In case you missed them, below are links to recently created videos of our clients and staff, as well as links to recorded webinars. New Videos Our healthcare provider clients share their experiences and best practices using Experian Health’s solutions. Watch Now Chris Lah from Cincinnati Children’s Hospital shares his insight around healthcare reimbursement challenges. Watch Now Rachel Papka from Steinberg Diagnostic Medical Imaging Centers outlines her orders management challenges and how her organization has overcome them. Watch Now Karly Rowe from Experian Health highlights the importance of matching, managing and protecting patient identities to safeguard medical information and reduce risk. Watch Now Tony Murdoch from Experian Data Quality explains how Experian’s Data Quality Solutions can add value to our clients. Watch Now On Demand Webinars Patient Identification – The Challenges Healthcare Leaders and the Industry are Facing Today (HealthLeaders-hosted event). View Now (registration required) The Importance of Managing and Protecting Patient Identities (NAHAM-hosted event). View Now (registration required)  

In its first year of consideration, Experian Health’s ClaimSource® solution garnered the 2017 Category Leader title for claims management. This was achieved by having products and customer support that address the top issues in Patient Accounting, including: Declining reimbursement making it more important to ensure accurate payments Slow payment from third-party payers Having to make analytics-based key financial and operational decisions Constantly changing governmental mandates and payer requirements Managing the move from fee-for-service reimbursement to value-based reimbursement The challenge of finding skilled resources The continual stress to do more with less The Experian Health ClaimSource product suite addresses these challenges first by providing excellent products that are all seamlessly interfaced and can provide exception-based processing for: Automation of processing clean claims through the use of an expansive library of national payer edits The ability and willingness to create provider specific custom edits Expediting the follow up process thru the use of enhanced claims status detailed responses Enabling more efficient processing of denials by analyzing denials reasons and automating workflow Automating the payment posting process with customized posting files for handling splits and contractual adjustments Providing the best interfaces available for Epic clients for both hospital and physician billing offices We follow that up by offering superior customer support for our clients. By leveraging our size, experience, and multiple locations in Sacramento, California and our new location in Schaumburg, Illinois, we support clients from Hawaii to New York to Alaska to Florida and everywhere in-between. These two offices allow our clients to get great hands on support for implementations, training, extensive custom programming, as well as experienced billing analysts with decades of billing knowledge. We always thought our claims products stood out against our competition, but now KLAS has validated that for us. Ask your Experian Health account representative or email us at experianhealth@experian.com to find out how we can help your business office address your specific needs.

Why is missing coverage so detrimental? When patients are unable to pay, providers see an increase in self-pay receivables – 97% of hospitals reported an increase in self-pay receivables compared with the prior fiscal year. When providers can’t collect, the result is uncompensated care $35.7 billion – The amount of uncompensated care hospitals provided in 2015 (AHA, Dec 2016, http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf) Registration errors and frequently changing insurance coverage contribute to an increase in self-pay receivables and bad debt: 20% error rate: Wastes an estimated $15.5B in claims that are never corrected and re-processed. Find previously unidentified coverage to reduce bad debt Experian Health’s Coverage Discovery® solution provides an efficient and trusted means for healthcare providers to reduce misclassified self-pay accounts. Our advanced self-pay engine maximizes the actionable coverage found for our customers across government and commercial payers, previously missed due to frequently changing insurances, data entry mistakes or patient misrepresentation to avoid high deductible health plans. The benefits to you: Make coverage identification more efficient Reduce number of accounts sent to collections & charity Maximize insurance reimbursement revenue Identify primary, secondary, & tertiary coverage Automate the self-pay scrubbing process What are our clients are saying about Coverage Discovery: [Video] Murry Ford, Grady Health System: “Coverage Discovery has brought in quite a bit of revenue for us—revenue that we would not have identified otherwise.” [Video] Mike Simms, Cone Health: “Since we’ve been using Coverage Discovery, we’ve received over $3 million in payments—more than a 300% ROI. It’s well worth every dollar spent.” Here’s why Coverage Discovery is different: Flexibility: Multiple delivery options easily fit Coverage Discovery into your revenue cycle Time matters: Find coverage on-demand Powered by Experian: Billions of data assets improve account specific intelligence and maximize found coverage Relevant: Confidence Scoring reduces data noise and removes potential false-positives to ensure staff time is focused on actionable accounts Uncover previously unidentified coverage with Coverage Discovery.

