pressures on patients by covering some or all of the cost of care in the form of partial or full discounts. Providers can offer patients information and support early in their healthcare journey to help them access such programs. The challenge is figuring out who is eligible. Eligibility criteria for financial assistance is often complex, covering the individual's income, household income and size, savings and medical need. Gathering and analyzing this data using manual processes can be time-consuming and often lead to gaps and inaccuracies. These inadequate screening processes result in missed opportunities to connect patients with the financial assistance they need, and risk falling foul of charity care regulations and policies. On-demand webinar: Hear how Eskenazi Health boosted Medicaid charity approvals by 111% with financial aid automation. How to use data to identify patients eligible for financial assistance Instead of asking the patient to fill out a stack of forms and manually checking data against the Federal Poverty Level to determine eligibility for charity care, providers can get the answers they need using data analytics and automation. Patient Financial Clearance automates eligibility checks prior to service to see if patients qualify for financial assistance programs. It uses Experian data and analytics to predict the patient's ability to pay and calculate the best-fit payment plan based on individual needs and circumstances. It also generates scripts for staff to use when running the tool and helping patients find assistance, which makes for a more compassionate experience. Alex Liao, Product Manager for Patient Financial Clearance at Experian Health, says, “Many patients are unaware that they're even eligible for financial assistance and need help to navigate the process. Discussing personal finances can also be uncomfortable, so it's not uncommon for patients to avoid sharing information that could actually lead to them getting support. Automating presumptive charity screening is more efficient and reliable. It's also a lot more compassionate than the old way of collecting forms and documents. Patient Financial Clearance pulls together credit information and demographic data to determine whether the patient qualifies without long, drawn-out discussions. Patients get the help they need and providers can reduce bad debt without delay.” Case study: Discover How UCHealth wrote off $26 million in charity care with Patient Financial Clearance. Using patient financial assistance technology to create compassionate patient experiences As Liao notes, many patients feel awkward or hesitant when discussing their financial situation with a stranger. Additionally, patients are increasingly looking for digital channels to handle their administrative tasks. Experian Health's Self-Service Patient Financial Clearance option offers patients a simple and more private way to complete eligibility checks, whenever and wherever it suits them. Using a mobile and web-based platform, patients can fill out screening forms and upload supporting documents, then get real-time status updates without having to call up their providers. Information is stored securely so staff can check application status as needed. How Self-Service Patient Financial Clearance works Self-Service Patient Financial Clearance puts patients in control, so more individuals complete their applications and find out if they’re eligible for financial assistance. This frees up staff to focus on other revenue-generating tasks that require their attention. With a cost-effective, compassionate and convenient option on the table, is it time to say goodbye to paper-based presumptive charity checks? Find out more about how Patient Financial Clearance helps providers reduce bad debt and improve the patient experience by quickly and correctly checking eligibility for charity care.

Time is not on the side of patient intake personnel. Getting bogged down with complex manual data collection isn't ideal when a worried family member or a sick patient is in the registration seat. Yet this is a familiar problem, punctuated by the tapping of keyboard keys and the scratch of a pen on a clipboard. The pressure to process patients quickly via these manual processes often leads to errors that carry through to claims administration. Given the prevalence of claims errors and the high rate of denials, patient registration is a step in the healthcare journey that could benefit from automation and self-service. Patient registration software can improve the experience and reduce manual errors. These tools can set the stage for a better patient journey, greater staff efficiency, and faster provider payments. What is patient registration? Patient registration is collecting and recording essential information about individuals seeking healthcare services from a medical facility or provider. It is typically one of the first steps when a patient interacts with a healthcare organization. From the provider's perspective, patient registration is also the beginning of the revenue cycle. Patient registration gathers pertinent demographic, medical, and payment information to create a comprehensive and accurate record for each customer. Healthcare personnel must capture: Personal information, such as the patient's name, date of birth, gender, address, contact details, and emergency contacts. Medical history details, such as previous illnesses or surgeries, allergies, current medications, and family health predispositions. Insurance or payment details, including primary and secondary