Tag: patient financial clearance

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Collecting patient payments is an ongoing struggle. Bills are confusing, reminders go missed and patients can't always afford to pay. Rising self-pay costs, new medical debt mitigation regulations, Medicaid changes and staff shortages all put added pressure on billing teams. The result is often poor patient financial experiences, wasted staff time and bad debt. As revenue cycle managers figure out a path forward in today's complex – and costly – healthcare environment, analytics-based collections optimization could be the answer. Solutions like Collection Optimization Manager help providers quickly understand a patient's ability and willingness to pay with screening and segmentation models, identify charity eligibility and implement effective patient billing outreach plans. This article summarizes a recent webinar with two longtime users, Wendi Cardwell of Novant Health and Wanda Taylor of Cone Health, who have successfully partnered with Experian Health to streamline collections, increase self-pay revenue and humanize patient financial experiences through segmentation and automation. How collections optimization boosts revenue Cari Cesaro-Hoffman, Senior Director–Enterprise Consultant for Collections Optimization Manager at Experian Health, set the stage with observations on how collections optimization solutions, like segmentation and automation, help providers maximize collections and engage patients compassionately. “Segmentation is the driver of successful patient billing cycles. It guides the team to focus on collections with those patients or guarantors with a higher likelihood to pay while helping to create patient-centric, positive patient financial experiences. Automation and customized operational processes embedded within collections optimization enhance the process even further.” Having the right collections optimization partner is critical. Both Cardwell and Taylor agree that Experian Health's unique consultative approach and comprehensive technology have been key to their success. The technology integrates seamlessly with account receivable data, helps streamline collections processes and allows for quick pivots to meet ongoing regulation changes — all while adding humanization to the revenue cycle. How to optimize collections with patient-centric insights In collections optimization, segmentation and automation allow healthcare organizations to evolve their payment collection strategies to keep up with rising healthcare costs, meet new industry regulations and drive more self-pay revenue. By using sophisticated, patient-centric insights, providers can make informed decisions on which accounts to prioritize, write off or refer to collection agencies. Collections optimization solutions, like Experian Health's Collection Optimization Manager, use multiple data sources to automatically screen and segment accounts based on propensity-to-pay scores. With a better understanding of each patient's financial situation, staff can prioritize high-value accounts and increase collections revenue. Experian Health's collections consultants provide ongoing support and expert advice, while advanced reporting allows revenue cycle managers to easily benchmark performance, refine patient payment forecasts and manage bad debt. Patient collections processes can be further optimized by integrating complementary financial screening and patient engagement tools, like Patient Financial Clearance, PatientDial and PatientText. Key takeaways from 2 real-world examples of successful collection optimization Cardwell and Taylor share how they are using collections optimization to boost revenue in today's increasingly high-cost healthcare environment. Below are the key takeaways from their conversation about how segmentation and automation are helping streamline collections, improve the patient experience and meet ever-evolving regulations. Segmentation and automation improve collections performance Segmentation and automation drive the patient billing cycle and enhance collection efforts – especially for self-pay collections. With the help of Experian Health's Collections Optimization Manager, Novant Health and Cone Health are able to quickly identify those patients likely to pay their bills and implement patient-first collection strategies. Cardwell shares how segmentation helps personalize the patient collections experience. "If patients have a high propensity to pay their bill and it's a low balance, like $300, they may not need a call quite yet since they may immediately make a payment when they get their bill. But if it's a high propensity to pay their bill and it's $3,000, they may be sitting at home wondering, 'How am I going to do this?' So, they just need that little nudge by someone calling and saying, 'Did you know we have payment plans that are interest-free? Let's help you get set up on that.'" Taylor agrees, "The automation is just remarkable for the ability to give our patients that white glove treatment and to be able to either contact them in some way, talk to people that want to talk to us or offer the automation that others want." Cardwell and Taylor also note that collections optimization helps their billing teams easily integrate charity care and financial assistance processes more closely with collections and revenue cycle workflows. This allows both organizations to quickly adapt to industry changes and new requirements, like medical debt mitigation regulations. Optimizing collections delivers real-world results The successful implementation of Collections Optimization Manager for Novant Health and Cone Health serves as a model for other healthcare organizations looking to improve their collections and revenue cycle performance. To date, Novant Health has seen an impressive ROI of 9.5/1 with a $16 million combined lift across hospital billing and provider billing, while Cone Health cleared $14M in patient payments and a 6:1 ROI. Additionally, Caldwell and Taylor both report saving valuable staff time and resources. Automating some of the screening processes and routing through bankruptcy, deceased and return mail has resulted in more than 3,000 manual hours saved between the two organizations. Caldwell says working with Experian Health reduces IT hours, especially for organizations that outsource IT like Novant Health. For example, “If you decide you no longer need to use a particular vendor partner and need to send data to another vendor partner, Experian Health can quickly make that flip for you.” Successful automated call campaigns driven by segmentation have been another win. Taylor describes using segmentation to efficiently “run unattended call campaigns that push calls out to patients with payment plan reminders.” Caldwell agrees, and shares that Novant Health has seen similar successes with collections call campaigns. Novant Health is using the data to run automated Medicaid enrollment call campaigns and is “looking into doing mother-baby” call campaigns to remind new moms to enroll their newborns for insurance coverage. Choosing the right collections optimization partner matters For providers looking to evolve their collections strategies, both Cardwell and Taylor stress the value of working with a collections optimization partner that offers turnkey solutions for a positive patient financial experience, seamless data integration and up-to-the-minute regulatory knowledge. Cone Health first adopted Coverage Discovery® and ClaimSource® before adding Collections Optimization Manager and Taylor says, “It just came together seamlessly. We've successfully evolved those products into a multi-item suite of information that is seamless in passing information back and forth. Experian Health also has their ear to what's happening at the state level and in federal and regulatory matters. So anytime there are new things coming down that impact our functionalities, they are coming to us with solutions to keep us cutting-edge.” Cardwell elaborates on how collections optimization helps Novant Health foster a human-centric financial experience. She says, “When we look at engaging our communities, Collections Optimization Manager has enabled us to do that effectively and efficiently, allowing us to deliver on our brand promise to care for our patients, each other and our communities.” The future of collections cycle management is here Healthcare organizations are already making strides to adopt collections optimization strategies that improve patient collection rates and boost self–pay collections. In today's fast-changing healthcare environment, it's critical for revenue cycle managers to evolve collections strategies to keep pace with patient needs and regulatory requirements. Working with a partner like Experian Health can help healthcare organizations better fulfill their financial goals, meet the needs of the patient population and deliver positive patient financial experiences. Find out more about how Collections Optimization Manager is changing the future of healthcare collections and watch the webinar to hear the full conversation on 'Boost self-pay collections: Novant Health & Cone Health's 7:1 ROI & $14M patient collections success.' Learn more Contact us

