Tag: price transparency

Almost every day, new developments come from Washington, D.C. regarding the U.S. healthcare system. From the Affordable Care Act and Medicaid expansion to laws and regulations governing cost transparency and debt collection — there's constant fluctuation. This affects healthcare organizations across the country. They don’t know what rules they’ll be operating under in the future, but they do know they’ll have to meet these changing laws and regulations to avoid fines or lost revenue. Consequently, a crucial question emerges: How do you comply without overburdening employees? Compliance with laws and regulations: 3 ways Experian Health can help The answer is in technology. Healthcare organizations need systematic changes and IT solutions that help establish stability and security. For example, Experian Health’s data-driven technologies help organizations remain compliant with laws and regulations while improving the population's health and ensuring more successful collections. Here are three ways Experian Health can help: 1. Early and accurate cost transparency Nearly 30 states have current laws and regulations that require and govern healthcare price transparency. This list will continue to grow, so organizations need to thoughtfully prepare. Even if it weren’t legally required, patients are now demanding more transparency as they bear more healthcare costs. Historically, the problem stems from patients not receiving accurate, upfront cost estimates. They’re surprised and dismayed when medical bills arrive weeks or months after treatment. If patients are unable to successfully budget for these high costs, then collecting payment becomes more difficult. Experian Health’s Patient Estimates solution solves this by producing fast, highly accurate estimates based on a variety of data. Employees don’t need to manually update price lists, which eliminates the guesswork that leads to outdated, inaccurate estimates. Patients can even self-request treatment estimates through a self-service portal or mobile app. When patients know what to expect before they receive treatment, they’re more willing and able to adhere to payment plans. With our Power Reporting feature, organizations can also accurately judge potential and actual revenue recovery to vastly increase the rate of successful upfront collections. 2. Ensured compliance of third-party vendors Accurate and upfront estimates make capturing revenue easier, but they don't eliminate the need for collections. With patients paying higher percentages of medical costs, healthcare organizations now rely more on agencies to collect debt on their behalf. However, if an agency doesn’t comply with all healthcare laws and regulations that govern debt collections, then it could be liable for its practices. The Fair Debt Collection Practices Act (FDCPA), the Telephone Consumer Protection Act (TCPA), and the Truth in Lending Act (TILA) are examples of these regulations. In addition to maintaining overall compliance in your organization, being responsible for a collection agency working on your behalf can be burdensome. This burden increases when a large percentage of your patients live out of state, making them harder to manage. 3. EMV-optimized payment solutions With more payments coming directly from patients, the risk of credit card fraud is exponentially higher. Healthcare organizations can be held liable for any fraud that occurs on their watch if they haven’t upgraded their systems to be compliant for EMV payments. To help avoid credit card fraud or liability, we offer state-of-the-art card acceptance devices. These are powered by our PaymentSafe technology to provide a patient payment solution that is highly secure and EMV-ready. Because PaymentSafe is processor agnostic, it can be integrated with Experian Health’s eCare NEXT suite of products to leverage the data created at other points in the revenue cycle. It also works in a standalone environment and can be used at a kiosk, through a patient portal, or on a mobile app to accept all forms of tender. PaymentSafe and other Experian Health solutions make up an advanced, integrated revenue cycle that consumes and displays information from a wide variety of sources. The goal is to increase collection opportunities and cash flow, lower the costs of collections, allow staff members to use their time more efficiently, and increase patient satisfaction. It also makes it easier to adapt to compliance regulations that can only be met with the help of advanced technology. The country's healthcare laws and regulations may be in flux, but Experian Health continues to help hospitals and medical groups keep up with safe and secure solutions. By providing increased price transparency, better oversight over debt collectors, and highly secure payment solutions, Experian Health’s suite of products can make navigating complex compliance laws and regulations a breeze. For more information about current laws and regulations in the healthcare industry, please visit: S. Department of Health & Human Services — Laws and Regulations overview Health Insurance Portability and Accountability Act (HIPAA)