Challenge: a disconnected healthcare ecosystem Exchanging information across the healthcare ecosystem and achieving interoperability is a goal and challenge all healthcare organizations share. While regulations such as the Affordable Care Act introduced incentives and requirements to drive adoption of electronic medical records, they also highlighted a critical gap in healthcare – a universal patient identifier. Impact: Felt downstream across your enterprise The lack of a universal patient identifier, compounded by data integration challenges and the increasing fluidity of patient data, has created significant issues downstream – billing errors, redundant treatments and testing, HIPAA breaches, incorrect administration of treatments and prescriptions, and more. These issues contribute to the pool of preventable medical errors, which is currently the number three leading cause of death in the United States. Solution: Universal Identity Manager Experian Health’s Universal Identity Manager (UIM) accurately identifies patients and matches records within and across disparate healthcare entities, creating a universal patient identifier to facilitate information exchange. Drawing on more than 40 years of experience managing universal identifiers across various industries and leveraging Experian’s consumer demographic information, the UIM achieves higher match rates than traditional industry solutions. Integration flexibility The UIM is integrated within eCare NEXT®, but also supports various API options. It can also be leveraged in conjunction with biometric and traditional Enterprise Master Patient Index solutions. Batch: Receives, processes, and loads patient demographic information via patient data file. Starting with an initial historical patient data file in batch is recommended. The UIM algorithm is applied to accurately identify duplicate records and assign a Universal Patient Identifier (UPI) that can be used to facilitate information exchange across different healthcare entities. The UIM Batch is currently being offered at no charge to the entire healthcare industry. Duplicate Merge Tool: Provides a workflow tool to address duplicate patient records identified through the UIM batch. The Duplicate Merge Tool encompasses robust access and issue assignment management, configurable merge strategies, customizable search and filter capabilities, comprehensive audit trails, and postback or file output options. Search & Duplicate Medical Record Number (MRN) Alert: Leverages in process scripting to perform a real-time search the UIM as patient demographic information is being entered into an HIS during registration. The optimized patient record for each potential patient match is returned. If the search is circumvented, a Duplicate MRN alert will be created within eCare NEXT and prompt manual user review. Real-time search can also be facilitated through a direct API integration. Experian Single Best Record: Leverages an algorithm to look across all linked patient accounts that exist within a client’s enterprise database and aliases and addresses from Experian’s demographic information and returns back a patient’s single best record by demographic field. Data Analysis: Offers standard, premium, and custom reporting options with detailed data analysis across your patient data file. Learn more about Universal Identity Manager here, or contact your account representative for more information.

Don’t miss Frank Abagnale at HIMSS17

Use a unique patient identifier to protect patients and link records within and across healthcare systems

Improve patient identification with Experian Health and NCPDP

Below is a collection of some of most compelling article we’ve read in recent months. We hope you find these interesting, too! One Goal; One Contract: How a Nationwide Health Data Sharing Framework is Revolutionizing Interoperability https://www.himss.org/news/one-goal-one-contract-how-nationwide-health-data-sharing-framework-revolutionizing-interoperability   7 things to know about Aetna’s ACA exchange exit https://www.beckershospitalreview.com/payer-issues/7-things-to-know-about-aetna-s-aca-exchange-exit.html   5 steps to cybersecurity for Internet of Things medical devices https://www.healthcareitnews.com/news/5-steps-cybersecurity-internet-things-medical-devices    CMS: ICD-10 specificity kicks in Oct. 1, 2016 https://www.healthcareitnews.com/news/cms-icd-10-specificity-kicks-oct-1-2016   3 leadership skills crucial for a culture change http://www.beckershospitalreview.com/hospital-management-administration/3-leadership-skills-crucial-for-a-culture-change.html