Published: February 21, 2025 by Experian Health

Improved automation and data-driven solutions are optimizing the patient collections process, even as providers face rising costs, shrinking reimbursements, looming changes to credit reporting, and an ongoing push toward greater efficiency. How do current solutions stack up against these challenges? Matt Hanas, Lead Product Manager at Experian Health, shares responses to some of the questions he's hearing from around the industry.  Q: Automation continues to be a buzzword in 2025, but what does it mean day-to-day for patient collections? What can automation do for healthcare providers and hospitals in 2025?  “Automation can mean many different things,” says Hanas. “It might mean saving on full-time employee hours or the number of clicks made by a user with an EHR like Epic. It could mean removing human intervention from a process, or trusting a vendor to deliver results without needing oversight.”  “When deployed correctly, automation will either reduce waste or increase profitability---or both,” he continues. “Imagine being able to export AR files out of an EHR on a daily basis. Those files trigger multiple processes that check for missed insurance coverage, bankruptcy filings, bad addresses and charity qualifications, to name a few possibilities. That information can be scored and segmented to drive hands-off dialer and text campaigns, with results delivered back to the EHR automatically and used to populate work lists and queues for staff to review—or, better yet, to create additional automation rules within the EHR to perform automated tasks like adjustments and write-offs.”  “Collections Optimization Manager has the proven ability to automate workflows. It's used at hospitals around the country to discover overlooked Medicaid coverage, apply charity write-offs, utilize interactive voice responses (IVR) to collect payments, send out text message payment reminders and more,” Hanas says. “These are all key drivers behind a profitable and efficient healthcare organization. Thousands of hours are being saved, while hospitals and providers achieve greater efficiency and profitability.”  Q: Can segmentation increase collections and boost patient satisfaction? How does the power of intuitive segmentation improve the patient collections process?  “For certain, failing to understand patients' individual needs is not a recipe for improving collections or increasing patient satisfaction,” says Hanas. Healthcare costs are rising, physician reimbursement is decreasing, and many consumers are feeling an economic squeeze. A 2024 survey by Commonwealth Fund found nearly half of respondents (48%) had skipped care, declined to fill a prescription, or decided against seeing a specialist because of cost. In this environment, segmentation can help providers develop a more responsive process, which may help to facilitate patient collections.  “When providers use detailed, comprehensive segmentation, they can implement specific contact strategies, payment plans or even automatic write-offs based on a patient's unique financial status,” says Hanas. “They can ensure that each patient has the right number of touches and can offer them a range of possible payment options.” For example, Patient Financial Clearance can connect eligible patients with financial assistance or charity.   “There are various data models used across the industry,” Hanas explains. “They group patients by credit data, payment history, demographics, geolocation, and a variety of other factors. What makes Experian Health segmentation so powerful is that it includes all of these factors. Having many types of data come together via algorithms and analytic models helps providers better understand their patients' financial factors, patient by patient. With properly deployed and utilized segmentation, collections can become a better-informed interaction between a patient and their provider that benefits both,” Hanas says.   Q: Outsourcing the patient collections process is standard practice, but do most providers really know how their agencies are performing? How can providers optimize these important relationships?  “Once providers have done the time-consuming research and picked an agency to partner with, their challenge is knowing whether those agencies are performing to standards,” Hanas says. “With thousands and thousands of accounts flying back and forth between the hospital and the agency (or agencies), monitoring performance manually would take an unimaginable amount of time.”  Experian Health has tools to automate the process. “Collections Optimization Manager has an offering built into it that monitors agency performance on multiple levels,” says Hanas. “It includes details [like] whether an agency's license has expired, or whether they've had a complaint or lawsuit filed against them. Because money collected is the true performance metric, it also compares account balances for each provider account against what the agency says they've collected. These results are then reported on dashboards, reports and scorecards, so providers get easily digestible information.”   Data also helps providers compare performance between agencies. “Clients are using performance metrics from Collections Optimization to line agencies up against each other and compare,” Hanas says. “This 'challenger' technique allows providers to see which agency is delivering superior performance,” and then these providers can ultimately make decisions on how to allocate business going forward.  Q: In addition to keeping up with operational challenges and technology, providers are navigating changes in the regulatory space. How are fast-evolving state regulations around financial assistance affecting collections strategies?  “More and more states are passing financial assistance-specific regulations,” says Hanas. “Illinois, Oregon, Minnesota, Maine, California, and North Carolina are just a few of the states that have enacted such laws, and each state has its own rules around how financial assistance should be approached. These regulations affect when action can be taken before sending statements to patients or sending accounts to collections."  “For example, in Maine, individuals who are eligible for charity care – defined as being at or below 150% of the federal poverty line (FPL) – may not have their bills sent to collections. For individuals over 150% FPL, nonprofit hospitals must wait at least 120 days after they send the first post-discharge bill before sending the bill to collections, by federal law,” Hanas explains.  “In New York, a bill can be sent to collections if the patient has been provided written notification of the financial assistance program within 30 days of the bill being referred to a collector,” Hanas says. “However, for a hospital to participate in New York's indigent care pool, a hospital cannot send a bill to collections if there is a pending financial assistance application.  “In New Jersey, an individual can only be sent to collections for amounts that are determined to be not eligible for charity care,” says Hanas. “A hospital must give applicants written notice informing them about charity care, Medicaid, or NJ FamilyCare, or refer them to a medical assistance program within three months of the date of service. If they don't, then the hospital cannot pursue collections.  “Because every state has different laws, it can be very cumbersome and time-consuming for providers to comply with these changes,” Hanas concludes. “Finding and implementing the tools needed to carry out these requirements can be a challenge.”  Q: How can the right tools help providers meet regulatory requirements without disrupting collections?   “One common theme among many of these regulations is for states to require providers to screen patients at the start of the patient care cycle to make sure they're offered the proper charity care and financial assistance options they may be eligible for,” says Hanas.   “Here's an example,” he continues. “On January 1, 2025, North Carolina enacted the Comprehensive Medical Debt Relief and Reform Incentive Program. The program focuses on two main aspects---providing medical debt relief for patients and helping them access financial assistance by focusing on their presumptive eligibility for charity care. To achieve this objective, hospitals will start to automatically qualify certain patients for charity care by looking at the patient’s FPL to make sure that discounts or full write-offs are applied to their medical services as appropriate.   “This is where a comprehensive end-to-end solution can be of great value,” Hanas notes. “It allows hospitals to obtain the data they need to proactively offer and provide charity care and financial assistance options based on each patient's FPL, which is derived from household income and household size.   “The Collections Optimization solution at Experian Health not only focuses on the collections part of the hospitals' workflows but the charity care part as well. Collections Optimization can return FPL scores for each patient so that these patients aren't being moved further down the patient care cycle and placed into the collections stream if they're eligible for financial assistance or charity care. As a result,” Hanas concludes, “patients are well-served by financial assistance programs, while providers are empowered to implement their programs effectively as they comply with changing state laws.”  Find out more about how Collections Optimization Manager helps providers adapt to constantly evolving challenges with the patient collections process.  Learn more Contact us

