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Why claim denial prevention is more effective than denial management

Learn why claim denial prevention is more effective than denial management for improving cash flow and reducing administrative costs.

Published: May 14, 2025 by Experian Health

How to prevent strained lab and hospital profit margins

Discover how bad data leads to strained lab and hospital profit margins and how healthcare organizations can solve this challenge.

Published: May 08, 2025 by Experian Health

Case study: How St. Luke’s Health System cut denials by 76% with Enhanced Claim Status

Discover how Enhanced Claim Status helped St. Luke’s Health System reduce claim denials, accelerate cash flow and more.

Published: May 07, 2025 by Experian Health

Contract management software for hospitals: Maximize revenue and resolve underpayments

See how hospital contract management software can help validate reimbursements, reduce revenue loss and strengthen payer relationships.

Published: Apr 30, 2025 by Experian Health

The State of Patient Access 2025

Get the State of Patient Access 2025 report to see what patients wants, what providers are doing to meet expectations and where the gaps are.

Published: Apr 28, 2025 by Experian Health

AI in healthcare: How artificial intelligence transforms care

Discover how AI in healthcare improves patient access, automates workflows and boosts efficiency, transforming the future of care delivery.

Published: Apr 24, 2025 by Experian Health

How to choose denial management software

See how to choose the best denial management software and how it helps healthcare organizations improve claims processes and reduce denials.

Published: Apr 22, 2025 by Experian Health

How insurance Coverage Discovery helps maximize revenue

Learn about common insurance coverage discovery challenges and how healthcare providers can streamline the process and reduce revenue losses.

Published: Apr 17, 2025 by Experian Health

Medical billing software: the future of RCM

Discover how medical billing software can reduce claim denials, improve billing accuracy and streamline revenue cycle management (RCM).

Published: Apr 01, 2025 by Experian Health

Enhance contract management in healthcare with advanced tools

Learn how a healthcare contract management solution can help negotiate favorable terms, check payer compliance, and more.

Published: Mar 27, 2025 by Experian Health

Case study: Denials reduced by 66% at UT Medical Center with improved patient intake

“Reducing denials upfront would improve our revenue, which could be channeled into current and future investments that support our mission.”—Joshua Gayman, Revenue Cycle Manager at UT Medical Center Challenge The University of Tennessee Medical Center (UT Medical Center) is a leading 710-bed acute care hospital with a rich history of exceptional patient care and award-winning services. During the pandemic, the hospital faced revenue losses of around $45 million that put serious strain on its capacity to invest in bigger and better facilities. UT Medical Center needed to find a strategy to recover some of this revenue by reducing claim denials at the point of patient registration. UT Medical Center relied on eligibility checks that often missed errors in patient registration, resulting in increased claims denials, costly reworks, and wasted staff time. The hospital urgently needed a solution to help staff identify and resolve potential patient registration errors in real time to prevent denials before they occur. Finding a more efficient way to capture accurate patient and benefits data would be essential. Proactively preventing claim denials would provide the hospital with a much-needed boost in cash collections and free up staff to focus on patient care. Solution To address its claims denials challenge, UT Medical Center partnered with Experian Health and implemented Registration QA, a solution designed to find and fix registration errors upfront. Now, when patients first arrive, front-end staff enter their data to verify insurance. If Registration QA finds an error, it alerts staff in real-time so they can resolve it within 72 hours. Alongside more than 400 alert rules curated by Experian Health, UT Medical Center also built custom alerts based on the organization's specific requirements, using demographics and benefits data. The tool easily integrates with existing workflows, and its configurable dashboard gives UT Medical Center Management detailed insights into department performance and allows staff to track trends and identify areas for improvement. This proactive approach to correcting errors significantly reduces the risk of downstream denials and helps patient registration staff take proper corrective actions for their errors without management intervention. More accurate patient registration is also better for patients, as fewer errors make for a smoother intake experience. Outcome UT Medical Center successfully optimized patient registration by using Registration QA to identify registration errors before and at the point of service, reducing denials and boosting revenue. In the 12 months after implementing Registration QA, UT Medical Center saw the following results: Now that registration errors can be identified before and at the point of service, UT Medical Center has seen initial denials drop from an average of $5 million per month in 2022 to just $1.7 million in 2023, representing a 66% decrease in average monthly initial denials value. Cash write-offs also decreased, dropping 57% from an average of $1 million to just over $400K, helping the organization keep bad debt low. Gayman notes that UT Medical Center's partnership with Experian Health was central to its success. Experian Health shared the organization's vision and provided weekly support to help realize it. They developed a customized curriculum to make sure staff were confident using Registration QA and offered insights into what was happening more widely in the industry, so UT Medical Center's team could benchmark their performance against similar organizations. Thanks to these savings, the hospital can increase its capacity to invest in new projects and deliver operational excellence, while improving patient satisfaction. Find out more about how Registration QA helps healthcare organizations minimize denials and increase cash flow through accurate patient registration. Learn more Contact us

Published: Mar 24, 2025 by Experian Health

The X Factor: Using Experian data to drive financial assistance automation

Learn how Community Health System implemented Experian Health’s Patient Financial Clearance and increased efficiency throughout the revenue cycle.

Published: Mar 20, 2025 by Experian Health

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