Tag: patient estimates

Few of us would buy a new car or TV without checking the price tag first. Why should our healthcare be any different? Yet this is exactly what many patients are forced to do when they need medical tests or treatment. Following the breadcrumbs on a provider’s website is a time-consuming and confusing way for patients to piece together a price estimate. Even with a rough idea of the cost of care, variations in health plan pricing often bump up the final bill. The lack of transparency is stressful for patients and costly for providers, who end up chasing slow payments and losing revenue to bad debt. But could things be about to change? Many providers have been proactive in offering transparent pricing, and thanks to recent regulatory changes, this could soon be an industry-wide requirement. The CMS Price Transparency Final Rule mandates that by 1 January 2021, hospitals should publish consumer-friendly pricing information on certain ‘shoppable’ services, to help patients understand and plan their bills ahead of time. The proposed Health PRICE Transparency Act would similarly compel providers to publish real cash prices alongside rates negotiated with insurers. As households, businesses and public bodies grapple with the economic impact of COVID-19, any additional clarity around pricing that could help make a dent in healthcare-related debt is to be welcomed. Liz Serie, Director of Product Management and Patient Experience at Experian Health, says that regardless of changes to the regulatory landscape, pricing transparency is here to stay: “It’s great for the patient because they have visibility, transparency and clarity about what they owe. They can prepare financially before their visit, so they can focus on what matters most – healing. Providers are excited about price transparency tools because they let patients pick and plan payment options, reducing the total cost to collect. And with more reliable billing data, it’s a win from a decision-making perspective too.” Transparency is becoming the norm in other aspects of healthcare consumer experience, and billing should be no different. 4 steps to fast and simple patient-friendly pricing 1. Remove the guesswork with accurate, upfront pricing estimates No one wants to play detective with their deductibles. Giving patients pricing information upfront puts them in control of their payments, improving their engagement and increasing the likelihood of faster collections – a top priority for providers today as they continue to feel the effects of COVID-19 on the bottom line. A Patient Estimates tool can generate accurate, easy-to-understand estimates based on known treatment costs, payer rates and real-time benefits data. Estimates and secure payment options can be sent straight to the patient’s mobile device, improving the patient financial experience with a single text message. 2. Give patients 24/7 control through their online portal With COVID-19 pushing even more of our lives online, a 24/7 patient portal is a must for providers that want to stay competitive. Yale New Haven Health (YNHH) used PatientSimple to give patients a mobile-friendly, self-service portal through which they can generate price estimates, choose payment plans, and monitor payment information. Sharlene Seidman, Executive Director Corporate Business Services at YNHH says patients have welcomed online access: “ROI is not just tangible dollars in additional revenue, it’s patient satisfaction and improving the financial experience.” 3. Minimize delayed payments with quicker insurance checks Millions of Americans have experienced sudden job losses or changes to their insurance status in the wake of the pandemic, causing confusion about their current coverage. Payment delays and denied claims are an inevitable side-effect. Providers can help by offering fast, automated insurance eligibility verification, so patients can confirm coverage at the point of service and take the next steps with confidence. 4. Move to mobile for a more convenient patient experience Imagine if your patients could have all the information they need about their healthcare account, right there in their pocket. Patient Payment Solutions offer real-time pricing estimates based on provider pricing, payer rates and benefit information, so patients can review their bill at a time and place that suits them. There’s also the option to offer secure and contactless payment methods, so they can settle their bill at the click of a button. Estimates suggest that the average family of four could save up to $11,000 a year if they had the option to choose care on the basis of more transparent pricing. Savings on this scale mean that demand for clear information about out-of-pocket expenses is going to soar, whatever happens with price transparency regulations. Learn how Experian Health can help your organization support patients and improve collections through more transparent pricing.

The regulatory requirements for price transparency are in full effect. The Centers for Medicare and Medicaid Services (CMS) is moving forward with the OPPS Price Transparency Final Rule (CMS-1717-F2), which states that hospitals must provide transparency that will help consumers understand medical costs and make informed decisions. At this point, it is recommended that hospitals begin to form a strategy for price transparency. The concept behind price transparency is simple: provide transparency that will help consumers understand medical costs and make informed decisions. Experian Heath's commitment is simple: provide solutions that benefit the patient and the provider, that improve collections and patient satisfaction. Discover how Experian Health can help you succeed with price transparency.