Published: February 7, 2025 by Experian Health

Collecting payments from patients has always been tough. Confusing bills, missed reminders and affordability concerns often lead to delays. Billing teams get bogged down in follow-up calls and paperwork, leaving little time for complex cases and a big question mark over whether they're using their time efficiently. As patients shoulder a greater share of their healthcare costs, there's increased pressure to make billing more accessible, transparent and manageable. Could automation be the answer? This article looks at how automation can simplify patient collections for everyone. With faster reminders, more accurate estimates, tailored payment plans and efficient collections management, providers can improve the patient experience and increase collections simultaneously. The importance of automation in patient collections One of the biggest frustrations for billing staff is seeing patients struggle to pay their bills. Medical costs can be daunting, and as patients are confronted with rising prices at the gas pumps and grocery stores, they may feel forced to delay healthcare payments or forego care altogether. Complicated bills with unclear charges and terminology only compound the problem: Experian Health's 2024 State of Patient Access (SOPA) survey found that 69% of providers see patients postpone services when they don't understand the financial impact. Many patients are able to pay their bills, but need clearer and more flexible payment options. In their attempts to support patients, billing teams spend a lot of time managing routine tasks like sending reminders, setting up payment plans and fielding questions about bills and unresolved insurance issues. What if these tasks could be handled automatically? There are opportunities to take advantage of automation, advanced data analytics and artificial intelligence in just about every corner of the collections process. Providers integrating automation in patient collections find it easier to help patients keep up with payments and maintain a steady cash flow — without draining staff resources. The benefits of automation for patient collections Here is a run-down of a few key automation benefits for patient collections: 1. Clearer billing, which boosts better cash flow In the SOPA survey, 88% of providers recognized that upfront price estimates contribute to collections success. Automation makes it easier to calculate accurate estimates based on the provider's current prices and the patient's specific insurance benefits. With user-friendly bills, patients can quickly grasp what they owe without needing to ask their provider for clarification. Automated systems can also issue friendly reminders to patients via text or email so they don't miss payment deadlines. Including quick payment links allows patients to click and pay in an instant. 2. Personalized payment options, which create a compassionate and convenient patient experience A survey by Experian Health and PYMNTs found that patients welcome tailored payment plans that allow them to pay their bills in stages. This is backed up by SOPA findings, which show that 40% of providers have seen reduced friction in patient intake thanks to payment plans. Automation can be used to calculate customized options that fit different budgets. Aligning payment plans to the patients' ability to pay improves the consumer experience and minimizes bad debt. Today's consumers want to choose how they pay for care, yet many providers lack the online and mobile-enabled payment options to support fast and convenient payments. With automation, healthcare organizations can enable multiple secure payment methods across their services and departments, giving patients more hassle-free ways to pay. 3. Increased efficiency, which reduces the admin burden for staff With automation handling routine billing tasks, staff can spend less time on paperwork and more time on patient care, leading to a more efficient and patient-focused service. Overall, automation creates a smoother billing experience. Patients appreciate clear information, convenient payment options, and timely reminders, which makes them more satisfied with their care. Key tools and technologies for automating patient collections When building a toolkit for automated patient collections, providers can choose from a growing range of technologies. For example: 1. Analytics-based collections optimization One way to simplify patient collections is to use data analytics to screen, segment and prioritize self-pay accounts so that each one can be handled in the most efficient way. Collections Optimization Manager screens patient accounts for bankruptcy, deceased status, Medicaid, and charity so staff can focus on higher-yield accounts. After screening, accounts are given a score based on the patient's propensity to pay and then routed to the most appropriate servicing channel. Users can access real-time dashboards and expert consultancy support to monitor and improve collections strategies. This improves the experience for patients, reduces repetitive manual work for staff, and maximizes collections while reducing the overall cost to collect. See it in action: How Wooster Community Hospital collected $3.8M in patient balances with Collections Optimization Manager 2. Financial aid automation Many patients with high out-of-pocket costs and co-pays are unaware that they might be eligible for financial assistance. By using Experian’s comprehensive data, Patient Financial Clearance automatically determines which patients may qualify for financial assistance and even auto-enrolls them in relevant programs. To make this process as easy as possible for patients, the tool prompts them to complete applications whenever it is convenient, either online or through their smartphones. This releases staff from time-consuming manual work and accelerates approvals and payments. In addition, the tool creates individualized payment plans that account for what the patient is likely to be able to afford, thus helping providers collect from patients who do not qualify for charity support, too. See it in action: How Eskenazi Health boosted Medicaid approvals by 111% with financial aid automation 3. Automated upfront, accurate estimates For patients with out-of-pocket bills, getting ahead of any surprise charges with accurate pre-service estimates is essential. Patient Estimates is a web-based pricing tool that pulls together every last detail about chargemaster pricing, payer contracts, insurance benefits and financial assistance policies to generate an accurate estimate for patients. It applies any prompt-pay discounts or payment plans so the patient knows what to expect. Helping patients understand and prepare for forthcoming bills smooths out the payment process and leads to more revenue being collected, sooner. 4. Digitally enabled payment technology The patient-friendly collections experience can be rounded out by offering a choice of digital-first payment methods. PaymentSafe® allows providers to securely accept patient payments at any time, expanding the number of collection points available to patients. The tool automatically integrates data from across the payments ecosystem to pre-populate fields in the patients' accounts, allowing them to pay multiple bills at once, and automatically settles and remits payments. Making it easy for patients to pay accelerates payments, including before and at the point of service. The future of patient collections through automation Bringing together automation and patient collections will continue to simplify and make these processes more patient-friendly. Automation and digital tools will enable more self-service options, making it easy for patients to manage bills, choose payment plans, and make payments at their convenience. Moving toward greater transparency and personalization will also give patients more control. Emerging technologies such as predictive analytics, machine learning and artificial intelligence will give providers greater insights into their patients' financial needs, so they can offer proactive and compassionate support to navigate the process. As these trends gather steam, patient collections will become faster, more adaptable and better aligned with the needs of today's healthcare consumers. Find out more about how simplifying patient collections with automation can improve patient experiences and increase collections. Learn more Contact us

