Tag: state of patient access

Key takeaways: Many eligible patients don't apply for charity care simply because they don't know it's available, leading to financial strain for patients and providers. Improving charity care communication helps patients understand their options early, builds trust and reduces uncompensated care for providers. Automating financial assistance screening with tools like Patient Financial Clearance supports compassionate financial conversations and ensures more patients are connected to support at scale. Patients face difficult choices when the cost of care feels out of reach. Some hesitate to proceed with planned services due to affordability concerns, even though financial assistance may be available. For providers, Medicaid rollbacks under the budget reconciliation bill could leave more patients without coverage, increasing the volume of uncompensated care and making revenue less predictable. Charity care programs provide a financial safety net – but only if patients know about them. This article looks at how improving charity care communication connects more patients to the financial support they need. Why clear communication about charity care matters Charity care programs are designed to remove financial barriers to care for those most in need. They provide full or partial discounts to uninsured or underinsured patients for medically necessary services, as set out in hospital policies and state-level regulations. However, according to a 2025 Lown Institute study, millions of eligible patients do not apply because they do not realize the support is available. This lack of charity care awareness could affect care decisions. Experian Health's 2025 State of Patient Access survey found that 43% of patients would consider cancelling or postponing care without an accurate cost estimate. Meanwhile, 34% report they often struggle to pay for healthcare, and 95% say they experience affordability challenges at least occasionally. Making patients aware of available support means they'll feel more confident about what they owe, build trust in their provider and reduce the risk of uncompensated care. The barriers patients face when learning about financial assistance Limited information isn't the only reason for low charity care uptake. Confusing eligibility rules and complicated application processes also make support harder to access. Socioeconomic factors, language barriers and poor digital literacy compound these obstacles. Without action, the challenge looks set to intensify. A Kaiser Family Foundation investigation found that hospitals in states with limited access to Medicaid generally had higher charity care costs. With the Congressional Budget Office projecting that changes under the “One Big Beautiful Bill” Act will result in a further 16.9 million Americans without insurance over the next decade, improving charity care and patient education is likely to become more urgent. Jason Considine, President at Experian Health, explains: “When coverage gaps widen, healthcare providers must be financial advocates for their patients. Hospitals can't afford to wait for patients to ask for help or default on bills. It will become even more important for providers to guide the financial journey. This includes helping patients qualify for financial aid or identify personal payment plans." He says, "Proactive financial screening must be embedded throughout the patient journey and providers need to take every opportunity to help patients understand their options. It's not just about protecting revenue, it's about ensuring that every patient has access to the care they need, regardless of their financial circumstances. That means offering clear education, transparent communication and robust charity care options at every touchpoint.” “When coverage gaps widen, healthcare providers must be financial advocates for their patients. Hospitals can't afford to wait for patients to ask for help or default on bills. It will become even more important for providers to guide the financial journey.”- Jason Considine, President at Experian Health How to build trust when discussing financial support to patients For many patients, discussing financial hardship can be uncomfortable. Providers must approach these conversations with empathy, clarity and consistency. When thinking about how to explain charity care to patients, staff should focus on using plain language, avoiding jargon and being as clear and compassionate as possible. Timing matters as much as tone: patients who understand their options early are more likely to meet their financial obligations. Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health, says talking about financial support should be normalized as part of the standard intake process: "While we know a lot of patients worry about cost, there are also those who are unsure if it's okay to bring up,” Liao says. “When providers take the first step and lead the conversation, it takes the pressure off patients and gives them extra reassurance. They feel more comfortable having honest and judgment-free discussions about how to manage their bills." Strategies for improving charity care awareness and understanding Liao says that providers need practical strategies for holding compassionate financial conversations: “Compassion isn't just about how we speak to patients. It's about making sure they trust and process the information they're given, and can act on it,” he says. “That means meeting patients where they are – financially, culturally and technologically. Staff should be trained to explain assistance options confidently and consistently, using standardized messaging, multilingual materials and awareness of culturally appropriate messaging.” Technology can further close the gap. Patient portals, SMS tools and mobile apps can deliver personalized financial messages and guide patients through eligibility pathways in a way that's particularly convenient for younger or mobile-first populations. Integrating charity care communication with eligibility screening Of course, these conversations depend on knowing who needs support in the first place. Automated screening processes make it easier to identify patients who qualify for assistance. This should be done as early as possible, so patients get early clarity about any support that may be available. Embedding charity care screening directly into scheduling, pre-registration and intake workflows means staff can proactively flag patients who need help before balances become unmanageable. By identifying eligible patients upfront, providers can reduce downstream bad debt and avoid the costs of collections and write-offs. On-demand webinar: Hear how Eskenazi Health boosted Medicaid charity approvals by 111% with financial aid automation Discover how Eskenazi Health partnered with Experian Health to automate the entire financial assistance process. How Experian Health supports better charity care communication at scale As states mandate charity care screening, Liao says these processes should be scalable: “We're seeing more states pass legislation that requires screening for financial assistance in hospitals. With other bills like Oregon's HB3320 being enacted, more patients will need to be screened for charity care eligibility. Because more individuals may now qualify, healthcare providers will need an efficient way to screen at scale and make sure patients are informed about their options. A tool like Patient Financial Clearance does well with volume.” Patient Financial Clearance helps reduce the manual burden of screening patients for financial assistance by automatically estimating the patient's income, household size and Federal