Medical expenses are often a source of anxiety for many patients, whether they are unsure about the amount owed or how they’ll ultimately pay for it. Unfortunately, intimidating collections processes don’t help, and a crisis like COVID-19 only exacerbates this stress. A more compassionate billing approach could help patients better navigate their financial obligations and also build long-term loyalty—a necessity for providers today looking to retain patient volume during a time of crisis. Consumers overwhelmingly want to understand the cost of healthcare services, prior to services being performed. Effective price transparency involves offering patients clear, accessible, and easy-to-understand estimates of their financial responsibility for services before they are performed. Give patients clarity from the start with precise pricing estimates and up-front info about what they’ll have to pay can reduce sticker shock, help them plan and create an overall better patient financial experience. By empowering your patients with financial expectations, their feeling of control increases, improving their engagement and the likelihood that you will collect payments faster and more efficiently. Just as you don’t provide identical medical treatment to every patient, processing all patient accounts the same way doesn’t make sense. Every patient is different. Using comprehensive data and advanced analytics, providers can better understand an individual's propensity to pay and make the payment process a positive one by assessing and assigning each patient to the appropriate financial pathway based on their unique financial situation. Medical bills are often the most direct contact providers have with patients after a service is rendered. Unfortunately, money is often a sensitive topic for patients and statements are often overwhelming and difficult for patients to read. Tailoring communications at each stage can convey compassion and increase patient satisfaction. Customizing patient statements gives providers the ability to simplify and customize bills quickly and easily, turning an often confusing process into one that adds value. Including relevant, personalized messages and educational updates can turn billing statements into a useful resource, all with the potential to drive revenue. In addition to offering personalized payment options, providers can also find out whether a patient prefers to discuss billing by phone or email. Minimizing friction at the point of payment is crucial to fostering compassionate collections. Providers should offer flexible options that include in-person, telephone, mobile and online patient portals, so they can pay in a way that’s most convenient for them. This also frees up staff to help those patients who may need a little extra help understanding their statement. Want to learn more? Check out Experian Health’s Collections Optimization Manager which helps providers segment patients based on an individual’s propensity to pay and payment preferences, informing a compassionate patient engagement strategy and improving collections.

Data-driven technology that automates, simplifies and unifies the revenue cycle can ensure timely communication between healthcare providers and insurers.

Data-driven technology creates a patient financial experience that is friendly, understandable and accessible, while delivering the good-faith estimates.

Providers who want to reduce friction around payments, optimize revenue and build a positive relationship with consumers should use data and technology.

Through an automated, data-driven process, Blessing Health is now able to provide personalized patient estimates that are 80 percent to 90 percent accurate.

El Camino Hospital launched a consumer self-service tool and patients receive an instant out-of-pocket cost estimate that is 95% to 99% accurate.