Published: December 11, 2024 by Experian Health

The growing shift from inpatient to outpatient care continues. The U.S. ambulatory services market was estimated at USD 289.5 billion in 2023 and is projected to grow at a CAGR of 5.38% from 2024 to 2030. A Deloitte study notes that the gap between inpatient and outpatient revenue has been closing for two decades. But what's driving this boom? Clinical advances, patient demand for lower-risk and lower-cost options and payer pressure all play a role. New technologies, like advances in orthopedics, allow more procedures to be performed at outpatient service centers instead of costly hospital settings. Free-standing ambulatory surgery sites are expected to see a 14% volume boost over the next decade as more service lines, like cardiovascular and neurosciences, begin to shift procedures from inpatient to outpatient facilities. The ongoing growth in outpatient services presents a unique opportunity for revenue cycle leaders to use technology to improve outpatient revenue—and the overall patient experience. Grow outpatient revenue with more digital care Patients want a better experience at every step of the patient journey. They want to see their doctor faster, manage appointments online and understand how much it costs—with as little red tape as possible. A lack of streamlined patient access and transparency often results in no-shows, a rise in claims denials, wasted staff time and patient complaints. However, by opening the digital front door, providers can give patients the self-service tools they crave, improve the care experience, keep outpatient schedules full and increase revenue. Additionally, providers can use technology like artificial intelligence (AI) to lower claim denial rates. Here are five strategies to increase outpatient revenue in 2025. 1. Make patient access simple Patients want to see their doctor faster. In Experian Health's latest State of Patient Access survey, eight in ten patients who reported being unhappy with their provider experience cited waiting for an appointment as a top complaint. When trying to schedule, patients are also frustrated by the friction that comes with complex processes, clunky technology systems and sparse provider communication. Outdated manual workflows, staffing shortages and lack of staff training often result in challenges for both patients and providers. Improved patient access is at the heart of patient-centered healthcare. Technology designed to put the patient in control, like online patient scheduling and digital patient intake tools, offer continuous patient engagement, optimized scheduling, and streamlined administrative processes. By leveraging modern patient access solutions, providers can improve patient experiences and alleviate the impact of staffing shortages. 2. Reduce appointment no-shows Missed appointments cause headaches for patients, providers, and revenue cycle managers. Online scheduling and mobile registration are also top of mind for patients. In Experian Health's State of Patient Access 2024 survey, 89% of patients said they wanted self-service scheduling and 85% reported a dislike for filling out repetitive intake paperwork. Online patient scheduling software puts patients in the driver's seat, providing convenient and secure 24/7 access to book, reschedule, and cancel appointments on their own time. Solutions like Patient Schedule sync seamlessly to an organization's scheduling rules, and patients receive automated appointment reminders by text or IVR. On average, providers that use Experian Health's scheduling solution experience an 89% show rate, a 50% reduction in scheduling time, and a 32% increase in patients per month. Patient intake tools like Registration Accelerator simplify mobile registration with a streamlined text-to-mobile experience. Once registration is complete, automated returns of forms, patient-check-ins and demographic information ease the burden on staff. 3. Help patients prepare for outpatient costs Patients need a clear breakdown of their financial responsibility before receiving care. Without it, they may be unable to prepare for care costs appropriately. While hospitals are now required to share detailed pricing for at least 300 common procedures, confusion around a patient's actual financial responsibility still persists. More than half of patients report turning to their provider for help understanding what insurance covers. Digital solutions that provide accurate, upfront estimates empower patients. More than eight in ten patients say pre-service estimates help them prepare for the cost of care. Patient Payment Estimates provide upfront, real-time estimates of what a patient will owe. Providers can offer convenient and secure payment links, and allow patients to pay their bills online or see customized payment plans. Outpatient providers can further maximize the chance of reimbursement by running health insurance coverage checks across the entire revenue cycle. This can help find billable coverage that may have been forgotten and give patients greater certainty about what they'll owe. 4. Automate healthcare collections Collections are often a major challenge in the outpatient revenue cycle. Outpatient procedures can be costly, even with insurance, leaving patients responsible for potentially large bills. Automating healthcare collections allows for faster, more efficient, and more compassionate collections. Tools like Collections Optimization Manager helped Novant Health achieve an overall recovery rate of 6.5% and increase revenue and cost savings to a rolling average return on investment of 8.5:1. With automated tools like Patient Financial Clearance, providers can assess patients' ability to pay and assign them to an appropriate financial pathway. This allows patients to quickly get the assistance they need while freeing up valuable staff time. 5. Streamline claims to increase outpatient revenue Denied claims continue to be problematic for providers. In Experian Health's State of Claims 2024 report, which surveyed 210 healthcare revenue cycle leaders, nearly three-quarters of providers feel claims denials are increasing, while 67% feel getting paid is taking longer. Claims management software can help end the cycle of denials. However, around half of providers still use a manual claims review process, and only 28% feel confident in their understanding of automation, machine learning and AI. Adopting automated and integrated healthcare claims management solutions can reduce errors, prevent undercharges, and ensure a higher first-pass payment rate. Tools like Experian Health's ClaimsSource® simplify the entire claims process, while Claim Scrubber helps providers submit more accurate claims. Digital solutions can also automate claim status monitoring and eliminate manual denial processes. Implementing AI tools to interpret past claims data and recommend next steps can improve outpatient claim denial statistics. Tools like AI AdvantageTM look at past payer behavior and historical claims data to predict and prevent denials. AI Advantage's two components, Predict Denials and Denial Triage, help providers respond to growing denial challenges by identifying claims with a high likelihood of denial before submission, and focus on remits that have the most impact. See how: Find out more about how Experian Health's revenue cycle management solutions can help healthcare organizations increase outpatient revenue, keep pace with growing patient volumes, improve patient satisfaction and boost their bottom lines. Learn more Contact us