Poverty Line percentage, and then scoring their propensity to pay. It can pre-populate charity care applications and help suggest custom-tailored payment plans to make patient bills more manageable. Automating key steps and communicating options early in the process helps staff and patients have better financial conversations. Patient Financial Advisor builds on that by allowing providers to contact patients directly with clear, upfront cost information before their visit. It sends a pre-service text message with a secure link to real-time estimates based on current rates and benefits data. Patients can easily see what they owe, explore available assistance and make secure payments, all through an intuitive, mobile-friendly platform. On-demand webinar: The X Factor - Using Experian data to drive financial assistance automation Discover how your peers are automating processes to meet new state charity screening regulations and finding new efficiencies. Empowering patients through transparent financial communication Too often, patients miss out on financial assistance simply because no one told them it was available. That communication gap creates a risk for patients facing unexpected bills, and for providers managing uncompensated care. Transparent financial conversations help remove barriers to care and build trust between patients and providers. With more patients likely to fall into eligible categories in the coming months and years, healthcare organizations need to rethink how and when they talk about financial assistance. Experian Health helps providers take a more proactive and compassionate approach to charity care communication, with scalable strategies that leave no patient overlooked. Learn more about how Experian Health's financial assistance solutions simplify charity care communication, so more patients get the help they need. Learn more Contact us

Key takeaways: As healthcare costs increase, the demand for patient financial assistance also rises as more patients find themselves without insurance coverage or facing economic hardship. Early identification of charity care eligibility reduces patient financial stress, makes the financial experience more compassionate, and protects providers from bad debt. Automated screening tools like Patient Financial Clearance, built on accurate, real-time data, are essential for flagging eligible patients before accounts go to collections and ensuring that no one misses out on vital support. Too often, patients who qualify for financial assistance aren't identified until after their accounts have been sent to collections. As healthcare costs increase and coverage becomes less certain, more patients will likely face financial challenges, making timely support even more critical. With estimated income data and financial behavior indicators, healthcare organizations can identify patient eligibility for charity care earlier, before the bills pile up. This article looks at how automated charity screening tools like Patient Financial Clearance can help providers support patients, protect revenue and remove the financial barriers that get in the way of care. The rising demand for patient financial assistance Demand for financial support is climbing quickly as economic pressures and policy changes make it harder for patients to keep up with medical costs. Nearly one in four adults are uninsured, often delaying or forgoing care because of high deductibles and out-of-pocket costs. Medicaid redeterminations have already resulted in more than 19 million disenrollments. At the same time, the Congressional Budget Office estimates that new federal spending provisions could push an additional 10.9 million people out of health coverage by 2034. As a result, revenue cycle teams will increasingly find themselves trying to collect payments from patients who are more likely to need financial help. "We're also seeing more states pass legislation that effectively mandates early screening for financial assistance before billing, such as Oregon's HB 3320," says Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health. "These policies are becoming major drivers of financial clearance efforts. Identifying financial need early in the process helps patients avoid unexpected medical debt, and gives providers the insight they need to manage accounts appropriately and protect revenue." For providers, growing administrative costs, claim denials and underpayments mean less flexibility to absorb uncompensated care. Early screening protects against the burden of medical debt and facilitates the transparency and clarity patients need to manage their bills. Why does early identification of patient charity care eligibility matter? When charity care eligibility is missed or delayed, patients can quickly accumulate medical debt they can't afford. In an interview about the latest State of Patient Access survey, Clarissa Riggins, Chief Product Officer at Experian Health, explains why this is so important: "Cost is a major pain point," she says. "The report shows that 34% of patients struggle to pay for healthcare. That number is up from 23% last year. And nearly all patients, 95%, say they at least sometimes have trouble paying. It's clear that affordability is still one of the top reasons people delay care." Identifying charity care eligibility early on ensures these patients don't fall through the cracks. This reduces financial stress for patients and protects providers from avoidable write-offs and bad debt. When staff know which patients are likely to need support, they can have more compassionate and helpful financial conversations and connect patients with appropriate resources. Unlock patient charity care eligibility with automated screening  Manual charity care screening processes are often time-consuming and prone to delays, especially when staff have huge volumes of information to handle. Automated financial assistance screening tools use real-time data to identify patients who may qualify for charity care with greater speed and accuracy. For example, Patient Financial Clearance (PFC) helps providers screen patients earlier in the financial journey by automatically checking for eligibility at or before the point of service. It uses a range of estimated data points, including household income, household size and Federal Poverty Level (FPL) percentage, to assess whether a patient qualifies for charity care, Medicaid or other financial assistance. After calculating a risk score to evaluate the patient's propensity to pay, PFC can pre-fill application forms, reducing the need for staff input and accelerating enrollment. For those who may not qualify for charity care, PFC can recommend payment plan options that align with the provider's financial policies. This proactive, behind-the-scenes screening enables providers to flag eligible patients at multiple points in the care journey, ensuring more patients get the support they qualify for while minimizing manual work for staff. Case study: How UCHealth wrote off $26 million in charity care with Patient Financial Clearance See how UCHealth partnered with Experian Health to create a more streamlined approach to providing charity care to patients who needed it. Take a smarter approach to patient financial assistance with Experian Health Automated charity screening tools like Patient Financial Clearance are faster, more consistent and easier for staff to act on. But they'll fall short without reliable data. "Strong data practices are key," says Riggins. "That means better systems to catch errors before they become problems, regular staff training, and giving patients the chance to double-check their records… By automating tasks traditionally