Product overview
Healthcare is complex. Experian® data, combined with our technology solutions, can make it simpler.
More than 60% of all U.S. hospitals — along with thousands of medical practices, labs, pharmacies and other healthcare providers — partner with Experian Health because they see efficiency gains in their operations, more dollars collected and an enhanced patient experience.
Revenue Cycle Management
Patient Access
Reduce financial risk, increase revenue and streamline staff workflow with real-time insurance eligibility verification.
Find previously unidentified coverage at any point in the revenue cycle continuum to reduce bad debt write-offs.
Automate and integrate required notices of admission, observation and discharge to avoid delayed and decreased reimbursement.
Automate 100% of prior authorization inquiries — and eliminate uncertainty.
Validate against commercial payers’ medical policies and Medicare National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and Correct Coding Initiative (CCI) edits.
Provide patients price estimates for authorized services before or at point-of-service.
Assess and assign patients to the appropriate financial pathway based on likelihood to pay and their qualification for assistance — to boost collections and satisfaction.
Automatically launch insurance eligibility in real time, store the information and identify registration inaccuracies at the earliest point in the revenue cycle, avoiding costly denials and rework.
Contract Management
Audit payer contract performance to assure compliance and maximize revenue.
Claims Management
Manage claims, remits, denials — and prioritize high-impact accounts — for better efficiency and more revenue.
Efficiently manage denials — and analyze remittance detail — to maximize payer reimbursement.
Improve cash flow by monitoring claims status early in the adjudication process.
Real-time intelligence and predictive modeling to prevent avoidable denials and prioritize resubmissions.
- Predictive Denials leverages client claims data to proactively identify claims with high likelihood of denial — before claim submission — so that teams can take corrective action.
- Denial Triage identifies and segments denials by potential value so that teams can focus on remits that have the most impact to their bottom line.
Eliminate undercharges and reduce denials by consistently submitting cleaner claims.
Collections
Accelerate your collections strategy with in-depth data and analytics available through Collections Optimization Manager.
Increase collections with our cloud-based dialing platform that offers both inbound and outbound communication options.
Engage patients with timely text messages to increase engagement and collections.
Reduce accounts receivable days through automatic correction of known bad addresses returned as undeliverable by the U.S. Postal Service®.
Validate patient address, Social Security number, date of birth and more to reduce denials, expedite reimbursement and decrease returned mail.
Patient Engagement
A digital coordination platform to help patients access and schedule care.
- Self Scheduling provides easy access for consumers to make online appointments in real-time, find the right providers and meet your scheduling rules all at the same time with our sophisticated decision support technology.
- Call Center Scheduling improves the patient experience by enabling staff to schedule accurate appointments faster via the phone, or onsite using our guided response technology. Staff can easily find the right providers and times based on your business rules and create appointments on behalf of the patient.
- Outreach helps close care gaps with automated messaging prompting that guides patients in scheduling their next appointment online, reducing your call center volumes.
Simplify your patient intake process with this text-tomobile experience that improves data accuracy, reduces administrative costs and facilitates collection of copays.
Deliver to your patient a pre-service, estimated financial responsibility based on real-time benefit information and a personalized payment experience via their mobile devices.
Protect healthcare identities during enrollment and at each login using multilayer portal security with identity and device intelligence.
Create the best financial engagement experience for your patients with this portal where patients can receive price estimates, pay bills on multiple accounts and view personalized payment options.
Simplify and customize patient billing statements and include important updates and messages.
Provide your staff with a secure method of accepting payments via phone or at the point of service.
Grow your patient base with consumer data approved for digital and traditional marketing outreach.