Published: December 2, 2024 by Experian Health

As more Americans feel the squeeze on their household budgets, paying for healthcare is a growing concern. A 2024 survey by Pew Research Center found that the number of Americans who rate their personal finances positively has dropped from 50% to 40% over the last three years, with nearly 60% of Americans now saying their financial situation is "fair" or "poor." A West Health-Gallup poll revealed that 35% of US adults would struggle to afford care, with some cutting back on essentials like utilities or food to pay for medical expenses. To address and mitigate these financial pressures, healthcare providers must take proactive steps to support patients and avoid a shortfall in collections. Patient payment plans can help patients manage costs without delaying or skipping necessary care. Providers that go the extra mile to improve the patient experience will boost patient attraction and retention rates, reduce collection costs and support the financial health of their patients and their organizations. The growing importance of healthcare payment plans Cost concerns often influence patients' perceptions of their providers. In Experian Health's State of Patient Access 2024 survey, 54% of patients who thought patient access had deteriorated over the previous twelve months said it was because they were less able to afford care. On the flip side, 32% of those who thought patient access was better said it was because payment plans made care more manageable. Healthcare payment plans allow patients to spread out the cost of their medical expenses into smaller, more manageable chunks, instead of paying the full amount at once. Previous research by Experian Health and PYMNTS confirms that patients welcome the flexibility, convenience and reassurance that this offers. This is particularly true of patients who would struggle to pay an unexpected bill: up to a fifth of these patients would switch providers based on the payment experience alone. The clear message for providers is that patients who struggle to pay bills—especially unexpected bills—are more likely to need healthcare payment plans and to seek out a provider that offers them. How flexible patient payment plans improve satisfaction By letting patients pay at a pace that works for them and their budget, payment plans reduce stress and create a more supportive and compassionate financial experience. When patients know they have options, they're more likely to stay on track with payments and feel more satisfied with their overall care. A major advantage is that these plans can be tailored to each patient's unique situation. For example, with PatientSimple®, patients can use a self-service portal to generate pricing estimates and explore suitable payment plans to make a more informed decision about how they'll pay for care. They can break down bills into smaller and more affordable payments, rather than facing the daunting prospect of a single large bill. Using Experian Health's unmatched data and advanced analytics, PatientSimple offers a richer understanding of each patient's propensity to pay, helping providers make better decisions about the optimal financial pathway for each patient. Patients can access their bills and statements online at any time. This is more convenient for them and frees up staff to give more attention to patients with more complex circumstances. Key benefits of healthcare payment plans for patients and providers Improving the patient experience with healthcare payment plans also translates into financial and operational benefits for providers. Helping patients navigate their financial responsibilities more easily — especially through automation and software-based tools — increases cash flow, reduces admin burdens and boosts overall efficiency. Here are a few examples of how payment plans and other financial tools can benefit patients and providers: 1. Patient Financial Clearance automatically screens patients to determine eligibility for Medicaid or other financial assistance programs. Calculating the optimal payment plan based on the patient's ability to pay gives patients more affordable options and providers more predictable revenue streams. Increasing access to financial assistance also increases access to care, as patients are more likely to follow care plans, leading to better health outcomes. Case study: How UCHealth wrote off $26 million in charity care with Patient Financial Clearance 2. Patient Financial Advisor and Patient Estimates give patients a pre-service, personalized breakdown of what their bill is likely to be, using accurate chargemaster data, payer rates and real-time benefits information. This upfront clarity makes it easier for patients to plan for payments, while providers benefit from fewer payment defaults and improved patient trust. And with fewer bills ending up in accounts receivable, providers can reduce the manual effort needed to manage outstanding balances. 3. Helping patients reduce out-of-pocket expenses is another way to achieve a better financial experience, boosting loyalty and retention. Coverage Discovery® finds any forgotten or overlooked commercial and government coverage, so no costs that should be covered elsewhere fall to the patient. The tool scans for potential coverage from pre-service through the entire accounts receivable file, and automates self-pay scrubbing to detect discrepancies that can be quickly corrected. Accounts that were previously destined for collections, charity or bad debt are instead submitted for payment. Case study: How Luminis Health found $240k in billable coverage each month with Coverage Discovery 4. Finally, removing friction from the payment process will always be a win with patients and providers. Consumers increasingly rely on mobile and contactless payment tools, so it makes sense to offer similar options in healthcare. PaymentSafe® allows providers to collect any payment securely and quickly. Patients can pay anytime and anywhere, while providers benefit from faster, more reliable revenue collection. Maximizing patient experience with effective healthcare payment plans Payment plans aren't just a financial lifeline for patients. They can make or break the whole patient experience. Alex Harwitz, VP of Product, Digital Front Door, at Experian Health, explains the importance of healthcare payment plans and why offering flexible payment options is at the heart of improving the patient experience: “Our most recent State of Patient Access report confirms that many consumers are concerned about how they'll handle their healthcare bills. Having a plan to make costs more manageable can immediately alleviate some of that stress. Providers have an opportunity to step up and help them figure out the best financial pathway.” He says, “At Experian Health, we use data and automated technology to help providers identify patients who need extra assistance and direct them toward appropriate support. Providers that don't offer payment plans, estimates and other financial solutions will struggle to attract and retain patients who can't pay upfront and risk more patient accounts being written off as bad debt.” Paying bills will never be an enjoyable part of the patient journey, but clear and compassionate healthcare payment plans make it easier. With the right technology, providers can simplify and accelerate the collections process, foster patient trust, and most importantly, allow patients to focus on their health instead of their bills. Prescribe the right financial pathway for your patients with Experian Health's industry-leading patient collections technology. Learn more Contact us