performed by human staff, healthcare organizations can save time associated with administrative intake and coverage verification. This also means solving for bad data in real-time, which can prevent billing and claim errors in the long run. Clean data makes everything easier, from billing to insurance verification to patient trust." She gives the specific example of Patient Access Curator, which uses artificial intelligence to run multiple data checks at once, covering eligibility verification, coordination of benefits, Medicare Beneficiary Identifiers, demographics, and coverage discovery. When thinking about how to use data to find charity care eligible patients, tools like this lay the foundation for more proactive financial engagement. By cleaning up data and automating repetitive tasks, Experian Health's revenue cycle solutions enable providers to streamline their financial operations and give financial counsellors the details they need to engage patients at the right time and help them understand their options. The bottom line Automation and accurate data aren't just backend upgrades. They're essential to building a smarter, more compassionate financial experience, with fewer accounts going to collections. By embracing the best practices for identifying patients needing financial assistance, early action, better data quality, and automation, providers will be better placed to make sure no one misses out on the help they need. Find out more about how Patient Financial Clearance can help healthcare organizations automate financial assistance and identify patients eligible for charity care. Learn more Contact us

Key takeaways: Error-prone manual processes are a top reason for delayed reimbursements. Automation across the revenue cycle can help providers see quicker reimbursements. Many processes can be automated: patient estimates, eligibility verification checks, collections, claims management, and more. Prompt reimbursements are crucial for today's healthcare organizations. Delayed reimbursements can lead to a domino effect that impacts the entire revenue cycle. Provider productivity goes down along with quality of care, patients have poor experiences and the bottom line takes a hit. Reimbursement delays often stem from error-prone, outdated manual processes, overburdened staff and excessive administrative work. However, incorporating revenue cycle management automation can help providers overcome numerous reimbursement challenges and improve processes overall. With revenue cycle automation, providers can eliminate many persistent pain points in traditional revenue cycle management (RCM). Staff no longer lose time to tedious manual tasks, patients get their queries answered faster, and managers get the meaningful data they need to drive improvements. And the biggest win? It's easier for providers to get reimbursed for their services, faster and in full. What is revenue cycle automation and how does it work? Healthcare revenue cycle management knits together the financial and clinical components of care to ensure providers are properly reimbursed. As staff and patients know all too well, this can be a complex and time-consuming process, involving repetitive tasks and lengthy forms to ensure the right parties get the right information at the right time. This requires data pulled from multiple databases and systems for accurate claims and billing, and is a perfect use case for automation. In practice, revenue cycle automation involves using technology to complete tasks and processes that may have previously been manually completed. These tasks might include: Automatically generating and issuing invoices, bills and financial statements Streamlining patient data management and exchanging information quickly and reliably Processing digital payments Collating and analyzing performance data to draw out valuable insights. Understanding the challenges in traditional revenue cycle management When it comes to delayed reimbursements, providers lacking revenue cycle management automation typically face the following challenges: Inefficiencies in patient access According to The State of Patient Access 2025, front-end operations are still a source of friction for patients and providers. Four out of the five top patient access challenges reported by providers relate to front-end data collection. Top concerns include insurance searches, reducing errors, and speeding up authorization. Nearly 48% say data collected at registration is “somewhere” or “not” accurate, while 85% report an urgent need for faster, more comprehensive insurance verification. Rising claim denials due to manual errors The State of Patient Access also showed that manual, error-prone processes often lead to delays, claim denials and patient frustration. In fact, more than half (56%) of providers say patient information errors are a primary cause of denied claims. When claims are denied, reworks are often time-consuming, costly and place additional burdens on already overworked staff. Difficulty in managing patient collections Due to rising costs, confusion over estimates and a lack of patient payment options, providers are often left to deal with unpaid medical bills. According to Experian Health data, 29% of patients say paying for healthcare is getting worse. Affordability is a key factor, but patients are also struggling to understand how much their insurance covers and looking for convenient payment options, like payment plans. Download The State of Patient Access 2025 report for a full run-down of patient and provider views about access to care. Six ways revenue cycle automation accelerates reimbursements Revenue cycle improvement through automation can help speed up reimbursements for healthcare providers by: 1. Capturing accurate information quickly during patient access Gathering patient data manually is time-consuming. Errors in the process can lead to denied claims and roadblocks in patient care. Tools like Experian Health's Patient Access Curator use artificial intelligence (AI) to streamline patient access and billing, improve data quality and address claim denials from the outset. This solution also ensures that all data is correct on the front end by checking eligibility, coordination of benefits (COB), Medicare Beneficiary Identifier (MBI), demographics and insurance discovery. 2. Simplifying collections and focusing on the right accounts Healthcare collections are a drag on resources. Automating the repetitive elements in the collections process helps reduce the burden on staff. Collections Optimization Manager leverages automation to analyze patients' payment histories and other financial information to route their accounts to the right collections pathway. Scoring and segmenting accounts means no time is wasted chasing the wrong accounts. Patients who can pay promptly can do so without unnecessary friction. As a result, providers get paid faster. 3. Reducing manual work and staff burnout Chronic staffing shortages continue to plague healthcare providers. In Experian Health's recent staffing survey, 96% of respondents said this affected payer reimbursements and patient collections. While automation cannot replace much-needed expert staff, it can ease pressure on busy teams by relieving them of repetitive tasks, reducing error rates and speeding up workflows. 4. Maintaining regulatory compliance with minimal effort While regulatory compliance may not directly influence how quickly providers get paid, it does play a crucial role in preventing the delays, denials and financial penalties that impede the overall revenue cycle. Constant changes in regulations and payer reimbursement policies can be difficult to track. Automation helps teams continuously monitor and adapt to these changes for a smoother revenue cycle, often with parallel benefits such as improving the patient experience. One example is Experian Health's price transparency solutions, which help providers demonstrate compliance with new legislation and provide extra clarity for patients. 