When was the last time you tried a new restaurant without reading at least one Yelp review beforehand? If you’re anything like the majority of American consumers, the answer is just about never. We live in an experience-driven world, after all, and whether you’re grabbing a bite to eat or trying out a new coffee shop, reviews are a great way to set expectations. But do patient reviews operate in the same way when it comes to hospitals? The answer is a resounding yes. Research shows that higher online ratings correlate with previously established metrics for evaluating hospitals, such as lower potentially preventable readmission rates. When it comes to overall satisfaction, patients are extremely perceptive, and they’re unafraid to share their opinions — good and bad. Yet Vanguard Communications found that about two-thirds of Yelp reviewers gave the top 20 hospitals rated by the U.S. News and World Report either a mediocre or poor rating. So where is the disconnect? One explanation might be that the areas assessed by U.S. News are too narrow. For instance, a hospital might rank highly for a certain specialty, bumping up its overall rating, but at the same time, its bill-pay system could be severely lacking, souring patients’ perception of the organization. Individual hospitals have the ability to assess all aspects of patient care — way beyond the scope of a top-20 list. The onus is on you to identify areas of improvement, and the best way to uncover hidden patient pain points is feedback.  And those pain points are more than just the bedside care received, but are often related on the financial experience. Creating a better experience At Experian Health, we don't focus on tackling every issue in healthcare; one of our specialties is helping healthcare organizations process and collect payment. However, that specific aspect of healthcare has a significant impact on overall patient satisfaction. In a recent study, Experian Health found the highest amount of opportunity for improvement is around the patient financial experience, which includes things like price transparency, understanding one’s ability for health payments, as well as options to pay for care. When it's easier for patients to pay their bills, they rate hospitals higher. Unfortunately, the first big obstacle in bill-pay is that patients often don’t understand what they’re paying for. Even if the quality of care was excellent, when a patient is unsure how much he or she owes, it’s all too easy to get frustrated and give a poor review. El Camino Hospital, a nonprofit hospital located in Mountain View, California, saw this problem play out with its own patients and, in response, made price transparency a major priority. Experian Health teamed up with El Camino to address this pain point. We debuted a self-service portal, allowing patients to access and manage a greater amount of data while still making account management, e-payment, eligibility, estimates, and billing information available. The most exciting element of the portal for patients and administrators alike was the addition of the patient price estimator, which gives instant estimates on a wide variety of procedures. The response to this tool was so positive that patients immediately began using it, even before El Camino promoted it. There was still room for improvement, though, so we worked to gather more patient feedback by incorporating a feedback survey into the portal. As surveys and comments rolled in, we discovered that patients were looking for a wider variety of services in the price estimator, so we’re now expanding the options. This consistent, patient-centered approach has shown tremendous benefits already. For instance, because availability to the portal is on demand, patients no longer need to directly contact the hospital for estimates, which typically results in a 24-hour waiting period. Because the call volume has greatly reduced, El Camino is now able to provide far more estimates in far less time. While El Camino Hospital's portal implementation is still in its early phases, other hospitals have seen impressive results with similar systems over a longer period of time. At Cincinnati Children's Hospital Medical Center, for example, they worked with Experian Health to revamp their online patient portal to make it more attractive and easier for patients to use. After the launch of their revised portal, online payments increased from $200,000 to $800,000, and patient billing satisfaction dramatically increased, as enrollment in their billing portal jumped from 900 to more than 45,000 families in a single year. The medical center’s patients now use the portal to ask questions of their healthcare providers, change on-file insurance information, and schedule or revise appointments. These features also reduce customer service phone calls and other related costs. The 3 steps of the patient feedback process When hospitals empower patients with access to their individual data and listen to their feedback, everyone wins. Patient feedback is essential at every level of implementing a new service to guarantee maximum efficiency. A successful patient feedback process includes these three steps: 1. Identify where feedback is needed. You don't need to harass patients for feedback on every single aspect of their hospital experience. Instead, look at which services would most benefit from patient insight; then, deploy surveys in those areas. Gathering feedback on high-volume services should be a priority simply because they affect the highest number of patients. Similarly, services that routinely trip patients up can only be clarified by directly asking patients what’s causing problems. At El Camino Hospital, creating the charge description master (CDM) was the first step in identifying where feedback was necessary. The list provided a convenient overview, so hospital administrators could easily pick out which services were high-volume or problematic and address them immediately. Whatever the method, pinpointing the services that are particularly troublesome for patients proves much more effective than trying to elevate the entire experience with no direction. 2. Make it multichannel. Feedback is often subject to selection bias, meaning a customer is more likely to write a Yelp review when he or she is either extremely pleased or extremely angry. Offering people several options for providing feedback increases the chances that you'll get a good sample size. You can gather patient feedback via polls using various methods, including text message, email, phone, and paper mail. El Camino Hospital chose to add an SMS feature, building a feedback function on its desktop interface while continuing to field phone calls regarding more complex issues. Its choice proved rewarding, and patient feedback rolled in. Limiting your feedback channels limits the amount and type of feedback you receive, so the more options that are available to patients, the more likely they will be to share their opinions and suggestions. 3. Identify patients who need help and offer it. Patient feedback is only valuable if you act on it. Once you’ve identified specific problems, reach out and offer a solution to patients who expressed concerns. In conjunction with increasing transparency, El Camino Hospital set a goal to identify and assist at-risk patient accounts. After gathering feedback and information on these accounts, El Camino integrated a medical billing fundraiser to lend a helping hand. From there, it created alerts for other at-risk accounts to spread the impact of the fundraiser. By responding to feedback, hospitals can respond to concerns before they become more serious problems, as well as anticipate patients’. If one patient encounters a problem, it's likely that several more will encounter the same issue — if they haven’t already. If hospitals aren't listening to their patients, they’re missing valuable insight into their problems and limiting their scope of improvement.