Published: November 19, 2024 by Experian Health

Self-pay collections are challenging for healthcare organizations of all shapes and sizes, but particularly for mid-size providers. Caught in an awkward middle ground, these organizations are often too large to operate with the agility and personal touch of small clinics, but too small to leverage the economies of scale available to large health systems. Revenue cycle managers must find the balance between operational efficiency, patient-centered services and financial constraints. With limited staff and resources, many mid-size hospitals feel like they're fighting an uphill battle to maintain cash flow and patient satisfaction as they contend with increasingly complex billing and insurance protocols. Implementing self-pay collections strategies tailored to mid-sized healthcare organizations can boost efficiency, reduce bad debt and create smoother patient billing processes. This article looks at practical strategies to help bring more dollars in the door without compromising the patient experience. Importance of effective self-pay collections in the mid-sized market Like other markets, mid-size providers are squeezed by self-pay collections on two fronts – the hospital's financial health and patient satisfaction. Finding the right collections strategy is vital to protect this “double bottom line.” Financially, failure to collect on bills seriously hurts cash flow. Unlike larger hospitals that might have more resources or smaller practices with fewer expenses, mid-size facilities often operate on tighter margins. Inefficient collections processes lead providers to risk revenue loss, which leads to cuts in services, staff and the ability to invest in new tech. At the same time, the way hospitals handle billing and collections plays a major role in how patients feel about their overall healthcare experience. Confusing bills or aggressive collections tactics can damage trust. An effective self-pay collections strategy that makes payments easy, straightforward and flexible contributes to a positive patient experience and will pay dividends in the long run. How to improve self-pay patient collections for mid-size hospitals and facilities Here is a breakdown of some key approaches and tools that can be adapted to suit the specific needs of mid-size providers and make billing and collections more efficient, patient-friendly and cost-effective: 1. Automate as much as possible One of the fastest ways to make better use of resources is with automation. Why have staff spend hours sending out bills and payment reminders by hand when this can be done automatically? Automated collections tools can also send email and text reminders to patients, set up auto-pay options, and guide patients to appropriate payment plans. Automatic alerts for overdue accounts can be used to help staff focus their limited time on high-value activities. This saves time, reduces errors and creates seamless patient experiences. Read more: Maximize patient collections with automated technology 2. Segment and conquer collections Every patient's financial situation is different, so why handle their accounts in the same way? Segmentation divides patients into groups based on their payment behaviors, financial situations and balance size so that providers can tailor their approach. Collections Optimization Manager screens and segments self-pay accounts to scrub accounts that need special handling (like bankruptcy, deceased status, Medicaid and charity) and focus on patients most likely to pay. Accounts are given a segment code based on the patient's propensity to pay, which then informs how the account is managed. For example, those who typically pay on time can get a simple text reminder, while those with larger balances or financial difficulties may need a more flexible payment plan. This solution can also be used with Patient Financial Clearance to create individualized payment plans for patients who may not qualify for charity care. A targeted approach to self-pay billing strategies for mid-sized healthcare facilities increases the chances of successful payments. 3. Implement interactive voice response (IVR) IVR systems allow patients to get important payment information through an automated phone system, without needing to talk to someone. Patients can receive automated voice messages or call in and follow prompts to pay their bills over the phone. Not only does this give patients far more flexibility to pay when convenient for them, but it also reduces the workload on staff, who don't have to handle so many incoming calls. Experian Health's cloud-based dialing platform, PatientDial, helps patients clear their bills quickly and conveniently, with minimal input from staff. In a single year, this tool helped clients collect over $50 million in self-pay collections and save 900,000 labor hours that would have been spent dialing manually. 4. Work with a dedicated collections consultant Bringing in a collections expert gives patient finance teams targeted support to improve collections rates while maintaining a positive patient experience. Clients who use Collections Optimization Manager get dedicated support from experienced revenue cycle consultants who can recommend the most appropriate collections strategies, evaluate opportunities to improve performance, and oversee scenarios to test and adopt new approaches. Some providers may find it more efficient to manage collections in-house, while others benefit from outsourcing to a specialist third party. Experian Health offers collections solutions to both, enabling mid-sized providers to choose the best fit. Collections Optimization consultants provide personalized attention and customized workflows tailored to the organization's needs, whether they're using Epic, Oracle, Meditech or other electronic health record platforms. Integrating patient-friendly billing practices Whatever the strategy, maintaining a positive patient-provider relationship through patient-friendly billing is essential. For example: Simplifying billing statements and using clear language reduces confusion and helps patients understand what they owe Running coverage discovery checks and offering upfront patient payment estimates gives patients greater clarity about their financial obligations Setting up automated reminders nudges patients to pay on time Highlighting available payment plans gives patients manageable options to reduce the risk of unpaid balances. Experian Health's data insights allow providers to better understand patients and develop strategies for proactive outreach before debts become unmanageable. Collection Optimization Manager's segmentation model draws together credit, behavior and demographic data, incorporating socio-economic modeling and income estimations to build a complete picture of each patient. Unlike traditional segmentation models that rely solely on payment history, the CO model includes estimated household size, income and federal poverty line analytics to generate a meaningful score without needing additional data. Automated communications such as PatientText and PatientDial make the billing and payment process less intrusive. Combining convenience and personalization builds trust and improves collections while supporting a more compassionate patient experience. Enhancing revenue for mid-sized medical groups with improved self-pay collections Going back to that “double bottom line,” Judy Wirtz, Senior Analytics Consultant at Experian Health, explains how Experian's collections toolkit helps mid-sized organizations boost financial performance while maintaining a positive patient experience: “Boosting self-pay collections for mid-size healthcare organizations doesn't have to be daunting,” she says. “Our goal is to simplify collections while keeping the patient experience front and center. We use industry-leading data, smart segmentation and dedicated support to help organizations customize their strategies based on their unique patient mix and resources. Other tools fill in different pieces of the collections puzzle, but Collections Optimization Manager is the only one to give providers the full picture. Our clients have seen an impressive 9:1 return on investment, so we're confident this approach makes a real difference.” Wirtz suggests that those who'd like to learn more about Collections Optimization Manager should watch Experian Health's recent webinar with Wooster Community Hospital. The hospital used CO to collect $3.8 million in patient balances. Find out more about how Collections Optimization Manager boosts self-pay collections for mid-size healthcare organizations. Learn more Contact us

Published: November 15, 2024 by Experian Health

Could healthcare organizations be doing more to open their digital front door? According to a 2024 study by HIMSS researchers, hospitals that embrace digital technology see stronger patient experience outcomes. This aligns with Experian Health's most recent State of Patient Access (SOPA) survey, in which patients and providers agreed that patient access had improved thanks to digital technology. Adoption of digital health technology accelerated in response to COVID-19, as healthcare organizations sought to manage demand and facilitate “contactless” access to care. Telehealth, mobile apps and patient portals gave patients more control over their health while allowing providers to deliver more personalized and efficient care. With over half of healthcare providers and nearly a third of patients acknowledging improvements in access since before the pandemic, it's clear that offering more digital options is a powerful strategy to improve patient engagement and streamline access. Progress is encouraging, but there are always opportunities to do more. What is healthcare's digital front door? Healthcare's “digital front door” includes all the digital channels through which patients access care, such as websites, patient portals, mobile registration and payment apps, telehealth platforms and online scheduling tools. The goals are to create convenient and user-friendly entry points for patients to engage with their providers, use online tools to expand access, improve patient satisfaction, and increase operational efficiency. Why a digital front door is crucial for healthcare providers When asked why they believe patient access has improved since before the pandemic, the top four reasons given by patients all relate to scheduling and registration processes: Being able to see a doctor quickly (72% agreed) Checking in and registration (61% agreed) Scheduling appointments (58% agreed) Finding appointments that work with their schedule (57% agreed). In other words, patient access improves when providers open the digital front door. Alex Harwitz, VP, Digital Front Door, at Experian Health, explains that for providers, this equates to two major benefits: 1. Improves patient engagement Harwitz says that putting access in the hands of patients gives patients more flexibility and choice about how and when they book appointments, fill out registration forms and pay for care. “There's a growing demand for easy, accessible healthcare, and opening the digital front door is how we meet it. Digital tools use automation and data analytics to create a more personalized and convenient patient experience, making it easier for patients to remember appointments, adhere to treatment plans and manage their financial obligations,” he says. “That's huge for busy households. The to-do list just got a lot shorter, so it's easier for them to engage.” 2. Streamlines patient access A second key benefit is reducing friction and bloat in patient access workflows. Harwitz says, “By expanding their online offerings, providers not only make it easier for patients to see their doctor sooner, but they also reduce demand on front office staff. Self-service options, performance reporting and data insights allow providers to allocate resources more effectively. It’s about making sure everyone gets the right support at the right time, whether that's online or in the office.” Getting the patient journey off on a strong footing also pays dividends throughout the rest of the revenue cycle: with fewer errors and faster throughput, collections and claims management improve, too. Read more: How patient access technology is transforming the healthcare revenue cycle Key components of a digital front door As more providers offer online patient access, competition for the digital front door is increasing. With 60% of patients looking for more digital and mobile options to meet with providers, schedule appointments, and manage bills and payments, these would be smart areas to prioritize for a competitive advantage. Here's what that might look like: 1. Cut paperwork and calls with self-service scheduling and mobile registration It should come as no surprise that a vast majority of patients say they do not like repetitive paperwork. Online and mobile-enabled scheduling and registration reduce form-filling and lengthy calls. For example, Patient Schedule gives patients a platform to book, cancel and reschedule appointments with ease, anytime and anywhere. Appointments are matched to patients' needs so no slots are wasted and patients see their doctor sooner. Mobile registration increases bookings further. With Registration Accelerator, patients receive a text that prompts them to scan their identity and insurance cards, so they don't need to wait in line to fill out forms. Validating their data from the start also improves billing accuracy and reduces the risk of downstream denials. 2. Make it easier to pay for care Simplifying the financial experience is a major component in opening the digital front door. Patients are worried about the cost of care and say that having accurate price estimates before treatment helps them plan for bills. With Patient Payment Estimates, providers can give patients accurate, upfront estimates of their out-of-pocket costs, while tools like Patient Financial Clearance can help direct them to appropriate payment plans. It's also important to make the actual payment process as straightforward as possible. Accepting payments 24/7 from any device allows patients to pay promptly and helps providers avoid bad debt. Checklist: 5 patient-friendly billing practices to accelerate collections 3. Communicate clearly for a great first impression At its core, opening the digital front door is about creating a welcoming first impression for patients. Patients don't want confusing instructions or radio silence when they have questions. They want proactive, helpful and clear communications. One of the benefits of digital tools is having the data and automation capabilities to send patients timely and personalized messages and reminders using their preferred channels. They can also drive targeted outreach campaigns using text messages and interactive voice responses to encourage patients to book appointments and make payments. The future of healthcare's digital front door These are just a few examples of how providers can expand their digital offerings to make it easier for patients to access care. But what will the digital welcome mat look like in the future? Advances in artificial intelligence, digital apps and wearable tech will transform the way patients interact with their providers. Hockey-stick growth in data generation will make data security and interoperability non-negotiable. It's a big ask of providers. Partnering with an expert third-party vendor will help digitally forward organizations remain responsive and adaptable. Find out more about how Experian Health helps providers open their digital front door with mobile scheduling, registration and payments.