Undoubtedly, you have been monitoring progress toward legislation for healthcare providers to furnish patients with estimates for their cost of care. And if it’s not already in place, there’s a strong chance your state will be next on the list to require price transparency. Additionally, with the continued popularity of high deductible health plans, patients are looking to price shop for their healthcare services. Patients expect more healthcare cost information available online, like in every other industry. Helping patients know what they will owe prior to service can enable them to make more informed decisions about their care and increase patient satisfaction. As more states begin to mandate providing pre-service estimates to patients, it’s critical for healthcare providers to know what solutions are available to help them comply. According to a recent Fierce Healthcare article, “Real healthcare price transparency for consumers is dependent on rich data sources that provide meaningful price information on a wide range of procedures and services.1″ Experian Health is here to help! Our Patient Estimates solution is a pricing transparency tool that enables you to create accurate estimates of services, before or at the point-of-service. Patient Estimates is also offered within our Patient Self-Service portal, allowing patients to access estimates on-demand. See how Patient Estimates helped St. Clair Hospital in the Pittsburgh market. According to the June 2016 KLAS Healthcare Price Transparency Solutions Performance Report, “…clients feel [Experian Health’s] Patient Estimates is a critical element in their efforts to help patients know up front what their costs will be, and clients report overall satisfaction with the product, services, and vendor engagement. The solution is seen as very complete and robust, with strong customer support.” Experian Health’s Patient Estimates can help your organization: Increase up-front collections Provide patient’s pricing prior to service Increase patient satisfaction Let us help you prepare now for state requirements that will ultimately increase accurate up-front collections and more importantly improve patient satisfaction! Call us at 1 888 661 5657 or email experianhealth@experian.com to get started!     1Ron Shinkman, “A few more states get passing grades on price transparency,” Fierce Healthcare, July 28, 2016

Scott Lee oversees the Experian Health Reference Program. Scott graduated with a BA in Business Management from The University of Texas at San Antonio, and has been with the organization for 12 years, beginning with MPV, which was acquired by Experian in 2011. Scott lives in San Antonio with his wife and two children and says his second home is the San Antonio Zoo based on how much time he and his family spend there. Scott is a catalyst for fostering the connection between Experian Health’s current and potential clients to allow the former to share their positive experience and ROI using our solutions. Our clients also benefit from being a reference by learning about the workflow and best practices of similar organizations. Because of the importance of protecting our clients’ privacy, Scott schedules calls on behalf of our clients and ensures that the experience is mutually beneficial and minimally disruptive for all parties involved. “We’re very appreciative of our reference clients, and it’s a privilege for our potential clients to hear their experiences firsthand.” he said. Share your story by being an Experian Health Reference Client! Contact your Sales Director/Account Manager or contact Scott Lee at scott.lee@experian.com or (210) 582-6320.

Below is an update from the Experian Health  Support Team. Network & System Performance Last six months: Upgrades to the network, compute and storage infrastructure have improved performance and scalability. Enhanced alerting and reporting to strengthen proactive measures for issues remediation Next six months: Data Center move and consolidation will localize production communications to improve efficiencies Automation improvements to reduce on-boarding times for new clients Subscribe to Receive Product Support Updates Opt in to receive emails about significant product updates or changes. Access the Experian Health Product Dashboard here.    

Care Coordination Manager is the industry’s first solution designed specifically to help hospitals, health systems, and provider-led health plans succeed with 30-90 day episode management.  It is a flexible, rules-driven care coordination system designed specifically for physician groups, hospitals, health systems, and provider-led health plans, whether for ensuring bundled payment profitability, maximizing ACO and health plan savings, managing post-acute costs, or reducing readmissions. Contact us today for more information at 1 888 661 5657 or visit the Care Coordination Manager page.