providers and policy numbers. Consent and authorizations, which are critical for regulatory compliance. Patient registration may also include the sometimes-difficult workflows where provider staff ask for co-pays or other self-pay requirements. It can be a challenging collection point; some patients may need education on the upfront, out-of-pocket payments their policies require. For providers, the registration process can serve as the baseline for patient payment accountability. It's an opportunity to provide the patient with cost estimates for their procedure. Despite federal requirements to provide these estimates, only 29% of patients report receiving this information before their procedure. Why is patient registration important? Patient registration serves several important functions: Establish the patient's medical record, which healthcare providers reference during diagnosis, treatment, and ongoing care. Ensure administrative and billing details so the provider gets paid for the services they render. The registrar can also facilitate communication between the healthcare provider and patient regarding appointment scheduling, reminders, and follow-ups. Manage compliance with various legal and regulatory requirements for patient privacy and healthcare documentation. Patient registration is a critical step in healthcare delivery, ensuring that providers capture the necessary information to deliver high-quality, personalized care while facilitating administrative and financial processes. The problem is the rate of manual errors during this process; one study showed providers frequently miss even the most basic details of patient identification. These errors cost healthcare providers $17.4 million or more annually in denied claims, but more importantly negatively impact patient care. Providers can improve the intake process by adopting better patient registration software. How can patient registration software improve the registration process? Patient registration software can significantly improve the healthcare intake process by streamlining workflows, enhancing accuracy and efficiency, and improving the overall patient experience. Streamlined workflows Experian Health's Registration Accelerator solution eliminates the scanning, faxing, and filing of patient forms. Automated patient intake also eliminates the need to call patients (and call again) to verify their data. With automated workflows, data captured with Registration Accelerator via the eCare Next® platform seamlessly flows into other Experian Health products, such as Eligibility for real-time insurance verification. It's a single source of truth for staff bogged down by multiple system logins. Training workflows improve with easy-to-use interfaces and automation to lessen the tedium and repetition of manual intake. Registration Accelerator integrates well with other Experian Health tools connected to the eCare Next Platform to streamline to streamline intake workflows. These applications can automate up to 80% of the pre-registration process. Enhanced accuracy and efficiency The “waiting room experience” often frustrates patients and their families. Experian Health's patient registration software captures financial and health information electronically, eliminating the need for paper forms Patients access the link from their favorite personal device to answer questions, sign forms, upload documents and scan their insurance cards. The data goes straight to Experian's eCare NEXT platform to be validated against information already held in the system, reducing the risk of paperwork errors that lead to claim denials. Anthony Myers, Director of Patient Access at West Tennessee Healthcare, described their patient registration as “cumbersome” before leveraging Experian Health's Registration Accelerator. He says, “We wanted to not be a bottleneck. People were waiting on us. We set the stage for the entire admission. We partnered with Experian, and the metrics went up every month,” for online registration. Capturing accurate patient data electronically from a card scan at the front end of the healthcare visit decreases the risk of a claim denial later on. Registration Accelerator eliminates the repetitive tasks often associated with intake paperwork that frustrate patients. Patient registration starts with one link sent via text. Authorization and consent forms are e-signed, turning the registration experience into an intuitive, efficient online process without clipboards or paper. Improved patient experience Providers say their patients want more digital tools. More than 80% of patients prefer an online experience. The State of Patient Access 2023 survey showed the most important digital services that improve the patient experience include: mobile device scheduling, online payments, and more digital options for managing healthcare. Experian Health's entire line of patient access software products is devoted to providing these experiences to patients while improving providers' efficiency and revenue cycle. Registration Accelerator is a patient-facing, mobile-friendly digital registration tool that improves customers' experience from the beginning of their healthcare journey. Intake teams can spend more time building patient relationships, answering questions, and setting the stage for a better experience throughout their encounter. Healthcare organizations seeking streamlined workflows, greater accuracy, and an improved patient experience at the point of registration—or throughout their journey—should contact Experian Health to discuss their options.