Published: September 3, 2024 by Experian Health

“For too many, coverage is either unavailable or insufficient.” This is the harsh reality the American Hospital Association highlighted in a recent statement to the US Senate, urging action to address growing medical debt. Despite efforts to expand insurance coverage, hospitals continue to lose billions of dollars through unpaid bills. The statement notes that hospitals provided over $42 billion in uncompensated care in 2020 alone. Guiding low-income patients to appropriate charity care programs can mitigate a significant portion of this uncompensated care. Unfortunately, many eligible patients are either unaware of these options or choose not to apply, causing hospitals to waste time and money chasing bills from people who cannot afford to pay. Helping those patients find and apply for financial support is critical to reducing bad debt. But that's a challenging prospect without automation. Presumptive screening with Patient Financial Clearance offers a faster route to reliable charity care classifications and a reduction in uncompensated care. What is charity care? Charity care programs provide free or discounted healthcare to patients who can't afford to pay their bills, covering medically necessary inpatient and emergency room services. Typically, programs offer full or partial discounts to uninsured patients, but those with insurance may be entitled to assistance if their plan doesn't cover their care. Eligibility depends on the hospital's financial assistance policies and relevant state regulations. Hospitals do not expect to be reimbursed for charity care, though tax exemptions and government funding may offset some of the cost. In this way, charity care is distinct from “bad debt,” which refers to unpaid patient bills that hospitals expect to collect. Frustratingly, too many accounts that could have been eligible for charity care are written off to bad debt—perhaps because patients don't realize they're eligible, don't know how to fill out the application, or feel embarrassed to seek help. The problem is further exacerbated by the growth in high-deductible and “skinny” health plans, as patients without sufficient coverage assume support is only for the uninsured. Several states are tackling medical debt by bolstering charity care programs. For example, North Carolina plans to boost federal payouts to hospitals that agree to waive medical debt for low-and middle-income patients. In Milwaukee, County Supervisors are taking a preventive approach, using income data to automatically enroll at-risk patients into charity care programs to stave off bad debt before it takes root, in a process known as presumptive charity. What is presumptive charity? Checking eligibility and helping patients apply for charity care is predictably form-heavy. Patients must provide tax returns, pay stubs, and bank statements to confirm their household income and financial status. Manual reviews are time-consuming for providers, while the overall experience can feel intrusive or confusing to patients. Presumptive charity screening expedites charity care checks by automatically screening patients for financial assistance eligibility. It uses automation and data analytics to quickly evaluate the patient's credit information, financial data and demographic details to make a 'presumptive' determination of eligibility for charity care, regardless of coverage status. Better charity care classifications reduce bad debt Automated charity care checks mean more patients will be classified correctly so hospitals can confidently seek reimbursement from the appropriate source. This offers several advantages, such as: Reducing bad debt: Presumptive charity screening results in fewer eligible patients missing out on financial support, so they're less likely to be sent bills they can't pay. Increasing efficiency: More accurate screening allows staff to cut time spent on administrative tasks and stop chasing collections from patients who are unlikely to be able to pay. Expediting classification decisions: Automation means eligible patients don't have to wait for long periods to find out if they'll get financial support, which is especially important in urgent and high-volume services, such as emergency departments and large hospital systems. Improving the patient experience: Speedy systems with fewer forms reduce the patient's involvement to a minimum, contributing to a more convenient and compassionate financial journey. Maintaining compliance: Hospitals comply and maintain their non-profit status by providing charity care to their community. Supporting patients: Providing accessible healthcare to those who are low-income and are most vulnerable. How can Patient Financial Clearance help providers improve charity care classifications? Patient Financial Clearance (PFC) is a presumptive screening tool designed to help providers quickly determine which patients may be eligible for financial assistance. It then connects those patients with relevant charity care programs and automatically enrolls them, or establishes tailored payment plans for the amount they owe based on their financial situation. First, Patient Financial Clearance triggers automatic checks before or at the point of service to rapidly assess whether the patient qualifies for Medicaid, charity care or other financial assistance programs. It uses Experian Health's superior data and analytics to accurately estimate the patient's income, household size and Federal Poverty Line (FPL) percentage, and it calculates a Healthcare Payment Risk Score to predict their propensity to pay. Unlike alternative models which are built to estimate incomes for consumers with higher incomes, PFC's income estimates are optimized to predict incomes below 400% of the FPL. Then, if patients are likely to be eligible for charity care, the tool pre-populates application forms and initiates auto-enrollment to reduce staff manual input and the risk of errors. There needs to be a prompt process to help patients who do not qualify for charity care manage their bills. For patients who do not qualify for charity care, there also needs to be a prompt process to help. Patient Financial Clearance recommends optimal payment plan amounts per the organization's terms and policies. Staff can pull up summarized and detailed views of the patient's credit history and custom scripts to guide financial counseling discussions. Alex Liao, Product Manager for Patient Financial Clearance at Experian Health, explains how better charity classifications help reduce bad debt and increase collections: “The obvious benefit is that clients can accelerate the charity care application process and ensure eligible patients get assistance quickly. However, having a more accurate picture of patients' financial needs offers wider benefits across the revenue cycle: it ensures each patient account is handled appropriately to increase upfront collections and reduce bad debt. Those with a low ability to pay receive a payment plan they can afford, while those with a greater capacity to pay are not just paying the minimums.” Patient Financial Clearance in practice See how UCHealth used PFC to create a more streamlined approach to charity care classifications, resulting in: $26 million in disbursed charity care. More than 1,700 patients covered. 600 charity cases closed in one month alone (August 2023). To hear more about how automating charity care classifications with Patient Financial Clearance could help your organization reduce bad debt, contact us today for a demo. Patient Financial Clearance Contact us