5. Improving the end-to-end claims process Perhaps the most apparent way RCM automation leads to faster reimbursement is in ensuring faster and more accurate claims submissions. Automated claims management solutions, like Experian Health's award-winning ClaimSource®, reduce the need for error-prone manual processes, while improving accuracy and efficiencies in the claims editing and submission process. Additional claims management tools, like Claim Scrubber, also help providers submit more complete and accurate claims. Other tools, like Denial Workflow Manager, can be used if claims are denied. With automation and its extensive data analysis capabilities, work lists are generated based on the client's specifications, like denial category and dollar amount, to identify the root cause of denials and improve upstream processes to prevent them. And as artificial intelligence (AI) gains traction, providers are discovering new ways to use technology to improve claims management. AI Advantage™ uses AI and machine learning to find patterns in payer behavior and identify undocumented rules that could lead to a claim being denied, alerting staff so they can act quickly and avert issues. Then, it uses algorithmic logic to help staff segment and rework denials most efficiently. Providers get paid sooner while minimizing downstream revenue loss. 6. Providing better visibility into improvement opportunities Finally, automation helps providers analyze and act on revenue cycle data by identifying bottlenecks, trends and improvement opportunities. Automated analyses bring together relevant data from multiple sources in an instant to validate decisions. Machine learning draws on historical information to predict future outcomes, so providers can understand the root cause of delays and take steps to resolve issues. A healthcare revenue cycle dashboard is not just a presentation tool; it facilitates real-time monitoring of the organization's financial health, so staff can optimize workflows and speed up reimbursement. Embracing automation for a more efficient revenue cycle Like any business, healthcare organizations must maintain a positive cash flow to remain viable and continue serving their communities. Revenue cycle automation strategies can cut through many of the common obstacles that get in the way of financial stability and growth and speed up reimbursements. Learn more about Experian Health's revenue cycle management technology and see where automation could have the biggest impact on your organization's financial health. 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Revenue cycle management (RCM) plays a central role in healthcare, influencing both patient access and the financial well-being of providers. As healthcare organizations navigate growing costs, shifting patient expectations, and increasingly complex administrative tasks, they're finding themselves at a crossroads. Experian Health's State of Patient Access 2025 report offers a look at these challenges from the views of patients and providers, while showcasing how technology is changing the way we approach patient access and revenue cycle operations. In this interview, Clarissa Riggins, Chief Product Officer at Experian Health, shares key takeaways from the report, offers actionable solutions for providers, and outlines trends that are set to shape the future of RCM.  Q1: "Let's start with the big picture. What's going on with patients' access to healthcare right now?" Riggins says, "It's stabilizing, which is a good sign. According to The State of Patient Access 2025, 68% of patients and 43% of providers say access has stayed the same. That's the highest it's been since 2022. Only 15% of patients said it's gotten worse, and that's the lowest number we've seen in a few years."  Q2: "That's reassuring. But there are still challenges, right? What are patients struggling with most?"  "The number one issue continues to be wait times," explains Riggins. "About 25% of patients said getting in to see a provider quickly is still a major hurdle. On top of that, 22% reported delays because of insurance verification, and 20% said they ran into problems with errors in their medical records or billing information. So, while some things have improved, there are still gaps to close.”  Q3: "You mentioned insurance verification. How much of a barrier is that?" "It's a big one," she says. "When insurance verification isn't seamless, it creates a domino effect. That 22% figure I mentioned, those are people who had to wait for care because their insurance details weren't sorted out. Automating that part of the process can make a huge difference in getting people the care they need faster.” Q4: "Are digital tools making a difference in these areas?"  "They have the potential to, but adoption is a challenge. 37% of providers said one of their biggest obstacles is getting patients to actually use the tools available. And 55% said patients don't know how to navigate self-scheduling. We're seeing some resistance, but it's not because the tech isn't there. It's more about awareness and ease of use. She continues, "For example, going back to insurance eligibility, Experian Health's Patient Access Curator uses artificial intelligence (AI) to automatically check coverage in real time. This helps providers confirm benefits instantly and spot issues early. That kind of automation takes the guesswork and delays out of the equation, so patients can get the care they need without unnecessary holdups. It's not just more efficient for staff; it literally speeds up access to treatment."  Q5: "Let's talk about cost. How is that affecting access for patients today?"  “Cost is a major pain point," she explains. "The report shows that 34% of patients say they often struggle to pay for healthcare. That number is up from 23% last year. And nearly all patients, 95%, say they at least sometimes have trouble paying. It's clear that affordability is still one of the top reasons people delay care."  Q6: "What can providers do to improve the payment experience for patients?"  “It starts with transparency. Patients want to know what they'll owe before they get care. When 81% of patients say they feel more prepared after receiving an accurate estimate, it shows just how critical that upfront information is," Riggins notes. "Experian Health's Patient Estimates solution was built around this need. It allows providers to give patients clear, personalized cost estimates before they receive care, helping them feel informed and in control." "And 43% said they would consider canceling or postponing care if they didn't get that information," she continues. "That's huge. It proves this isn't just about convenience; it's about access. These tools help patients avoid financial surprises, which can be the deciding factor in whether they follow through with treatment." “This solution isn't just making billing easier. It's directly supporting better health outcomes by making care more accessible and less intimidating financially."  Q7: "So, it's not just about having the tools. It's about how they're used?"  "Exactly. Providers need to make sure the tools are easy to use and that patients understand how to use them. That means clear instructions, mobile-friendly interfaces, and support when people get stuck. If the experience feels complicated, people just won't engage." Q8: "What are patients looking for when it comes to better access?"  "Patients are very clear. They want convenience," Riggins says. "According to The State of Patient Access 2025 report:  82% don't want to complete forms multiple times if their information hasn't changed  80% want to be able to schedule appointments from their phone (via a browser or an app)  77% want a heads-up on insurance coverage before treatment  52% want more digital options, period  So, if providers listen to these preferences and meet patients where they are, access improves naturally."  Q9: "What about billing and patient record issues? How can providers avoid those mistakes?"  "Strong data practices are key. That means better systems to catch errors before they become problems, regular staff training, and giving patients the chance to double-check their records. Adding tools like Patient Access Curator can really make a difference. It uses artificial intelligence to handle a bunch of tasks all at once – eligibility checks, COB, MBI, demographics, and insurance discovery. By automating tasks that are traditionally performed by human staff, healthcare organizations can save time associated with administrative intake and coverage verification. This also means solving for bad data in real-time, which can help prevent billing and claim errors in the long run.  Clean data makes everything easier, from billing to insurance verification to patient trust," Riggins concludes.   Patient access is evolving, but not without its challenges. As the State of Patient Access 2025 report highlights, stability is improving, but issues like price transparency, low adoption of digital access tools and insurance verification continue to create friction. The path forward lies in listening to what patients are asking for: easy-to-use digital tools, clear pricing, and fewer administrative headaches. By utilizing automation and AI, providers can streamline access and build stronger, more trusted relationships with their patients.  Learn more about how Experian Health can help healthcare organizations improve patient access, and download the report for the full survey results.   Download now Contact us

Healthcare providers have heard it before – high employee turnover and the constant need to train on new solutions can severely impact the efficiency of revenue cycle management (RCM) teams. As denials increase, the resources required to address them grow, putting additional strain on healthcare providers and their teams.  For decades, manual claim management has been the cornerstone of revenue cycle operations. However, with shifting payer algorithms, higher patient volumes, and evolving insurance coverages, this approach is no longer sustainable. Getting the highest percentage of claims paid with the exact amount of human capital is unachievable. Many health systems can't keep up, and RCM teams are experiencing burnout. There is a glaring need for the rapid adaptation of automation to improve front-end data collection, where reducing errors can have the highest impact on claims, and the teams responsible for them. According to Experian Health's latest State of Patient Access survey, 56% of providers say patient information errors are a primary cause of denied claims, 48% report inaccuracies in data collected at registration, and 83% emphasize the urgent need for faster, more comprehensive insurance verification.  Front-end operations are a major source of friction. Four out of the five top patient access challenges reported by providers relate to front-end data collection, including improving insurance eligibility searches, reducing errors and speeding up authorizations. Is it any wonder that these actions are typically performed by hard-working and taxed humans?   These inefficiencies don't just slow down internal workflows. Manual, error-prone processes lead to delays, claim denials and patient frustration, not to mention low morale with revenue cycle teams trying to find the errant data. Providers note that staffing shortages are compounding the problem, which suggests that tackling front-end workflows would be a strategic operational win.  How Patient Access Curator enhances revenue cycle efficiency  What if providers could take that manually laden process, integrate automation, and allow their staff to apply their revenue cycle experience, equity and strategic thinking in the right place?   Patient Access Curator (PAC) uses automation and artificial intelligence (AI) to streamline patient access and billing, address claim denials and improve data quality without the need for human intervention. This integrated solution performs rapid eligibility, coordination of benefits (COB), Medicare Beneficiary Identifier (MBI), demographics and insurance discovery checks to ensure that all data is correct on the front end, freeing teams up to focus on more strategic tasks.   It doesn't require the long training requirement of standalone products; it fits seamlessly into existing EHR systems, and works directly within the system, with no need for drawn-out onboarding programs.   According to one of the early adopters of the Patient Access Curator, their revenue cycle team is already seeing – and feeling – the results of automation.   A Senior Director of Revenue Cycle at a large Midwestern health system says, “One of the primary reasons we chose the Patient Access Curator was because it makes the normally manual work of revenue cycle much easier, which in turn improves productivity, empowerment and morale. Registrars are now able to make determinations right within the system. It's easy to use.” With so much data to capture, manual strategies are bound to stumble and apply downward pressure on those tasked with high-volume work. Patient Access Curator removes the need for manual checks on multiple payer websites and data repositories to verify insurance eligibility, and checks for any billable coverage that might have been missed. Experian Health's industry-leading claims management products are designed to simplify these processes. The  newest denial prevention technology  strengthens this suite with capabilities previously unavailable.  Efficient claims management with artificial intelligence and automation  Patient Access Curator captures and processes patient insurance data at registration using an “if-then” logic that returns multiple data points from a single inquiry, in seconds. Registration staff can leverage this technology to collect and verify much of the information they need to compile an accurate claim, with just a single click. In a matter of seconds, they'll have a comprehensive readout of:  Eligibility verification: PAC automatically interrogates 271 responses, flagging up active secondary and tertiary coverage information to eliminate coverage gaps Coordination of Benefits: Integrating with eligibility verification workflow, PAC automatically analyzes payer responses to find hidden signs of additional insurances that may be missed by a human eye, and triggers additional inquiries to those third parties to determine primacy, for faster COB processing Medicare Beneficiary Identifiers: PAC uses AI and robotic process automation to find and fix patient identifiers so no one misses out on essential support  Insurance discovery: For patient accounts marked as self-pay or unbillable, PAC automates additional coverage searches Demographics: The platform can quickly check and verify patient contact information Patient Access Curator achieves such speedy results “because the underlying code acts like a Rosetta Stone, automatically translating the language of the user and the health system into the terms required by the payer,” says Jordan Levitt, Senior Vice President of Experian Health. “This means data can be transferred easily between interfaces.” Hear how Columbus Regional Hospital has used the Patient Access Curator to simplify and streamline its revenue cycle operations. With Patient Access Curator, better data adds up to increased revenue cycle efficiency, along with the following:   Reduced errors: Automation minimizes human intervention in repetitive tasks.  