Managing claims efficiently—and reducing denials—remains one of the biggest challenges for healthcare providers. Statistics reveal that 46% of denials are caused by missing or inaccurate data, as highlighted by Experian Health’s 2024 State of Claims Survey. For providers, these denials translate into endless follow-ups with patients, staff burnout, rising bad debt (which has increased by 7% year-over-year), and slim revenue margins. Reworking a denied claim costs providers an average of $25 and hospitals $181—an expense that is difficult to justify.
Introducing Patient Access Curator: Automated claims accuracy from day 1
Fortunately, there is now a way to ensure claims are processed accurately from the start, without excessive effort: Patient Access Curator (PAC), Experian Health’s groundbreaking new tool that uses artificial intelligence (AI) to revolutionize the claims process. As a central component of Experian Health’s Patient Access portfolio, this innovative solution automates front-end processes, identifies incorrect data upfront, and resolves inaccuracies in real time, preventing costly claim denials before they occur. Introduced in early 2024, the curation tool is getting the attention of revenue cycle leaders at health systems and laboratories, with good reason.
This article gives a run-down of Patient Access Curator and how it helps providers prevent claim denials in seconds.
Discover how leading organizations like Exact Sciences and Trinity Health have leveraged Patient Access Curator to automate eligibility, reduce denials, and transform their revenue cycles. Watch our pre-recorded session from the 2024 Experian Health High-Performance Summit to see Patient Access Curator in action.
Built-in AI for more accurate data and seamless claims denial prevention
Most issues that lead to denials crop up early in the revenue cycle, when information is missed or captured incorrectly during patient registration. For this reason, it makes sense to focus on denial prevention strategies on the front end.With so much data to capture, manual strategies are bound to stumble. Unfortunately, many digital tools still require staff to check multiple payer websites and data repositories to verify insurance eligibility and check for any billable coverage that might have been missed.
Patient Access Curator takes on these tasks seamlessly, and right within Epic workflows. From patient demographics and eligibility checks to coordination of benefits (COB) primacy, Medicare Beneficiary Identifiers (MBI), and insurance discovery, the system automates these essential processes, providing precise data within moments. This solution ensures data integrity from the moment of registration by replacing manual guesswork with advanced AI-driven technology. This reduces the frequency of denials, minimizes A/R write-offs, and curtails vendor fees. Beyond enhancing efficiency, the tool safeguards the financial health of healthcare providers.
Jason Considine, President of Experian Health, says, “Our mission is to simplify healthcare. Patient Access Curator’s advanced AI technology equips providers to address claim denials more effectively and efficiently than ever before.”
Say goodbye to manual work with instant eligibility and insurance verification
Patient Access Curator simplifies operations for billing teams, healthcare staff and patients. By removing administrative hurdles, staff can focus on patient engagement, rather than spending time on paperwork, phone calls and browsing websites for data. The outcome is improved satisfaction for both healthcare providers and their patients.
“We know this technology is revolutionizing the healthcare industry,” shares Jordan Levitt, Senior Vice President at Experian Health. Levitt, who developed the AI-powered data capture technology, explains, “By delivering faster, more accurate results, providers can improve financial solvency while giving staff and patients a better experience.”
Gone are the days of asking patients for insurance cards or verifying numbers and dates that might be inaccurate. With this solution, registrars and billing teams can be confident in the data they collect, right from the start.
PAC was created to replace the manual guesswork that often bogs down eligibility and insurance verification processes. From patient demographics and eligibility checks to COB primacy, MBI, and insurance discovery, this solution automates these critical touchpoints, delivering accurate data in seconds.
Fewer denials, faster reimbursements
The impact on denial prevention is unparalleled. Patient Access Curator ensures fewer claim rejections and faster payer reimbursements by identifying and correcting bad data across eligibility, COB, and discovery at the start of the revenue cycle. Providers are left with more retained revenue, which can be reinvested into what truly matters: patient care.
Patient Access Curator: Key features that set it apart
Patient Access Curator differentiates itself as a comprehensive, all-in-one product that simplifies the most complex aspects of claims management. Key features include:
- Real-time data correction: Fixes inaccurate data instantly without staff intervention.
- Comprehensive coverage: Finds and corrects bad data across eligibility, COB primacy, MBI, demographics, and insurance discovery.
- Eligibility verification: PAC automatically interrogates 271 responses, flagging up active secondary and tertiary coverage information to eliminate coverage gaps
- Coordination of Benefits: Integrating with eligibility verification workflow, PAC automatically analyzes payer responses to find hidden signs of additional insurances that may be missed by a human eye, and triggers additional inquiries to those third parties to determine primacy, for faster COB processing
- Medicare Beneficiary Identifiers: PAC uses AI and robotic process automation to find and fix patient identifiers so no one misses out on essential support
- Insurance discovery: For patient accounts marked as self-pay or unbillable, PAC automates additional coverage searches
- Demographics: The platform can quickly check and correct patient contact information.
- Seamless integration: Automatically updates host systems (Epic) with verified and corrected coverage data in seconds.
The results? Fewer clicks, faster workflows, and more accurate billing processes. PAC doesn’t just prevent claim denials; it transforms how healthcare teams approach patient access and revenue cycle management.
Improve financial health by focusing on patient health
By eliminating redundant administrative questions, Patient Access Curator allows patients to focus on their health rather than the complexities of billing and coverage. Meanwhile, healthcare staff enjoy a boost in morale, thanks to fewer manual tasks and more efficient workflows—a benefit that can lead to higher staff retention over time.
Patient Access Curator is more than a tool; it’s a game-changer for healthcare organizations looking to protect their revenue while delivering a better, more seamless experience for both staff and patients. Say goodbye to manual guesswork and hello to a smarter, faster, and more reliable way to manage claims. With PAC, healthcare organizations can finally get claims right from the start, without the hassle.
Patient Access Curator is available now – learn how your healthcare organization can get started and prevent claim denials in seconds.