Published: August 19, 2024 by Experian Health

The fine line between getting paid what they're owed and delivering compassionate care puts patient collections among the top challenges for providers. Improvements to collections processes feature prominently in Experian Health's most recent State of Patient Access survey: 94% of providers pointed to the need for more accurate patient estimates, while equally many want faster, more comprehensive insights into what patients' insurance actually covers so they can make the billing process easier for everyone. The challenge is even starker when the patient's perspective is considered. More than four in ten patients are so worried about the bill that will later land on their doorstep that they’d avoid care altogether. Even those who have insurance are struggling: 53% of total bad debt write-offs in 2023 came from patients with some form of insurance. As healthcare becomes more expensive, insurance becomes more complex, and patients become more cost-conscious, providers must find ways to improve the patient collections processes. This article looks at how technology can bridge these competing demands. What are patient collections in healthcare? Patient collection processes cover all the steps involved in calculating, invoicing and obtaining payment for the amount the patient owes for their healthcare treatment. Figuring out the patient's financial responsibility starts when the patient registers for care and when the provider can check for active insurance coverage. Once verification and eligibility processes are complete and the provider knows how much of the total cost will be covered by an insurer (if any), they can estimate the patient's responsibility. The earlier this happens, the better. What makes the process so complex is the number of moving parts: Payer policies change regularly, and staff must keep up to date or there will be gaps and errors in claims submissions and patient estimates Healthcare costs are increasing, leaving providers with tighter margins and less room to maneuver Patients are increasingly worried about whether they can afford healthcare, as household bills continue to increase despite economic improvements Patients expect a wider range of payment options, with 72% of patients emphasizing the need for online and mobile payments to enhance their health experience. Billing staff cannot tell which patients are able and likely to pay due to insufficient data on patients' economic and credit history. Part of the problem for healthcare providers is that their systems are geared more toward traditional collections from government or private payers. Still, the average patient's responsibility is at an all-time high. For healthcare providers to increase the volume of revenues they collect from patients, they must invest in technologies that provide consumers with a frictionless payment experience. How can patient billing and collections be improved? One way to think about improving patient collections is to break it down into its parts: How to calculate and communicate more accurate, upfront estimates to patients How to figure out a patient's propensity to pay based on segmentation data How to compile and share clear and comprehensive bills and financial statements How to offer patients various digital and mobile options to make prompt payments. Advanced technology offers solutions for each step, while creating a seamless experience overall. In a recent byline, Clarissa Riggins, Chief Product Officer at Experian Health, says that manual systems can't cut it any longer: “It's time to move away from the notion of collections as a one-off, manual and labor-intensive process. Instead, let's view it as a part of an ecosystem that begins before patients receive treatment, starting with upfront, self-service payment options and early screening of patients for potential coverage. In this way, we can transform collections from a destination into a process—and perhaps, by doing so, we can even put our traditional collections departments out of business.” How does technology improve patient collections? Prompt and accurate patient estimates Almost nine in ten providers agree that providing accurate, up-front estimates improves patient collections success. Patient Payment Estimates give patients the expected cost of care ahead of time, so they're in a stronger position to plan – and providers get paid faster. Automated estimates increase revenue and help providers stay on the right side of compliance with rules and regulations. Analytics-based collections optimization When compiling accurate bills to patients and payers, providers have a wealth of technical options at their disposal. For example, Collections Optimization Manager uses in-depth data and advanced analytics so providers can identify patients most likely to pay and ensure patient accounts are handled most efficiently. Patients are segmented by propensity-to-pay scores based on behavioral, demographic and credit data. This supports tailored billing and collections strategies and improves financial outcomes by identifying patients most likely to pay and ensuring patient accounts are handled most efficiently. Case study: See how St Luke's University Health Network used Collections Optimization Manager to improve patient engagement and boost cash collections by 22%. Quick and convenient ways to pay Riggins says that improving payment processes is a significant step toward maximizing patient collections in healthcare. Previous research has shown that while credit and debit cards are the most popular payment methods, patients would use them less often if their preferred digital options were available. Providers should consider digital tools such as PaymentSafe® to offer patients fast, frictionless and secure payment options across multiple collection points, including interactive voice response, mobile, kiosks and patient portals. Automating patient outreach to increase collections Another use case for patient access technology is in facilitating direct and efficient communications with patients while reducing the workload for staff. Automated patient outreach tools such as PatientDial and PatientText send patients timely bill reminders and self-pay options via voice or text message to increase collections without the need for agent interaction. These tools bring more dollars in the door while reducing operational costs: PatientDial helped Experian Health's clients collect over $50 million in one year via automated call campaigns, saving many thousands of labor hours compared to manual outreach. Personalizing payment plans for every individual From the patient's point of view, a winning strategy calls for transparency and personalized support. Creating a collections process that accommodates patients' individual circumstances will increase revenue while improving the patient's financial experience. For example, Patient Financial Clearance analyzes each patient's financial situation and creates a personalized payment path that fits their needs. It screens self-pay patients to identify those who need extra support and reroutes them to the proper channels. Where relevant, providers can then offer the option to pay in more affordable installments or connect the patient to financial assistance programs. Together, these tools improve collections by streamlining how patients pay – and how providers get paid. Maximize patient collections with Experian Health Walking the patient collections tightrope demands that providers take bold action and experiment with new approaches. That might feel risky when the stakes are so high, but working with a trusted vendor with experience in delivering leading patient collections solutions should ease concerns. Experian Health's suite of collections management and secure, reliable payment solutions integrate easily with existing systems and processes for a seamless end-to-end collections experience. Contact us today to learn more about maximizing patient collections in healthcare with Experian Health's leading collections management technology.

Published: August 14, 2024 by Experian Health

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