Faster processing: Automated systems can handle large volumes of claims and payments much faster than manual processes, accelerating the reimbursement cycle, improving cash flow and reducing delays in revenue collection.  Enhanced compliance: Automation tools like Patient Access Curator are continually learning from inputs, and adapt to stay up-to-date with evolving regulatory requirements and payer policies. This ensures that claims are compliant, reducing the risk of denials and costly rework.  Improved denial prevention: Patient Access Curator identifies patterns in historical claim data, flagging or fixing potential errors before submission. This proactive approach helps in preventing denials and optimizing revenue recovery.  Streamlined workflows: Automation frees up staff from mundane tasks, allowing them to focus on strategic initiatives such as patient engagement and financial planning. This leads to more efficient use of resources and improved overall productivity.   At a time when revenue cycles are under increasing pressure from changing payer rules, labor dynamics and operational constraints, this new solution offers a long-awaited boost to both reimbursement rates and productivity. Patient Access Curator is available now – learn how it can help healthcare organizations boost revenue cycle efficiency and prevent claim denials in seconds. Learn more Contact us

Patient access continues to improve, with both providers and patients reporting steady progress, according to The State of Patient Access 2025. Building on the momentum of the 2024 State of Patient Access survey (when 55% of providers reported better access), 36% now say it has improved even further. Around six in ten patients agree that the experience is the same or better than a year ago. Now in its fifth year, Experian Health's latest annual survey shows how patient and provider perceptions of patient access have changed, and where there's still work to do. In February 2025, more than 200 healthcare revenue cycle decision-makers and over 1000 healthcare consumers were surveyed about their experiences over the previous year. The findings point to three key opportunities for organizations looking to improve the patient experience and boost revenue, which are discussed below. Download The State of Patient Access 2025 report for a full run-down of patient and provider views about access to care. What patients and providers think of patient access (and 3 immediate opportunities) The overall sentiment is encouraging, but there's always room for improvement. The report gives a detailed breakdown of the reasons why respondents think access has improved – or not – and how many respondents gave those reasons. These insights will help providers target their improvement efforts where they matter most. Opportunity 1: Focus on the financial experience 29% of patients say paying for healthcare is getting worse 56% of patients say they need help from their provider to understand what their insurance covers 50% of providers say access is better because patients have more flexible payment options Financial concerns continue to shape the patient experience. Affordability is a key factor in whether patients think paying for care is getting easier or tougher, but it's not the only one. Patients who feel that paying for healthcare has improved cite reasons like being able to understand what their insurance covers, having payment plans that make costs more manageable, and being able to complete paperwork digitally prior to care. Conversely, those with a negative view mention confusion over what they owe, difficulty making payments, excess paperwork and lack of payment plans among their top concerns. To address these challenges, providers can turn to tools that streamline the financial journey from the start. Automating patient financial clearance helps get patients on the right financial pathway as quickly as possible, while segmentation data enables smarter and more personalized collection strategies. Offering flexible payment plans and convenient digital payment options rounds out a financial experience that's easier, more transparent and aligned with patients' needs. Case study: See how UCHealth used automated financial clearance to identify $26 million in charity care. Opportunity 2: Prioritize accurate price estimates 81% of patients say an accurate estimate helps them better prepare to pay 43% of patients say that without an estimate, they're likely to postpone or cancel care 88% of providers say there's an urgency to improve or implement accurate estimates Sticking with the financial theme, the findings suggest that despite ongoing efforts, price transparency in particular still needs some work. While more patients received estimates, accuracy has fallen for a third year in a row. As a result, patients are left uncertain about what they'll owe, prompting some to avoid care altogether. On the flipside, 38% of patients say that understanding the cost of care in advance of treatment made for a better payment experience. With 77% of patients saying it's important that their provider can explain what their insurance covers before treatment, there's a clear opportunity to help patients feel more in control. Not only will this reduce patient stress, but it also builds trust and increases the chance of prompt payments. Almost all patients say they struggle to pay for care at some point, so improving the accuracy of estimates should be an immediate priority for providers. Timely, personalized estimates that reflect the true cost of care will give patients early clarity and avoid surprises later. Experian Health's patient estimates tools use real-time data, including insurance coverage, updated payer contract terms and current provider pricing, to calculate accurate estimates before services are delivered. Patients can receive estimates sent directly to their mobile device or generate estimates through a self-service web-based portal. Opportunity 3: Use automation to improve front-end data collection 56% of providers say patient information errors are a primary cause of denied claims 48% say data collected at registration is “somewhat” or “not” accurate 83% say there's an urgent need for faster, more comprehensive insurance verification Front-end operations are a major source of friction for both providers and patients. Four out of the five top patient access challenges reported by providers relate to front-end data collection, including improving insurance searches, reducing errors and speeding up authorizations. These inefficiencies don't just slow down internal workflows. Manual, error-prone processes lead to delays, claim denials and patient frustration. Providers note that staffing shortages are compounding the problem, which suggests that tackling these front-end workflows would be a strategic operational win. It's also a financial opportunity. In the CAQH's latest Index Report, shifting from manual to electronic transactions for administrative tasks such as eligibility checks, insurance verification and prior authorizations could save the healthcare industry up to $20 billion. Patient Access Curator uses automation and artificial intelligence (AI) to streamline patient access and billing, address claim denials and improve