Experian Health is pleased to announce that its Patient Estimates solution has joined the athenahealth® Marketplace, also known as  the More Disruption Please (MDP) program. Experian Health has participated in this program since the launch of the marketplace in 2013 (starting with our Contract Management offerings) and has worked with athenahealth to integrate its industry-leading capabilities into the organization’s growing network of more than 73,000 healthcare providers. Learn more about Experian Health’s Patient Estimates solution. Read the press release To learn more about athenahealth’s MDP program and partnership opportunities, please visit https://www.athenahealth.com/disruption.

Experian Health is pleased to announce that we went live with Patient Estimates at St. Clair Hospital located in Pittsburgh, PA on February 22, 2016. A true representation of vendor and hospital collaboration and commitment, the Patient Estimates cost transparency tool gives St. Clair a competitive edge as the first hospital in its region to offer patients cost estimates in advance. Patient Estimates is not a list of charges, but an interactive and user-friendly tool that provides information that is highly specific to the individual. Estimates are designed to determine, in advance, each patient’s out-of-pocket costs (deductibles, co-pays and co-insurance) for services at St. Clair based upon his/her insurance coverage. The estimates also incorporate St. Clair’s discounts for payment on the date of service and for those without insurance. The estimates remain in the system and can be recalled for future reference. Patient Estimates is simple to use and is conveniently available 24/7 at www.stclair.org. On the home page, patients will select the “Financial Tools” option, then click on Patient Estimates. They will then enter their health insurance information before choosing one of the 100 listed clinical services (e.g., a procedure, treatment or diagnostic test) from the drop-down menu. The tool then provides a customized estimate of their out-of-pocket expenses. Patient Estimates is designed to help insured and uninsured patients get clear, real-time, easy-to-understand cost estimates for St. Clair’s services so patients can make informed decisions about their care. Below are some of the press mentions of St. Clair Hospital's implementation of Patient Estimates: Pittsburgh TRIBLIVE https://bit.ly/1oxlKna Pittsburgh Post-Gazette: https://bit.ly/219dqfd Pittsburgh Business Times: https://bit.ly/1QWfqNa

There’s a unique dichotomy in healthcare that’s not found in other service industries. For example, when you go out to eat at a restaurant, you don’t expect the server to ask you to pay before the meal is served. Conversely, you also don’t expect to walk out of the restaurant after the meal without paying. However, if you have ever ordered the special of the day and been shocked when the check arrives and the item costs twice as much as other menu items, you can certainly understand the patient’s viewpoint. How can a patient make informed choices about his or her healthcare without knowing the cost? Price transparency – one of today’s hottest healthcare topics – offers significant benefits to both providers and patients, including: Empowering the patient to make well-informed decisions on healthcare treatments Improving patient satisfaction and involvement with their care management Allowing appropriate upfront collections based on realistic estimates Serving as a foundation for establishing payment plans or seeking charity The difficulty of providing a reliable estimate has hindered efforts to collect from patients at the point of service, when they are most likely to pay. In order for the estimate to be relevant and timely, it must bring together financial data from the chargemaster, claims history and payer contract terms, and integrate that with the patient’s insurance benefits. Thankfully, this is a task that is ideally suited to technology. Not only can you use a payment estimator to quickly and easily create a targeted estimate, healthcare organizations can also eliminate the need to manually update price lists, as well as remove guesswork and tedious searches through potentially outdated patient information. An estimator is the base of an effective upfront collections strategy, and is complemented by the ability to determine if a patient is eligible for charity care in addition to their propensity to pay. An additional complement is to streamline the payment process by facilitating the collection of patient open balances through eChecking, signature debit, credit, recurring billing, cash, check or money orders. The ability to create price transparency that is applicable to each patient’s individual situation is critical to a healthcare organization’s financial performance.