Discovering that a patient's insurance doesn't cover planned care is frustrating for patients and providers. With revenue and patient satisfaction on the line, verifying active coverage should be simple and efficient. However, the process often involves digging through an ever-expanding mountain of data, which consumes valuable time and resources. Increasing patient volumes, frequent payer updates, and new demands for pre-authorization all play a role. Additionally, the impact of nearly 12 million Americans losing Medicaid coverage since April 2023 adds to the challenge.  It's unsurprising that many healthcare organizations no longer rely on manual processes to verify a patient's insurance details. To address these issues, many providers are turning to medical insurance verification software. The CAQH 2022 Index reports that automation of eligibility and benefits verification has increased by 25% over the last 10 years, as providers turn to medical insurance eligibility verification software for more reliable results. This article looks at how these tools are helping healthcare organizations increase their profitability and the questions to consider when selecting the right eligibility verification solution. What is medical insurance verification software? Medical insurance verification software automates the process of checking that a patient's insurance information is current and correct. With just a few clicks (or just a single click when using Patient Access Curator), the software collects data from multiple sources to confirm that prescribed services or treatment are covered by the patient's health plan. Unlike manual processes that involve checking individual payer websites and cross-referencing patient data by hand, an automated solution returns accurate information in an instant. Adoption of this software has grown significantly in recent years because of its ability to drive operational efficiency and reduce revenue loss. More than 90% of medical providers now opt for electronic eligibility verification, according to the CAQH 2022 Index. The report highlights this as a top savings opportunity for the industry, having helped providers avoid almost $81m in costs arising from manual transactions. It's particularly cost-effective for smaller organizations with tighter budgets. How it works: the eligibility workflow Here's what the insurance eligibility verification process looks like in practice: As soon as the user registers the patient, they can make an eligibility request and the software immediately determines whether the patient has coverage on file and whether that coverage has been verified. An optional MBI lookup service can be used to check transactions against MBI databases to see if the patient may be eligible for Medicare. If a patient is eligible for Medicare, the response will confirm the type of Medicare and flag up any missing patient information. If they are not eligible, the transaction will be routed through the regular verification process. For non-Medicare transactions, the software will confirm any other coverage found and provide subscriber details. Benefits of medical insurance eligibility verification software for providers and patients As with all data-driven revenue cycle processes, even the smallest eligibility verification errors can result in denied claims, wasted staff time and lost dollars. Automating the process minimizes the risk of incomplete patient data, outdated insurance information and simple human mistakes. But while accuracy is paramount, the benefits of insurance eligibility software go much further: Boost cash flow and cost savings: Identifying the correct insurance coverage improves the billing process to increase and accelerate reimbursement. With fewer denied claims, more revenue comes in the door and staff time need not be spent on costly rework. Increase operational efficiency: Software automates and streamlines the verification process, saving time and reducing the burden on staff. As labor shortages persist, fewer staff may be available, so any action that makes better use of resources will result in efficiency gains and let staff focus on higher-value tasks. Simplify workflows: Busy providers don't have time for lengthy onboarding exercises or training programs. An eligibility verification product with an intuitive interface that integrates with other information management systems can shortcut the learning curve, while alerts and smart work queues help staff prioritize the right tasks. Leave room to grow: Providers need solutions that can scale in step with increasing patient numbers and administrative complexity. Medical insurance eligibility verification software can adapt to changing needs with minimal disruption. Improve the patient experience: A more reliable verification process means providers can generate accurate and timely cost estimates for patients, which makes it easier for them to understand their financial responsibility and plan for bills. And by eliminating time-consuming manual tasks, software speeds up registration and gives staff more time to focus on patient care. Again, this means more dollars coming in the door. Key features to look for in medical insurance verification software When selecting a platform, healthcare organizations should consider the following questions: Does it pull from reliable data sources? Does the software integrate with existing payer and information management systems? Is the system easy for staff to use? Does it incorporate monitoring and reporting functions? Does the supplier offer ongoing support? Experian Health's Insurance Eligibility Verification solution was developed with these questions in mind. It gathers data from more than 900 payer websites, along with other sources, to generate detailed responses. Advanced search optimization increases the chance of a positive match, so no active coverage slips through the net, while the CAQH Coordination of Benefits Solution data feature gives access to real-time primary and secondary coverage data with 99.5 percent accuracy. Providers that already use Experian Health products, such as eCare NEXT®, can access Eligibility through the same interface, so staff can use it right away and generate combined performance reports. One of the major advantages of Eligibility is the optional Medicare beneficiary identifier (MBI) look-up service, as described below. And now, healthcare providers have an additional tool to add to their eligibility arsenal: Patient Access Curator. With Experian Health's recent acquisition of Wave HDC, users can leverage AI-guided data capture technology to quickly check and correct patient insurance information. Patient Access Curator not only verifies insurance eligibility, it also facilitates accelerated coordination of benefits processing, runs automated MBI checks, searches for missing coverage, and analyzes a patient's propensity to pay – all in a single click. Close the coverage gap with medical insurance verification software While insurance verification software improves eligibility review processes, one question remains: how can providers help patients who are found to have invalid coverage? One option is to help patients find alternative coverage, using a solution like Coverage Discovery. Similarly, Patient Financial Clearance can identify patients who may be eligible for Medicaid or charity assistance, and can point them toward manageable payment plans if they have a self-pay balance. In this way, automated solutions can go even further to help providers create a positive patient experience and ultimately reduce the burden of bad debt. As providers embrace the benefits of automation, selecting the right solution is crucial. Tools that integrate workflows throughout patient access and the wider revenue cycle will make it easier to manage change, maximize resources and boost profitability. Find out more about how Insurance Eligibility Verification helps healthcare organizations increase reimbursements with automated eligibility checks. Learn more Contact us