data quality from the outset. This integrated solution performs rapid eligibility, coordination of benefits (COB), Medicare Beneficiary Identifier (MBI), demographics and insurance discovery checks to ensure that all data is correct on the front end. Case study: See how Exact Sciences boosted their bottom line by $100 million with Patient Access Curator The State of Patient Access: From survey to strategy The overall takeaway in The State of Patient Access 2025 is that while progress is heading in the right direction, meaningful opportunities remain, especially when it comes to improving the patient financial experience, price transparency and front-end operations. Going forward, patients want financial clarity and confidence when accessing care. Providers, facing ongoing staffing and operational pressures, need smart and scalable solutions to meet those expectations. Now it's time to take those findings and deploy the right tools and strategies to keep the good work going. Download The State of Patient Access 2025 report to get the full survey results and contact us to see how we help healthcare organizations improve patient access with automation, AI and digital tools. Download the report Contact us

A positive patient experience can quickly sour when difficult financial conversations enter the picture. High out-of-pocket costs and confusing medical bills make payments a sensitive issue for many patients. For providers, the challenge is clear: how to improve patient collections while delivering compassionate care. This article considers proven strategies and best practices to simplify patient collections, maximize revenue, and keep the focus on patient-centered care. The importance of optimizing patient collections for healthcare providers For many patients, an unforeseen medical emergency can quickly become a financial one. According to a 2024 report by the Consumer Financial Protection Bureau, medical debt rose from an average of $2,000 per person to over $3,100 in a year, while 15 million Americans carry medical collections on their credit reports. Such financial strain erodes the patient experience, with one in five patients experiencing distress over healthcare costs they can't afford. Experian Health's State of Patient Access 2024 survey found that both patients and providers agree that understanding coverage helps patients manage their healthcare costs. Still, unpaid bills and aging accounts are a persistent concern for providers. Hospitals' operating margins may have rebounded, but remain extremely tight. Remaining alert to risks and opportunities in patient collections is essential for long-term financial health. As patients shoulder a greater share of their medical costs—and those costs continue to rise—efficient collections are critical for patient trust and financial resilience. Breaking down the patient collections process The patient collections process involves determining how much of the cost of care falls to the patient, and then billing and collecting the correct amounts. During registration, providers verify insurance coverage and eligibility to estimate what the insurer will cover. Accurate cost estimates can then be provided to patients upfront, giving them the option to make payments before or at the time of service. The bulk of billing and collections activities take place post-visit, sometimes involving third-party agencies. However, collections can be thwarted by several challenges. Staff must keep up with frequent changes in insurance policies to prevent errors in billing or cost calculations. Patients may worry about affordability, leading to late payments. Billing teams often lack information about patients' financial circumstances, making it hard to predict how likely they are to pay. On top of this, many patients expect more convenient payment options, such as online or mobile payment methods, and will express frustration if the process feels inconvenient. Proven strategies to collect more revenue, sooner Three ways to create a patient-friendly billing experience and ensure prompt payment include the following: 1. Reduce stress with clear pricing and flexible payment plans Patients want collections processes to be clearer and more transparent. The State of Patient Access survey found that more than four in ten patients say they would be more likely to cancel or postpone care without an accurate estimate. Six in ten say they'd be more confident in their ability to pay for care if they were offered a payment plan that took account of their financial situation. Automated patient estimates arm patients with accurate information about the expected cost of care in advance. They have more time to make their financial arrangements and are less likely to be surprised by a surprise bill. Providers can offer additional clarity and flexibility through tailored payment plans. Experian Health's Collections Optimization software uses advanced analytics and data to analyze individual patient accounts and determine their ability to pay. Patient Financial Clearance takes this a step further by helping providers run their presumptive charity process, which estimates a patients' Federal Poverty Level percentage (FPL%), to identify those who qualify for greater financial assistance. These solutions support more compassionate financial conversations, as staff can adjust their approach to suit each patient's financial situation. 2. Help patients find and understand coverage Relying on manual processes can slow down registration and miss potential payment sources. Since 2000, unidentified coverage opportunities have landed hospitals with more than $745 billion in uncompensated care. Given that patients are asking for help understanding coverage, it makes sense to build coverage discovery into the collections process. Experian Health's Coverage Discovery® automatically scans patient accounts throughout their care journey to uncover alternative payment methods and reduce financial strain. This has helped healthcare organizations like Luminis Health identify over $240k in active coverage per month, greatly reducing the financial risk for patients and providers. 3. Make payments easier to prevent delays Improving patient collections processes will be fruitless if patients can't easily make payments. Digital and mobile payment options are non-negotiable for today's digital-first consumers. Accepting payments at multiple collection points, including mobile devices, kiosks and patient portals, gives patients the convenience and choice they need to pay promptly. Best practices for patient collections management Aside from automation and digital tools, the strongest strategies for improving patient collections rest on one key ingredient: robust data. Collections software is only as good as the data behind it. With a tool like Collections Optimization Manager, providers can deploy advanced analytics to segment patient accounts so they can be handled appropriately. Using credit, behavior and demographic data, it applies a proprietary propensity-to-pay score to each account, so staff know which accounts to prioritize, write off or refer out. This approach has helped organizations like Novant Health and Cone Health bring in millions of dollars with personalized, patient-centric collections. On-demand webinar: Hear how Novant Health and Cone Health achieved 7:1 ROI and $14 million in patient collections with Collections Optimization Manager. Tracking patient collections success By monitoring key performance indicators like collection rates, accounts receivable days and patient feedback, providers can continue to fine-tune their processes. Collections Optimization Manager captures this data in user-friendly dashboards and reports, so staff can assess their performance against their own history and industry trends. Users also benefit from expert support from Experian Health consultants, who help teams evaluate reports and recommend the right collections strategies every step of the way. How to build a patient collection strategy that gets results For millions of Americans, medical debt isn't just a financial burden: it's a barrier to care. To overcome this challenge, providers need proactive collections strategies that prioritize patient well-being and financial stability. By incorporating automation, analytics, and digital tools, healthcare organizations can create patient collections processes that are clear, compassionate and effective, delivering better outcomes for both patients and providers. Find out more about how Experian Health's suite of healthcare collections products helps providers boost collections, cash flow and patient satisfaction. Learn more Contact us

As margins tighten, traditional revenue cycle management strategies are on shaky ground. Many healthcare providers are turning to automation and AI to simplify payments, prevent revenue loss and protect profits. This article breaks down some of the most common revenue cycle management (RCM) challenges facing healthcare leaders and offers a practical checklist to optimize patient access, collections and claims management, while building a resilient and patient-centered revenue cycle. Common challenges in revenue cycle management Revenue cycle management is how healthcare organizations handle the financial side of patient care, from patient billing to claims management. Healthcare providers rely on RCM to ensure they are properly paid, so they can keep the lights on, pay their staff and deliver quality patient care. Are traditional RCM strategies still fit for purpose? Consider some of the current challenges: Patients are responsible for a larger share of costs due to high-deductible health plans. How can providers help them understand their financial obligations and make it easier to pay without hurting their experience? Minimizing claim denials is a daily focus, thanks to constantly changing policies and regulatory updates. How do revenue cycle teams keep up with payers? Staffing shortages remain on the agenda. How can providers ease pressure on staff to maintain productivity and morale? There's also the question of how to turn mountains of data into actionable insights. How do teams interpret it correctly to identify bottlenecks and opportunities for improvement? Automation and AI offer a way through. When implemented thoughtfully, these tools can speed up processes, reduce errors and clear operational roadblocks for a more resilient revenue cycle. The following revenue cycle management checklist includes some of the key questions to consider along the way. Checklist for improving revenue cycle management Automating patient access Can patients book appointments online? Does the online scheduler automate business rules to guide patients to the right provider? Are patient identities verified at registration and point of service? A healthy revenue cycle starts with efficient patient access. According to the State of Patient Access 2024, 60% of patients want more digital options for scheduling appointments, managing bills and communicating with providers. Providers who see improvements in patient access also credit automation, which speeds up intake and improves accuracy. A good first step is to replace paper-based processes with online self-scheduling and self-service registration. These tools make life easier for patients, boosting satisfaction, retention and engagement. Behind the scenes, Experian Health's new AI-powered tool, Patient Access Curator, helps providers get paid faster by verifying and updating patient information with a single click – accelerating registration and paving the way for faster reimbursement. Register now: Exact Sciences and Trinity Health will share how Patient Access Curator is redefining patient access in this upcoming webinar. Optimize patient collections with data and analytics Are patient estimates provided upfront? Are notice of care requirements being addressed? Are patients offered appropriate financial plans and easy ways to pay? With more financial responsibility resting on patients' shoulders, patient collections are under the spotlight. The State of Patient Access report shows that upfront estimates and clarity about coverage are top priorities for patients, because when they know what they owe, they're more likely to pay on time. Implementing tools to promote price transparency and easy payment methods should feature in any RCM checklist. With Coverage Discovery, healthcare organizations can run checks across the entire revenue cycle to find billable commercial and government coverage that may have been forgotten, to maximize the chance of reimbursement. Meanwhile, Patient Payment Estimates offers patients clear, accessible estimates of their financial responsibility before treatment, so that hose who need financial assistance can be directed automatically to payment plans and charity options. Case study: How UCHealth secured $62M+ in insurance payments with Coverage Discovery® Improve claims management to reduce denials Are high-impact accounts prioritized? Are remittances reconciled with payments received? Does claims management software generate real-time insights and reports? With 73% of healthcare leaders agreeing that denial increased in 2024, and 67% saying it takes longer to get reimbursed, claims management is a great use case for automation. ClaimSource®, ranked Best in KLAS in 2024 for claims management, automates the entire claims cycle in a single application. It integrates national and local payer edits with custom provider edits to verify that each claim is properly coded before submission. By focusing on high-priority accounts, providers can target resources in the most effective way to ensure a higher first-pass payment rate. A major advantage for ClaimSource users is access to AI Advantage™. This tool utilizes AI to “learn” from an organization's historical claims data and trends in payer behavior to predict the probability of denial. It also segments denials so staff can prioritize those that are most likely to be reimbursed, reducing the time and cost of manual appeals and rework. Case study: After using AI Advantage for just six months, Schneck Medical Center reduced denials by an average of 4.6% each month, and cut rework time from 12 to 15 minutes per correction to under 5 minutes. Benefits of implementing a revenue cycle management checklist The key to choosing the right RCM tools and technologies is to build the strategy around what patients need most. A clear, transparent and compassionate billing experience is more manageable for patients and helps providers get paid faster. An RCM checklist helps teams stay focused on the tasks that matter. Providers can build on the suggestions above by choosing the key performance indicators (KPIs) that align with their specific goals. Metrics like financial performance, billing efficiency and collections rates can be combined to guide resource allocation, drive improvements and speed up reimbursement. With a well-designed checklist informed by clear KPIs, revenue cycle leaders can keep their teams on track and take their organizations from “surviving” to “thriving.” Learn more about how Experian Health's revenue cycle management tools can help healthcare providers meet current challenges, improve the patient experience and increase cash flow. Learn more Contact us

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